Structured Education Program Research Articles

Abstract #1325426: The Effect of Low-Carbohydrate Diet on Glycemic Control and Body Weight in People with Type 1 Diabetes

The role of low-carbohydrate diets (LCDs) on glycemic control in T1DM has not been extensively studied. The objective of the present study is to investigate the efficacy and safety of LCD on glycemia and weight management in DAFNE graduates where they are taught in a structured education program over 25 hours to adjust their insulin dose according to their carbohydrate intake.

Abstract #1324711: Implementing a Structured Educational Program for Adolescents With Type 1 Diabetes in Arabic Culture: Are we Ready?

The increasing rates of newly diagnosed cases with type 1 diabetes among the youths (<20 years of age) with the suggestive evidence of poor glycemic control in teens with type 1 diabetes and the high rates of no show to clinic appointments have strived us to initiate the WICKED program, adapted from the UK. Improving transitional care for young people has the potential to improve health for many years to come. Currently there is a lack of any group strucuted education program in the MENA region.

RF16 | PSUN204 Improving Inpatient Insulin Management amongst Internal Medicine Residents with a Multi-Media Structured Educational Program

Abstract Introduction Approximately 1 in 4 patients admitted to the hospital carry a diagnosis of diabetes mellitus1 and 1 in 10 patients are admitted due to diabetes complications.2 Although Internal Medicine residents comprise the primary care team for the vast majority of patients admitted to major academic hospitals, there is a paucity of resources and standardized training for inpatient diabetes management, specifically designed for residents. Methods We developed a structured resident education program consisting of a mobile/web application ("EndoApp") as an accessible resource combined with a series of short lectures. The EndoApp is comprised of checklists, guidelines, and calculators based on the most recent American Diabetes Association (ADA) and American Association of Family Physicians (AAFP) recommendations. The application addresses five major areas of inpatient insulin management—i) insulin pharmacokinetics, ii) admission dosage calculation, iii) inpatient insulin regimen adjustment, iv) management of diabetic emergencies, and v) equipment and prescription management at discharge. The confidence level of residents for each of the five areas were surveyed at months 0, 1, and 3, after the start of the program on a scale of 1-5. Results Our 3-month interim analysis showed that the confidence of residents in all five areas of inpatient insulin management improved over the study period. Increased confidence was seen in post-graduate year (PGY) 1, 2, and 3 residents. The Admission Insulin Dosing Calculator was the most frequently used function (45% of residents), followed by DKA/HHS helper (23% of residents), and Inpatient Dosage Adjustment Guidelines (21% of residents). Residents who used the Admission Insulin Dosing Calculator had greater increase in provider confidence compared to those who did not use the function. Subjective feedback from residents included expanding functions to include hypoglycemia and non-emergent hyperglycemia management, as well as having recordings of supplementary lectures available on the application. Conclusion Structured resident education in inpatient insulin management utilizing a mobile/web application and lectures as supplementary material is a promising approach to improve resident education and confidence in inpatient diabetes management.

Analysis of real-world capillary blood glucose data to help reduce HbA1c and hypoglycaemia in type 1 diabetes: Evidence in favour of using the percentage of readings in target and coefficient of variation.

To examine real-world capillary blood glucose (CBG) data according to HbA1c to define proportions of CBG readings at different HbA1c levels, and evaluate patterns in CBG measurements to suggest areas to focus on with regard to self-management. A retrospective analysis stratified 682 adults with type 1 diabetes split into quartiles based on their HbA1c . The proportions of results in different CBG ranges and associations with HbA1c were evaluated. Patterns in readings following episodes of hyperglycaemia and hypoglycaemia were examined, using glucose to next glucose reading table (G2G). CBG readings in the target range (3.9-10 mmol/L) increase by ~10% across each CBG quartile (31% in the highest versus 63% in the lowest quartile, p < 0.05). The novel G2G table helps the treatment-based interpretation of data. Hypoglycaemia is often preceded by hyperglycaemia, and vice-versa, and is twice as likely in the highest HbA1c quartile. Re-testing within 30 min of hypoglycaemia is associated with less hypoglycaemia, 1.6% versus 7.2%, p < 0.001, and also reduces subsequent hyperglycaemia and further hypoglycaemia in the proceeding 24 h. The coefficient of variation, but not standard deviation, is highly associated with hypoglycaemia, r=0.71, and a CV ≤ 36% equates to 3.3% of CBG readings in the hypoglycaemic range. HbA1c <58 mmol/mol (7.5%) is achievable even when only ~60% of CBG readings are between 3.9-10 mmol/L. Examining readings subsequent to out-of-range readings suggests useful behaviours which people with type 1 diabetes could be supported to adhere to, both in a clinic and structured education programmes, thereby decreasing the risk of hypoglycaemia whilst also reducing hyperglycaemia and improving HbA1c .

