1. Structured Education for people with Type 1 Diabetes in Forth Valley: 3 year follow up data
Kathryn Fraser, Ann Bramley, Helen Millar, Alison Mackenzie, Chris Kelly
NHS Forth Valley
Background and Aim
Methods
New Diabetes Education on Adjustments for Living (New DEAL), a structured education package, was established in Forth Valley in June It runs over 4 weeks (1 day per week) and covers the core skills of carbohydrate counting along with education on other key skills required for the self-management of Type 1 Diabetes.
Since 2008 demographic data (weight, gender, ethnicity and duration of diabetes) and glucose control (HbA1c) have been recorded and from June 2009 we added frequency of hypoglycaemia/DKA along with psychological measures (PAID Problem Areas in Diabetes).
Results 1
Results 2
There were 131 participants with 6-month follow-up data on Data is shown as mean±SD.
Hba1c improved from 8.8±0.9 at baseline to 8.6±0.9 at 6 months (p=0.2), and 8.1±1.0 at 36 months (p<0.01).
PAID (n=88) dropped significantly at 6 months from 23±15 to 13±10 (p=0.001).
There are almost no data on metabolic emergencies.
We split the data into two groups dependant on entry HbA1c: Group 1 <8.5% (n=57) Group 2 ≥8.5% (n=69).
Glycaemic control in group 1 remained stable 7.8%±0.8 at entry 7.8±1 at 3 years. Hba1c significantly improved at all time points in Group 2; 9.8±0.9 at baseline 9.2±1.0 at 6 months (p=0.02) and 8.8±1.2 at 3 years (p=0.002).
Entry PAID score was greater in group 1 31 v 23 (p=0.05).
Conclusions
There has been a sustainable improvement in glycaemic control as measured by HbA1c over the 3 year period. Additionally there has been a significant improvement in PAID.
Comparing groups split by entry HbA1c there has been a significant and sustained improvement in HbA1c in the group with higher entry HbA1c at all time points. Diabetes related stress as measured by PAID was higher in the group with lower HbA1c but the difference failed to reach statistical significance.