When delivered through routine health care in the United Kingdom, diabetes education led to long-term glycemic control and improved quality of life in adults with type 1 diabetes.
Researchers from the UK National Institute for Health Research Dose Adjustment for Normal Eating (NIHR DAFNE) study group examined 262 patients with type 1 diabetes before and after evaluation of the DAFNE program.
DAFNE consisted of a 5-day course with a follow-up booster session at 6 weeks. The diabetes educators promoted carbohydrate counting, dose adjustments and other management techniques.
HbA1c data were collected from routine records up to 8 weeks before and 6 and 12 months after the course of the program, the researchers wrote. Before enrollment, patients (average age, 40 years) completed the Diabetes-Specific Quality of Life Scale (DSQOLS) and again at 3, 6 and 12 months after the course. The researchers said there were no differences between men and women in the study.
According to data, the mean baseline HbA1c was 8.5% and one-quarter of patients (n=65) had an HbA1c <7.5%. Patients with an HbA1c of <7.5% were ultimately excluded from an analysis of patients with suboptimal control; further improvements would have increased the risk for severe hypoglycemia.
Upon further analysis, significant improvements were noted among HbA1c levels in patients from baseline to 6 months (P<.001), continuing through 12 months (P<.001), researchers wrote.
“Each DSQOLS subscale and total score showed significant improvements by 3 months, all of which were maintained at 6 and 12 months in the total sample,” researchers said.
Based on these findings, they said it is possible to achieve sustainable improvements in HbA1c and QOL among adults with type 1 diabetes through routine diabetes education programs.
- By using a structured group education format for type 1 diabetes patients, researchers found positive outcomes. The format was to provide intensive insulin therapy with flexible food choices. By teaching freedom in choosing foods without restrictions and flexible dosing, overall quality of life (QOL) will be improved. The goal was to decrease HbA1c and increase QOL. As this program is included as part of the routine diabetes care provided, it should decrease medical costs by doing group education and support. Having this education separate from the individual clinic appointments gave additional attention to their diabetes and other concerns. The HbA1c in this study decreased in relation to improved QOL.
The paradigm for diabetes care in type 1 diabetes patients has long been individual visits and care. The group setting was used more in the type 2 diabetes population. In the clinical setting, this will impact education, in teaching to a group rather than individually a support focus will be created. The format and intense education worked well in their population, which was mainly well educated and motivated. Time will tell how it works in the less educated and motivated population.
This research and following programs bear close watching to evaluate further successes or concerns. Myself, I am excited about the implications for this innovative format.
- Carol Rasmussen, MSN, APRN, CDE, FAADE
- Family medicine nurse practitioner at the Exodus Healthcare Network in Magna, Utah
- Source: Endocrine Today