It is well recognised that people with diabetes, both young ones with type 1 disease and adults with type 2 diabetes, need to develop skills in self management to manage their condition successfully. In the past few decades different strategies aimed at promoting self management have been developed and tested across a wide range of patient groups and settings. Two linked papers (doi:10.1136/bmj.e2333; doi:10.1136/bmj.e2359), which examine two different approaches delivered in routine practice, improve our understanding of the longitudinal dose-response relation between educational and consultation interventions and improvements in the self management behaviours and subsequent health outcomes of patients with diabetes.1 2

A systematic review found that group based programmes for self management strategies in type 2 diabetes were effective in terms of improving blood glucose, blood pressure, body weight, and requirement for antidiabetes drugs.3 The Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) programme was developed in the United Kingdom and tested in 824 patients who had been newly diagnosed with type 2 diabetes in a clustered randomised trial in primary care. At one year follow-up, the programme was shown to …