The Scottish Intercollegiate Guidelines Network (SIGN) Clinical Guidelines for the Management of Diabetes (2010) state ‘structured diabetes education based on adult learning (including empowerment and experiential learning) is associated with psychological wellbeing, reduced anxiety and overall improvement in quality of life for people with type 1 and type 2 diabetes. The effect of structured education on glycaemic control in people with type 1 diabetes varies across different programmes’ (p 10). Furthermore, they state ‘Structured education based on developing problem-solving skills targeted at children and adolescents has a positive effect on a number of behavioural outcomes (including frequency of self-monitoring of blood glucose, better compliance with sick day rules, increased levels of exercise, dietary intake and improved medication adherence) and overall quality of life. There is limited evidence for a small reduction in HbA1c (approximately 3 mmol/mol)’ (p 11). www.sign.ac.uk/pdf/sign116.pdf.