Cyclic improvement of a structured education programme teaching dynamic glucose management strategies in children and young people with type 1 diabetes using continuous glucose monitoring

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Progression of chronic kidney disease in patients with hypertension or type 2 diabetes mellitus, can it be delayed?

Background: In India, the number of patients with type II diabetes mellitus in 2006 was 40.9 million and is expected to increase by 2025 to 69.9 million. Annually 1,00,000 new patients get diagnosed with End-Stage Renal Disease and require maintenance dialysis. Diabetes Mellitus and hypertension were the usual triggers of Chronic Kidney Disease (CKD). A structured education program helps in the prevention of diabetes and hypertension related complications. Methods: This quasi-experimental study was conducted among 88 participants who had hypertension, diabetes mellitus, or both for five or more years with an objective to find the effect of a Disease Management Program on delaying progression of CKD in patients with hypertension or diabetes mellitus. The baseline data were collected on demographic proforma, serum creatinine, blood pressure, and random blood sugar, and the patients were taught the management of hypertension and diabetes mellitus. In the fourth and the eighth month, blood pressure and blood sugar were reassessed. At one-year blood pressure, blood sugar, and serum creatinine were tested. Baseline and one-year follow-up blood pressure, blood sugar, and estimated Glomerular Filtration Rate were compared. Descriptive statistics and "Wilcoxon signed-rank test" were used to analyze the data. Results: In one year, the mean systolic blood pressure reduced by six mm of Hg and mean blood sugar by 24 mg/dl. The prevalence of CKD stage three and above (&lt; 60 ml/min/m2) was nine (10.22%). The median decline in eGFR was 5 ml/min/m2 (Z= 5.925, P&lt; 0.001). Conclusion: The Disease Management Program led to improvements in blood pressure and diabetes control and median progression of CKD was estimated at five ml/min/m2/year.

The impact of a 12-hour educational program on nurses’ knowledge and attitudes regarding pain management: a quasi-experimental study

BackgroundProper pain assessment is fundamental to effective pain management. Training nursing staff is critical for improving pain assessment competence and patient clinical outcomes. However, there is a dearth of research examining interventions that can enhance nurses’ knowledge and attitudes toward pain management, especially in Saudi Arabia. Thus, this study aimed to evaluate the effectiveness of a structured education program on nurses’ knowledge and attitudes towards pain management.MethodsA quasi-experimental design was used. The study sample included 124 registered nurses working in intensive care or inpatient units in Saudi Arabia. Data were collected between March and September 2021 using a knowledge and attitudes survey regarding pain, satisfaction with and self-confidence in learning, and the learning self-efficacy scale for clinical skills.ResultsNurses showed moderate levels of knowledge and attitudes regarding pain before (M = 20.3, SD = 4.80) pain management education, which were significantly higher after the intervention (M = 22.2, SD = 5.09, t = 2.87, p < .01). Before the intervention, nurses with a baccalaureate degree had more knowledge and better attitudes regarding pain management than diploma nurses (t = 3.06, p < .01). However, there was no significant difference between the two groups after the intervention (p > .05), indicating that the education was effective in enhancing nurses’ knowledge and attitudes, regardless of nursing education level. Nurses in this study had high mean scores for self-confidence in learning (M = 35.6, SD = 4.68, range = 18–40), self-learning efficacy (M = 52.9, SD = 7.70, range = 25–60), and satisfaction with learning (M = 22.2, SD = 3.24, range: 10–25).ConclusionRegular pain education programs can improve nurses’ knowledge and attitudes. Increasing the breadth and depth of educational courses, alongside appropriate training, competency-based assessment, and pain education programs, is also recommended. Future research should consider the subjectivity and individualized nature of nursing by including patient satisfaction surveys to measure the improvement in nurses’ knowledge and attitudes from the patient perspective.

