Endocrine Abstracts

Introduction: Good patient education is the key to successful self-management of diabetes. In October 2013, we introduced a revised and extended ‘Newly Diagnosed Patient Education Programme’ involving 20 structured education sessions delivered by the multidisciplinary team.

Aim: To assess the effect of the new patient education programme on HbA1c at the end of two years and compare this to a control group undergoing the old education programme.

Methods: All patients diagnosed with type 1 diabetes between October 2013 and October 2014 undergoing the new education programme were included. The control group included the pre-intervention group diagnosed between January-December 2010. Data on HbA1c, patient demographics and psychosocial factors were collected.

Results: Twenty four patients (8 males) were included in the study group and 17 (6 males) in the pre-intervention group. The median HbA1c at baseline was significantly different in the two groups (Study=111 mmol/mol vs control=88 mmol/mol, P=0.02). HbA1c improved significantly at 3 months in both groups (study=53 mmol/mol and control=46 mmol/mol). HbA1c at 2 years were similar in the two groups (study=70 mmol/mol vs control=74 mmol/mol, P=0.59). Psychosocial factors varied greatly between groups, with the study group having higher numbers of social risk factors (CAF 2 vs. 0, split families 9 vs. 3, domestic violence 3 vs. 0, ongoing psychology support 8 vs. 2, clinical depression 2 vs. 0).

Discussion: Despite the barriers of increased prevalence of psychosocial factors in the study group the median HbA1c in the two groups were similar at 2 years. There is a downward trend in the median HbA1c of the unit (69 mmol/mol in 2009/10 to 64 mmol/mol in 2015) and upward trend in percentage achieving HbA1c <58 mmol/mol (20% in 2009/10 to 32.7% in 2015), although not reflected in the chosen cohort.

Outcome: We are critically reviewing the education sessions to restructure the order to maximise benefits in early weeks. We are considering additional education session at the end of honeymoon period at 9–12 months before the predicted rise in HbA1c.