1512-P: Diabetes Self-Management Education (DSME) and Cause-Specific Mortality Rates in Adults with Type 2 Diabetes in England: An Epidemiological Analysis

Published Date: 05th June 2026

Publication Authors: Lewis. GA, Hughes. D, Wilding. J, Irving. GJ, Hardy. K

Introduction and Objective
Mortality is increased in type 2 diabetes, but a 2025 scoping review reported a 45% mortality risk reduction (pooled RR 0.55, 95% CI 0.47-0.63, p < 0.0001) after DSME(1). We examined DSME impact on cause specific mortality rates in type 2 diabetes in England.

Methods
In a retrospective epidemiological analysis, primary care records of 364,703 adults with type 2 diabetes were linked to UK Office for National Statistics mortality data(2) in patients matched at baseline for age, sex, age at diagnosis and diabetes duration. We used Poisson and negative binomial regression to estimate all-cause and cause-specific mortality rates in those that had ever (n=75,343) or never (n=289,360) had DSME, adjusting for covariates.

Results
In patients, mean age 70 years, diabetes duration 6 years and HbA1c 7.9%, there were 11,230 deaths in those who had ever and 73,010 in those who had never attended DSME. All-cause mortality was lower in DSME attendees (26.99 vs. 44.85 deaths per 1,000 person-years, rate ratio [RR] 0.60), incidence rate ratio 37% (0.63, 0.61-0.64, p<0.001), including renal disease (0.42), diabetes (0.47), sepsis (0.45), dementia (0.49), liver disease (0.49), respiratory disease (0.51), and stroke (0.51).

Conclusions
DSME attendance was associated with lower all-cause and cause-specific mortality in adults with type 2 diabetes, underscoring the importance of DSME, although causality cannot be inferred.

Lewis, GA; Hughes, D; Irving, G; Wilding, J; Hardy, KJ. (2026). 1512-P: Diabetes Self-Management Education (DSME) and Cause-Specific Mortality Rates in Adults with Type 2 Diabetes in England: An Epidemiological Analysis. Diabetes. 75(Suppl 1). [Online]. Available at: https://dx.doi.org/10.2337/db26-1512-P [Accessed 7 August 2026].