The effects of a nurse-led integrative medicine-based structured education program on self-management behaviors among individuals with newly diagnosed type 2 diabetes: a randomized controlled trial

BackgroundInternational guidelines advocate providing prompt structured education to individuals with diabetes at diagnosis. However, among the few eligible structured education programs, heterogeneous intervention regimens and inconsistent findings were reported. Eligible programs for Chinese individuals with diabetes are lacking. This study aimed to investigate the effects of a nurse-led integrative medicine-based structured education program on self-management behaviors, glycemic control and self-efficacy among individuals with newly diagnosed type 2 diabetes.MethodsEmploying a randomized controlled trial, 128 individuals with type 2 diabetes diagnosed in the preceding three to nine months were recruited from four university-affiliated tertiary hospitals in Xi’an City, Northwest China, and randomly allocated to the intervention or control groups after baseline assessments. Participants in the intervention group received a 4-week nurse-led integrative medicine-based structured education program, which is theoretically based on the Health Belief Model and Self-Efficacy Theory, in line with updated diabetes management guidelines, and informed by relevant systematic reviews. Participants in the control group received routine care. Self-management behaviors and self-efficacy were measured with the Summary of Diabetes Self-Care Activities and the Diabetes Management Self-Efficacy Scale at baseline, immediate post-intervention and 12 weeks following the intervention while Glycated Hemoglobin A was measured at baseline and the 12th-week follow-up. The intervention effects were estimated using the generalized estimating equation models.ResultsParticipants in the intervention group exhibited significantly better self-management performance in specific diet regarding intake of fruits and vegetables at both follow-ups (β = 1.02, p = 0.011 and β = 0.98, p = 0.016, respectively), specific diet regarding intake of high-fat foods at the immediate post-intervention follow-up (β = 0.83, p = 0.023), blood glucose monitoring at the 12th-week follow-up (β = 0.64, p = 0.004), foot care at both follow-ups (β = 1.80, p < 0.001 and β = 2.02, p < 0.001, respectively), and medication management at both follow-ups (β = 0.83, p = 0.005 and β = 0.95, p = 0.003, respectively). The intervention also introduced significant improvements in Glycated Hemoglobin A (β = − 0.32%, p < 0.001), and self-efficacy at both follow-ups (β = 8.73, p < 0.001 and β = 9.71, p < 0.001, respectively).ConclusionsThe nurse-led integrative medicine-based structured education program could produce beneficial effects on multiple diabetes self-management behaviors, glycemic control and self-efficacy.Trial registrationThis study was retrospectively registered in the ClinicalTrials.gov. on 25/08/2017; registration number: NCT03261895.

An effective and cost-saving structured education program teaching dynamic glucose management strategies to a socio-economically deprived cohort with type 1 diabetes in a VIRTUAL setting.

Compare the clinical and cost-effectiveness of an established face to face (F2F) structured education program to a new remote (VIRTUAL) program teaching dynamic glucose management (DynamicGM) to children and young people with type 1 diabetes (CYPD) using continuous glucose monitoring (CGM). To ascertain the most effective DynamicGM strategies predicting time in range (TIR) (3.9-10.0 mmol/L) and incorporating these into a user-friendly teaching aid. Effectiveness of the F2F and VIRTUAL programs were ascertained by comparing the mean change (Δ) from baseline to 6 months in HbA1c, TIR and severe hypoglycemia. Delivery cost for the two programs were evaluated. Factors predicting TIR in the combined cohort were determined and incorporated into a user-friendly infographic. First 50 graduates per group were evaluated. The mean difference in Δ HbA1c, Δ TIR and Δ episodes of severe hypoglycemia between VIRTUAL and F2F groups were 1.16 (p= 0.47), 0.76 (p= 0.78) and -0.06 (p= 0.61) respectively. Delivery cost per 50 CYPD for VIRTUAL and F2F were $5752 and $7020, respectively. The strongest predictors of TIR (n= 100) were short bursts of exercise (10-40min) to lower hyperglycemia (p< 0.001), using trend arrow adjustment tools (p< 0.001) and adjusting pre-meal bolus timing based on trend arrows (p< 0.01). These strategies were translated into a GAME (Stop highs), SET (Stay in target), MATCH (Prevent lows) mnemonic. Teaching DynamicGM VIRTUALLY is just as effective as F2F delivery and cost saving. Short bursts of exercise and using CGM trend arrows to adjust insulin dose and timing improves TIR.

