Implementation of an effective outpatient intensive education programme for patients with type 1 diabetes

Education for our local clinic population with type 1 diabetes was unsatisfactory with an HbA_1c audit revealing suboptimal diabetes control. Clinical practice was changed to offer structured, group education to newly diagnosed and established patients with type 1 diabetes. Since 1999, 58 patients, 28 male, mean age 32 (range 18–65) years, mean duration of diabetes 2 (range 0.6–34) years have completed the programme.

HbA_1c (mean±SE) fell from 8.9±0.2% to 8.4±0.2% (p<0.001) at three months, was maintained at six months, 8.6%±0.3 at 12 months and 8.3%±0.5 at 24 months. These results were dependent upon the duration of diabetes and the HbA_1c level at entry. Mean diabetes management skills, as measured by the Ipswich Questionnaire, rose from 135 (95% CI 126–138) to 151 (95% CI 147–155) at three months (p<0.0001, paired t test) and this was maintained to 12 months. Food knowledge improved in terms of recognising and counting carbohydrates.

In conclusion, we have demonstrated that an intensive education programme for type 1 diabetes can be implemented, audited and resourced within a clinic population. Copyright © 2003 John Wiley & Sons, Ltd.