Summary Background and aims: We showed that continuing education can be embedded into routine diabetes care by seeing patients in small groups rather than individually. Group care was cost-effective in improving quality of life, knowledge of diabetes, health behaviours and clinical outcomes in people with type 2 diabetes. The aim of this study was to verify if group care can also be applied to type 1 diabetes. Methods and results: Randomized, controlled clinical trial comparing 31 patients managed by group care with 31 managed by traditional one-to-one care. A syllabus was built and later remodulated with the patients in a series of focus-group meetings. The primary end-point was changes in quality of life. Secondary endpoints were: knowledge of diabetes, health behaviours, HbA1c and circulating lipids. Differential costs to the Italian National Health System and to the patients were also calculated.After 3 years, quality of life improved among patients on group care, along with knowledge and health behaviours (p ! 0.001, all). Knowledge added its effects to those of group care by independently influencing behaviours (p Z 0.004) while quality of life changed independently of either (p ! 0.001). Among controls, quality of life worsened (p ! 0.001) whereas knowledge and behaviours remained unchanged. HDL cholesterol increased among patients on group care (p Z 0.027) and total cholesterol decreased in the controls (p ! 0.05). HbA1c

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