Identifying if patient's living with heart failure retain knowledge better by gaining it through lived experience rather than through education.

Abstract Funding Acknowledgements Type of funding sources: None. Background Self-care is when a patient possesses a set of knowledge and skills that are used to process information to make correct health decisions. Self-care in heart failure (HF) includes monitoring symptoms for deterioration in HF and having an appropriate response time in contacting their health care provider. One of the main principles of a heart failure clinic is to provide a structured education programme for the patient regarding self-care. Patient education is the leading intervention to equip patients with the skills for symptom recognition. The education aims to ensure the patient can recall the knowledge from memory if required. Purpose The aim of this study was to evaluate patient knowledge, through testing memory, regarding symptom recognition in a single center HF clinic. To identify if there was a difference between attaining knowledge on symptom recognition gained through lived experience versus knowledge on symptom recognition gained through education. Methods 50 patients were recruited for this study. Average age was 72 years old. 38 male and 12 female. All participants had previously experienced at least one symptom of HF. All participants had a minimum of 2 education sessions in the HF clinic. All patients had evidence from their weight logbook of daily weight monitoring. Question "a" tests knowledge acquired from education and question "b" tests knowledge acquired from lived experience. All participants were asked two questions: a) what is the amount of weight increase you are monitoring for? b) name one symptom you are monitoring that would indicate possible deterioration in HF. Results single center prospective analysis Question a: 35% answered correctly Question b: 82% answered correctly Conclusions Processes of learning and the transfer of learning are central to understanding how people can achieve competency in self-care. In this study patients seem to remember information better from a lived experience rather than trying to recall taught information. It important to identify the patients’ individual factors and needs to successfully support their self-care management. Further evaluation of assessing the implementation of other supports available such as, mobile Apps and multimedia-based education, to address knowledge recall deficits is needed to determine if they aid the patient to achieve competency in self-care.

Progress in application of structured education program for stroke patients

Progress in application of structured education program for stroke patients

Development and evaluation of a patient education programme for children, adolescents, and young adults with differences of sex development (DSD) and their parents: study protocol of Empower-DSD

BackgroundDifferences in sexual development (DSD) are rare diseases, which affect the chromosomal, anatomical or gonadal sex differentiation. Although patient education is recommended as essential in a holistic care approach, standardised programmes are still lacking. The present protocol describes the aims, study design and methods of the Empower-DSD project, which developed an age-adapted multidisciplinary education programme to improve the diagnosis-specific knowledge, skills and empowerment of patients and their parents.MethodsThe new patient education programme was developed for children, adolescents and young adults with congenital adrenal hyperplasia, Turner syndrome, Klinefelter syndrome or XX-/or XY-DSD and their parents. The quantitative and qualitative evaluation methods include standardised questionnaires, semi-structured interviews, and participatory observation. The main outcomes (assessed three and six months after the end of the programme) are health-related quality of life, disease burden, coping, and diagnosis-specific knowledge. The qualitative evaluation examines individual expectations and perceptions of the programme. The results of the quantitative and qualitative evaluation will be triangulated.DiscussionThe study Empower-DSD was designed to reduce knowledge gaps regarding the feasibility, acceptance and effects of standardised patient education programmes for children and youth with DSD and their parents. A modular structured patient education programme with four generic and three diagnosis-specific modules based on the ModuS concept previously established for other chronic diseases was developed. The topics, learning objectives and recommended teaching methods are summarised in the structured curricula, one for each diagnosis and age group. At five study centres, 56 trainers were qualified for the implementation of the training programmes. A total of 336 subjects have been already enrolled in the study. The recruitment will go on until August 2022, the last follow-up survey is scheduled for February 2023. The results will help improve multidisciplinary and integrated care for children and youth with DSD and their families.Trial registrationGerman Clinical Trials Register, DRKS00023096. Registered 8 October 2020 – Retrospectively registered.

