Type 1 diabetes from adolescence to adulthood: is there a permanent need for nutrition education and re-education?

Abstract

The transition for type 1 diabetes patients from pediatric to adult diabetology care is challenging process for both medical team and patients. Adult diabetology usually insists on stricter goals and focuses on increased empowerment and self-care. We set to find a more practical and effective way to determine patient knowledge and skills during the transition. The aim of the study was to identify screening questions which best represent knowledge in management of type 1 diabetes and to explore the differences in the effect of a structured educational program for type 1 diabetes patient diagnosed in childhood versus adulthood. It was an observational study exploring effect of a structured educational program for 39 participants diagnosed with type 1 diabetes in childhood (group 1) vs. 20 patients diagnosed in adulthood (group 2). Main outcome measures were A1C and knowledge questionnaire results change before and after education. The effect of education was equal in both groups, with higher basal level of knowledge in group 1. There was a significant correlation between questions regarding carbohydrate counting and A1C after 3 and 6-12 months in group 1. We found that questions regarding carbohydrate counting may predict glycemic control and represent general knowledge. Carbohydrate counting is crucial in predicting glycemic control and representing general knowledge about diabetes. Patients diagnosed in childhood may be more knowledgeable in diabetes management, but their practical skill in matching insulin dose and carbohydrate content is poor. Both groups improved their knowledge in similar proportion with same educational program.