Utilization of diabetes education centres in Ontario by individuals without diabetes

Objective — To describe the utilization of diabetes education centres by people not diagnosed with diabetes in real-world clinical care in Ontario.

Methods — Using population-level health administrative databases and registries, all people in Ontario, Canada, who attended a diabetes self-management education centre in 2006 were identified. The proportion of attendees without diagnosed diabetes at the time of their visit was determined, stratified by centre and health region, and their utilization of diabetes education centres was characterized. They were then followed until 2010 for incident diabetes.

Results — Out of 117,660 adults attending a diabetes education centre, 19,920 (16.9%) did not have diagnosed diabetes. There was a marked variation in the proportion of attendees without diagnosed diabetes between health regions and between individual centres. More attendees did not have diagnosed diabetes at centres based in Community Health Centres (47.5%) or First Nations communities (22.1%) than those based in hospitals (13.9%) or other community settings (13.0%). Only 2,741 (13.8%) attendees without diabetes attended group education classes; most attended individual counseling sessions. Diabetes incidence during follow-up was 11.2 cases per 100 person–years.

Conclusions — One in six people receiving care at a diabetes education centre in Ontario did not have diabetes, and the significant regional variations could represent inappropriate over- or underutilization. Although education and counseling for patients at risk for diabetes is clinically important, the volume of such individuals served at Ontario diabetes education centres may detract from the centres’ core function of supporting and managing patients already diagnosed with diabetes.