Adherence to Contraceptive Use Guidelines and Preconception Advice in a Diabetes Clinic

Background: Women with diabetes have more complications during pregnancy. Contraceptive advice to prevent unplanned pregnancy is of utmost importance for them. Maintenance of strict glycaemic control is essential to have a positive outcome in pregnancy and proper care. Preconception care and counselling to help pregnancy planning is thus essential. Aim: To assess whether proper education regarding importance of contraceptive use, preconception care and advice is being imparted to female diabetics according to NICE guidelines Method: This is a proposed monocentric retrospective clinical audit to evaluate adherence of a diabetes clinic to NICE guidelines regarding education and advice on contraceptive use and preconception care. The three criteria being assessed include documentation of patient’s intentions regarding contraceptive use and pregnancy at each visit with the diabetes care team; offering patients intending to get pregnant a structured education programme as soon as possible; and preconception care and advice being imparted to patients wanting to try for pregnancy before discontinuing contraception. Two patient cohorts, each consisting of 50 patients who meet the inclusion and exclusion parameters for the respective criteria will be made. Data collection will be done by the diabetologist, the diabetes specialist nurse and the practice nurse at St. June’s Diabetes Clinic. Data will be collected by accessing previous records of patients from 01 January 2021 to 31 December 2021. Data will be compiled as a percentage and compared with the standard. Conclusion: Improved patient-staff communication is the key point to improve compliance with NICE guidelines regarding these standards.

Evaluation and Analysis of the Intervention Effect of Systematic Parent Training Based on Computational Intelligence on Child Autism.

Autism, also known as pervasive developmental disorder or autism spectrum disorder, is a group of clinical syndromes of developmental delay or impairment. Social impairment, verbal communication impairment, and behavioral impairment are the three conditions for the diagnosis of autism spectrum disorder, according to the American Psychiatric Association's Diagnostic and Statistical Manual. According to relevant statistics, about 1 in 100 children is now diagnosed with autism, and their rehabilitation treatment is also valued by people from all walks of life. In the rehabilitation training of autistic children, it is found that the rehabilitation training of autistic children should pay attention to the role of parents and family environment. It is crucial that parents receive systematic training and act as partners in the development of the intervention plan. Research shows that a specific structured education and skills training program for parents of children with autism can be beneficial in improving behavioral problems, functional communication, and symptoms of autism in children with autism. To this end, this paper has completed the following work: Secondly, a portion of the systematic training of CA parents is discussed, followed by an explanation of the structure and principles of BPNN. Finally, the BPNN is utilized to create a model for assessing the impact of systematic parent instruction on CA. The experimental findings suggest that the proposed BPNN outperforms the competition.

Multimodal intervention to improve the transition of patients with inflammatory bowel disease from pediatric to adult care: protocol for a randomized controlled trial

BackgroundTransition in care is defined as the “purposeful and planned movement of adolescents and young adults with a chronic medical condition from pediatric to adult-oriented healthcare systems/care providers.” Currently, there are no Level 1 evidence-based interventions to improve the care of transitioning adolescents and young adults (AYAs) with inflammatory bowel disease (IBD). The development of a transition program using a biopsychosocial approach will improve the standards for healthcare delivery to transitioning IBD patients. This is a protocol for a structured randomized controlled trial (RCT) to assess the clinical and implementation effectiveness of a multimodal intervention focused on improving patient function, transition readiness and outcomes among AYA patients with IBD being cared for at pediatric centers in Canada.MethodsThis multi-center RCT is a type 1 hybrid effectiveness-implementation trial to evaluate effectiveness of the intervention and how it can be implemented more widely after the trial. We will include patients aged 16.0–17.5 years. The intervention program consists of 4 core components: (1) individualized assessment, (2) transition navigator, (3) virtual patient skills-building with a focus on building resilience, self-management and self-efficacy, and (4) a virtual structured education program. The control group will undergo standard-of-care defined by each participating center. The primary outcome will be the IBD Disability Index, a validated measure to assess patient functioning. Secondary outcomes include transition readiness and success, anxiety and depression scales, and health service utilization rates. Additionally, we will measure implementation outcomes and related barriers and facilitators for the intervention program.DiscussionThe type 1 hybrid effectiveness-implementation design will allow for the development of a feasible, sustainable, and acceptable final intervention model. The intervention will consist of modules that can be accessed in an online, virtual platform. The implementation will allow centralization of interventions and funding in order to minimize the impact on local clinical practice or hospital resources. The authors anticipate that the main study limitation will relate to study subjects not completely adhering to every component of the intervention, which will be evaluated and addressed using the implementation science approach.Trial registrationNCT05221281. Registry: ClinicalTrials.gov. Date of registration: February 2, 2022. https://clinicaltrials.gov/ct2/show/NCT05221281.

