249 Diabetes in cystic fibrosis – education (DICE) – the impact of a structured education programme for the management of cystic fibrosis related diabetes (CFRD) on quality of life

Abstract

No structured educational programmes for patients with CFRD exist in the UK. We developed the diabetes in cystic fibrosis-education (DICE) programme by adapting DAFNE (dose adjustment for normal eating), a structured education programme for type 1 diabetics. Patients receive 1:1 education focused on carbohydrate counting and insulin dose adjustment. Aim To determine whether the introduction of DICE improves quality of life (QoL) of patients with CFRD. Methods DICE was delivered by two DAFNE trained educators. Each participant received four, three hour education sessions with the same educator over eight weeks. Outcomes were measured at 0, 6 and 12 months; this paper presents data on the Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire and CFQ-R. Results 18 participants were recruited, 15 completed the study. No significant changes in the CFQ-R domain scores were observed. Conclusions Although some positive changes were noted in QoL these were not significant. The small sample size and greater dietary freedom in the management of patients with CFRD may explain this. ADDQolMean (SD)Baseline6 months12 monthsWeighted impact of diabetes on freedom to eat as I wish a −3.5 (3.8)−2.7 (2.9) p=0.48−2.5 (2.1) p=0.29 enjoyment of food a −2.3 (2.4)−1.5 (1.8) p=0.22−1.3 (1.8) p=0.10 freedom to drink as I wish a −3.3 (2.9)−2.1 (2.2) p=0.13−1.7 (1.9) p=0.02Average weighted impact of diabetes on QoL a −1.1 (0.9)−0.9 (0.8) p=0.23−0.9 (0.9) p=0.48Present QoL b 1.3 (1.2)1.4 (1.0) p=0.711.0 (1.4) p=0.14a–9 (max negative impact) to +9 (max positive impact).b–3 (extremely bad) to +3 (excellent).