1. Leicestershire Nutrition & Dietetic Service FABB Flexible Adjustment of Basal Bolus

2. Leicestershire Nutrition & Dietetic Service What is FABB? Structured group education sessions in line with Department of Health and Diabetes UK guidance. Sessions provide the information to enable participants to dose adjust insulin as part of a basal bolus regimen. Session plans are used to guide sessions, with an emphasis on experiential learning and goal setting.

3. Leicestershire Nutrition & Dietetic Service Why should we use FABB? Withdrawal of some mixed insulins Patient choice Information and education being given previously in a time consuming way (individually advised) Other group education pilots had limited success at the time of FABB establishment. Potentially a reduction in admissions

4. Leicestershire Nutrition & Dietetic Service Current case load Total around 320 children and young people –~ 10 using CSII (insulin pumps) –~ 65 on MDI (taught pre-FABB) –85 have attended FABB courses –8 booked on to future FABB courses

5. Leicestershire Nutrition & Dietetic Service FABB groups Each group is age banded 6 young people are invited, each with a parent/carer A Specialist Children’s Diabetes Nurse and Specialist Children’s Diabetes Dietitian lead the sessions Two 2-3 hour long sessions are arranged 1 week apart 17 courses took place in 2007 Includes Extra FABB and Little FABB Courses arranged on an ad hoc basis from 2008

6. Leicestershire Nutrition & Dietetic Service FABB timetable Session 1Session 2 What is diabetes? Insulins Hypoglycaemia Hyperglycaemia Carbohydrate counting Goal setting Illness Exercise and activity Travel More carbohydrate counting! Alcohol if appropriate Goal setting & evaluation

7. Leicestershire Nutrition & Dietetic Service FABB outcomes Currently: HbA1c Height, weight and BMI Goal setting and achievement of aims Future developments in addition: Other medical markers (lipids, blood pressure…) Quality of Life indicators

8. Leicestershire Nutrition & Dietetic Service Evaluations “The FABB team have been very supportive, understanding and very patient in explaining everything so I feel more confident”

9. Leicestershire Nutrition & Dietetic Service Evaluations “Course superb. I thought it would be quite confusing but you put it over really well”

10. Leicestershire Nutrition & Dietetic Service Evaluations “My son’s blood sugars have never been so good!”

11. Leicestershire Nutrition & Dietetic Service Evaluations “It’s really helped me with my injections and self esteem”

12. Leicestershire Nutrition & Dietetic Service Evaluations “The FABB lifestyle is so flexible”

13. Leicestershire Nutrition & Dietetic Service FABB future Development of sessions, determined by need and feedback. Regular follow up sessions for FABB graduates (e.g. carbohydrate counting for eating out, school meals, parties etc., alcohol…) FABB on pumps Support for pre FABB MDI users

14. Leicestershire Nutrition & Dietetic Service Any FABB questions? For more FABB information, please contact Emma.Marcus@uhl-tr.nhs.uk