Barriers and Facilitators to Diabetes Device Adoption for People with Type 1 Diabetes.

Diabetes technology (insulin pumps, continuous glucose monitoring, automated insulin delivery systems) has advanced significantly and provides benefits to the user. This article reviews the current barriers to diabetes device adoption and sustained use, and outlines the known and potential facilitators for increasing and sustaining device adoption. Barriers to diabetes device adoption continue to exist at the system-, provider-, and individual-level. Known facilitators to promote sustained adoption include consistent insurance coverage, support for providers and clinics, structured education and support for technology users, and device user access to support as needed (e.g., through online resources). Systemic barriers to diabetes device adoption persist while growing evidence demonstrates the increasing benefits of newest devices and systems. There are ongoing efforts to develop evidence-based structured education programs to support device adoption and sustained use.

Preliminary Effects of a Structured Educational Program in Cardiac Patients at Different Stages of Enrollment in Cardiovascular Rehabilitation.

This quasi-experimental study investigated the preliminary effects of a structured education intervention in a pooled sample of cardiovascular rehabilitation (CR) patients in Brazil. Recently enrolled (RE) and long-term enrolled (LTE) patients attended 12 weekly education sessions in addition to three weekly exercise sessions. Patients completed surveys assessing disease-related knowledge, physical activity, food intake, self-efficacy, and health literacy. Functional capacity was assessed by the 6-minutes walking test. All outcomes were assessed at pre-,post-CR, and 6-months follow-up. Bonferroni correction was applied. In total, 69 (69.7%) patients completed all three assessments. There were significant improvements in knowledge pre-to post-test in both subgroups (p < 0.001), and in functional capacity (p ≤ 0.001) and food intake (p ≤ 0.001) pre-to post-test in the RE subgroup. Post-test knowledge was correlated to physical activity, functional capacity and health literacy. This preliminary study suggests the importance of structured education for CR patients. A larger study using a randomized controlled design is needed to determine efficacy.

A qualitative study exploring the barriers to attending structured education programmes among adults with type 2 diabetes

BackgroundDiabetes self-management education, a universally recommended component of diabetes care, aims to support self-management in people with type 2 diabetes. However, attendance is low (approx. 10%). Previous research investigating the reasons for low attendance have not yet linked findings to theory, making it difficult to translate findings into practice. This study explores why some adults with type 2 diabetes do not attend diabetes self-management education and considers how services can be adapted accordingly, using Andersen’s Behavioural Model of Health Service Utilisation as a framework.MethodsA cross-sectional semi-structured qualitative interview study was carried out. Semi-structured interviews were conducted by telephone with 14 adults with type 2 diabetes who had verbally declined their invitation to attend diabetes self-management education in Bath and North East Somerset, UK, within the last 2 years. Data were analysed using inductive thematic analysis before mapping the themes onto the factors of Andersen’s Behavioural Model.ResultsTwo main themes were identified: ‘perceived need’ and ‘practical barriers’. The former theme explored participants’ tendency to decline diabetes education when they perceived they did not need the programme. This perception tended to arise from participants’ high self-efficacy to manage their type 2 diabetes, the low priority they attributed to their condition and limited knowledge about the programme. The latter theme, ‘practical barriers’, explored the notion that some participants wanted to attend but were unable to due to other commitments and/or transportation issues in getting to the venue.ConclusionsAll sub-themes resonated with one or more factors of Andersen’s Behavioural Model indicating that the model may help to elucidate attendance barriers and ways to improve services. To fully understand low attendance to diabetes education, the complex and individualised reasons for non-attendance must be recognised and a person-centred approach should be taken to understand people’s experience, needs and capabilities.

