Growth of Structured Growth of Structured Education for People with Education for People with

Type 1 Diabetes in the UK.Type 1 Diabetes in the UK.

Joan Everett Joan Everett (on behalf of Diabetes (on behalf of Diabetes Education Network)Education Network)

www.diabetes-education.netwww.diabetes-education.net

Type 1 education: does it work Type 1 education: does it work in the UK?in the UK?

Diabetes Education NetworkDiabetes Education NetworkAudit dataAudit data

Collected from 7 centresCollected from 7 centres BristolBristol BournemouthBournemouth EastbourneEastbourne GwentGwent LutonLuton PeterboroughPeterborough TorquayTorquay

HbAIcHbAIc

BaselineBaseline

mean (sd) % mean (sd) %

1 year 1 year

mean (sd) % mean (sd) %

p valuep value

AllAll 8.71 (1.4) 8.71 (1.4) n=549n=549

8.39 (1.29)8.39 (1.29)n=284n=284

<0.001<0.001

>7.5% >7.5% at at baselinebaseline

9.13 (1.19)9.13 (1.19)n=448n=448

8.68 (1.18)8.68 (1.18)n=211n=211

<0.001<0.001

WeightWeight

N=209N=209 BaselineBaselinemean mean (SD)(SD)

1 year 1 year mean mean (SD)(SD)

p valuep value

WeightWeight 75.3 Kg75.3 Kg

(15.5)(15.5)

74.8 Kg74.8 Kg

(14.2)(14.2)

n/sn/s

Problem Area In DiabetesProblem Area In Diabetes

N=177N=177 Baseline Baseline mean (SD)mean (SD)

1 year 1 year mean mean (SD)(SD)

p valuep value

Problem Area Problem Area in Diabetesin Diabetes

(PAID)(PAID)

29.5 (19.8)29.5 (19.8) 18.3 (15.5)18.3 (15.5) <0.001<0.001

DKADKA

BaselineBaseline 1 year1 year

DKA episodes per DKA episodes per year (no of patients) year (no of patients)

36 (393)36 (393) 6 (135)6 (135)

Episode per patient Episode per patient per yearper year

0.090.09 0.040.04

HypoglycaemiaHypoglycaemia

BaselineBaseline 1 year1 year

Total hypos / year Total hypos / year

(no of patients)(no of patients)

410 (404)410 (404) 34 (121)34 (121)

Hypos -paramedicHypos -paramedic 107 107 00

Total hypos per patient Total hypos per patient per yearper year

1.021.02 0.280.28

SummarySummary

Education for type 1 diabetes patients has improved due Education for type 1 diabetes patients has improved due to political and clinical influenceto political and clinical influence

DEN has been successful in supporting and training DEN has been successful in supporting and training teams to deliver structured education for type 1 patientsteams to deliver structured education for type 1 patients

Audit data shows reduced HbAIc, DKA and Audit data shows reduced HbAIc, DKA and hypoglycaemia episodes and an improved quality of lifehypoglycaemia episodes and an improved quality of life

Good progress has been made since 2000Good progress has been made since 2000 education programmes available in 2/3 of health districtseducation programmes available in 2/3 of health districts Emerging framework for quality control Emerging framework for quality control

Next stepsNext steps

To integrate ongoing education into long To integrate ongoing education into long term follow up (“educational model of care”)term follow up (“educational model of care”)

To ensure availability of education in all To ensure availability of education in all areasareas

To develop generic accreditation for To develop generic accreditation for centres and educatorscentres and educators