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. (2015) 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, 112 65-72. doi:10.1016/j.diabres.2015.11.002

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Author Speight, Jane
Holmes-Truscott, Elizabeth
Harvey, Dianne M.
Hendrieckx, Christel
Hagger, Virginia L.
Harris, Susan E.
Knight, Brigid A.
McIntyre, Harold D.
Title Structured type 1 diabetes education delivered in routine care in Australia reduces diabetes-related emergencies and severe diabetes-related distress: The OzDAFNE program
Journal name Diabetes Research and Clinical Practice   Check publisher's open access policy
ISSN 1872-8227
0168-8227
Publication date 2015-11-23
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.diabres.2015.11.002
Open Access Status File (Author Post-print)
Volume 112
Start page 65
End page 72
Total pages 8
Place of publication Shannon, Clare Ireland
Publisher Elsevier
Language eng
Formatted abstract
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 ± 12 mmol/mol) to 8.2 ± 1.1% (66 ± 12 mmol/mol). HbA1c improvement was clinically significant among those in the highest baseline quartile (n = 122, 9.7 ± 1.1% (82 ± 11 mmol/mol) to 9.0 ± 1.2% (75 ± 13 mmol/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% (7 mmol/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.
Keyword Type 1 diabetes
Structured diabetes education
Diabetes distress
Hypoglycaemia
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Official 2016 Collection
School of Medicine Publications
 
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