Application of TELSA structured education program in adults with type 1 diabetes mellitus

Objective: To evaluate the effect of TELSA structured education program in adults with type 1 diabetes mellitus (T1DM) in China. Methods: From January 2019 to January 2020, 64 adult T1DM patients who met the standard of entry and had the intention to participate in TELSA structured education program were selected from the outpatient of type 1 diabetes comprehensive management in the Second Xiangya Hospital as intervention group. A total of 64 patients matched by age and sex were enrolled as the control group. During the program, the intervention group lost 3 cases and the control group lost 4 cases. Finally, there were 61 effective samples in the intervention group and 60 effective samples in the control group. The patients in the control group were given face-to-face education by a T1DM educator for about 2 hours. The patients in the intervention group were intervened according to TELSA structured education program. The level of glycosylated hemoglobin, the frequency of hypoglycemia, self-management ability and quality of life were evaluated before intervention, 6 months after intervention and 12 months after intervention. Results: The ages of the intervention group and the control group were 30.0(22.0,43.5) and 29.5(22.3,42.5) (P>0.05), and the proportions of males were 47.54%(29 cases) and 45.00%(27 cases), respectively (P>0.05). There were interaction effects (P<0.05) on the level of glycosylated hemoglobin, self-management ability and quality of life in the two groups. At 6 and 12 months after intervention of TELSA structured education program, the level of glycosylated hemoglobin in the intervention group decreased from the baseline level (7.87±1.45)% to (7.23±1.06)% and (7.28±0.93)%, respectively, which was significantly lower than that in the control group at 6 months (7.72±1.20)% and at 12 months(7.76±1.24)% (all P<0.05). After TELSA structured education intervention, the scores of self-management scale for adult type 1 diabetes mellitus (SMOD-CA) in the intervention group showed an upward trend (P<0.001), and the scores of diabetes-specific quality of life scale (A-DQOL) showed a downward trend (P<0.001). In contrast, there was no statistically significant difference in the trend of scores in the control group (P=0.853 and 0.227). The comparison between groups at different time points showed that at 6 and 12 months after the intervention, the SMOD-CA scores of the patients in the intervention group were higher than those in the control group (P<0.001), and the A-DQOL scores were lower than those in the control group (P<0.001). Conclusions: The TELSA structured education program can effectively ameliorate glycemic control, with the improvement of self-management ability and quality of life in adult T1DM patients.

Structured diabetes self-management education and its association with perceived diabetes knowledge, information, and disease distress: Results of a nationwide population-based study

ObjectiveTo evaluate, how participation in structured diabetes self-management education (DSME) programs is associated with perceived level of knowledge about diabetes, information needs, information sources and disease distress. MethodsWe included 796 ever- and 277 never-DSME participants of the population-based survey “Disease knowledge and information needs - Diabetes mellitus (2017)” from Germany. Data on perceived level of diabetes knowledge (12 items), information needs (11 items), information sources (13 items) and disease distress (2 indices) were collected. Multiple logistic regression analyses were used to examine the association of DSME-participation with these outcomes. ResultsDSME-participants showed a higher level of diabetes knowledge compared to never-DSME participants, particularly in aspects concerning diabetes in general (odds ratio 2.53; 95% confidence intervals 1.48–4.33), treatment (2.41; 1.36–4.26), acute complications (1.91; 1.07–3.41) and diabetes in everyday life (1.83; 1.04–3.22). DSME-participants showed higher information needs regarding late complications (1.51; 1.04–2.18) and acute complications (1.71; 1.71–2.48) than DSME never participants. DSME-participants more frequently consulted diabetologists (5.54; 3.56–8.60) and diabetes care specialists (5.62; 3.61–8.75) as information sources. DSME participation was not associated with disease distress. ConclusionDSME is a valuable tool for improving individual knowledge about diabetes. However, DSME should focus more on psychosocial aspects to reduce the disease burden.