Endocrine Abstracts (2011) 27 P63

Audit of structured educational programme for carbohydrate counting for children with type 1 diabetes

Mihirani Balapatabendi, K Grilli, James Greening & S M O’Riordan

The University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, UK.

Introduction: The paediatric diabetes team in Leicester identified an unmet need for educating children about carbohydrate counting, following the initiation of most diagnosed patients on multiple dose insulin therapy (MDI). The team therefore started a new structured group education programme (SGEP) for children with type 1 diabetes (T1DM) called flexible adjustment of basal bolus (FABB) that has run since January 2007.

Aims: To determine the effectiveness of SGEP for children with T1DM and to compare the outcomes of MDI therapy before (data from previous audit) and after introduction of SGEP.

Methods: This is a retrospective audit of children with T1DM who had SGEP over a period of 1 year (1 Jan–31 Dec 2008). Thirty-five case notes were identified and HbA1C, BMI and number of hypoglycaemic episodes (NHE) at baseline, 6 months, and 1 year were analysed.

Results: Mean HbA1C improved by 0.9% (9.5–8.6%) at 6 months 0.8% (9.5–8.7%) at 1 year, compared to pre FABB that didn’t show improvement in HbA1C 9.1% at all the time points. Mean BMI was not significantly different between the time points (post FABB 19.6, 20.0, 20.6 kg/m2, pre FABB 22,9,22.9,22.8 kg/m2). Mean NHE didn’t differ between time points in the post FABB group. However mean NHE was increased in the post FABB group compared to pre FABB at the final 1 year time point but not at baseline and 6 months. (0.028, 0.028, 0.033 vs. 0.02, 0.03, 0.00).

Conclusion: Since the introduction of our SGEP there was a sustained improvement in HBA1C by mean of 0.9 and 0.8% at 6 and 12 months compared to a group of children who were started on MDI that didn’t receive SGEP. It did not change the outcomes of BMI and NHE at 6 months but increased at 1 year in post FABB group. However our mean HbA1C is higher than the NICE recommended standard of <7.5% and reaudit prospectively from 2011 is needed to assess if we are nearer to this target having run the SGEP for 4 years.

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