1046-OR: Diabetes Self-Management Education (DSME) and Hospital Admission Rates in Adults with Type 2 Diabetes in England: An Epidemiological Analysis

Published Date: 05th June 2026

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

Introduction and Objective
Type 2 diabetes increases all-cause hospitalization. A 2025 scoping review reported a non-significant 9% reduction in hospitalization with DSME (pooled RR 0.91, 95% CI 0.76-1.10, p<0.34)(1). We examined DSME impact on hospital admission 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 Hospital Episode Statistics(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 admission rates in those who 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 of 7.9%, there were 2,087,097 admissions in ever and 9,885,238 in never had DSME. All-cause admissions were lower in DSME (5015.98 vs. 6071.99 admissions per 1,000 person-years, RR 0.83, adjusted IRR 0.88 95% CI 0.87-0.89, p<0.001). After covariate adjustment, DSME was associated with fewer admissions for diabetes, kidney infections, liver disease, renal disease, respiratory disease, other cancers, and stroke.

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