Structured type 1 diabetes education delivered in routine care in Australia reduces diabetes-related emergencies and severe diabetes-related distress: the OzDAFNE program

Speight, Jane, Holmes-Truscott, Elizabeth, Harvey, Dianne M., Hendrieckx, Christel, Hagger, Virginia L., Harris, Susan E., Knight, Brigid A. and McIntyre, Harold D. 2016, Structured type 1 diabetes education delivered in routine care in Australia reduces diabetes-related emergencies and severe diabetes-related distress: the OzDAFNE program, Diabetes research and clinical practice, vol. 112, pp. 65-72, doi: 10.1016/j.diabres.2015.11.002.

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Title Structured type 1 diabetes education delivered in routine care in Australia reduces diabetes-related emergencies and severe diabetes-related distress: the OzDAFNE program
Author(s) Speight, JaneORCID iD for Speight, Jane orcid.org/0000-0002-1204-6896
Holmes-Truscott, ElizabethORCID iD for Holmes-Truscott, Elizabeth orcid.org/0000-0001-9139-4663
Harvey, Dianne M.
Hendrieckx, ChristelORCID iD for Hendrieckx, Christel orcid.org/0000-0002-0075-828X
Hagger, Virginia L.ORCID iD for Hagger, Virginia L. orcid.org/0000-0003-3845-2814
Harris, Susan E.
Knight, Brigid A.
McIntyre, Harold D.
Journal name Diabetes research and clinical practice
Volume number 112
Start page 65
End page 72
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-02
ISSN 1872-8227
Keyword(s) Diabetes distress
Hypoglycaemia
Structured diabetes education
Type 1 diabetes
Summary AIMS: To evaluate structured type 1 diabetes education delivered in routine practice throughout Australia.

METHODS: Participants attended a five-day training program in insulin dose adjustment and carbohydrate counting between April 2007 and February 2012. Using an uncontrolled before-and-after study design, we investigated: HbA1c (% and mmol/mol); severe hypoglycaemia; diabetes ketoacidosis (DKA) requiring hospitalisation, and diabetes-related distress (Problem Areas in Diabetes scale; PAID), weight (kg); body mass index. Data were collected pre-training and 6-18 months post-training. Change in outcome scores were examined overall as well as between groups stratified by baseline HbA1c quartiles. Data are mean±SD or % (n).

RESULTS: 506 participants had data eligible for analysis. From baseline to follow-up, significant reductions were observed in the proportion of participants reporting at least one severe hypoglycaemic event (24.7% (n=123) vs 12.1% (n=59), p<0.001); and severe diabetes-related distress (29.3% (n=145) vs 12.6% (n=60), p<0.001). DKA requiring hospitalisation in the past year reduced from 4.1% (n=20) to 1.2% (n=6). For those with above target baseline HbA1c there was a small, statistically significant improvement (n=418, 8.4±1.1% (69±12mmol/mol) to 8.2±1.1% (66±12mmol/mol). HbA1c improvement was clinically significant among those in the highest baseline quartile (n=122, 9.7±1.1% (82±11mmol/mol) to 9.0±1.2% (75±13mmol/mol), p<0.001).

CONCLUSIONS: The proportion of participants reporting severe hypoglycaemia, DKA and severe diabetes-related distress was at least halved, and HbA1c reduced by 0.7% (7mmol/mol) among those with highest baseline levels. Structured type 1 diabetes education delivered in routine practice offers clinically important benefits for those with greatest clinical need.
Language eng
DOI 10.1016/j.diabres.2015.11.002
Field of Research 1103 Clinical Sciences
110306 Endocrinology
Socio Economic Objective 920401 Behaviour and Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080655

Document type: Journal Article
Collection: School of Psychology
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