Endocrine Abstracts

Diabetes education for children, adolescents and their parents is recommended by several guidelines and widely accepted as an integral part of type 1 diabetes therapy. Structured comprehensive courses at disease onset are regularly followed by education updates until transition to adult diabetes care. Especially in paediatric diabetes care age-appropriate, demand-oriented and individualized practical information and skills-training are mandatory for achieving good metabolic control and psychosocial well-being. A paediatric multidisciplinary diabetes team experienced in an intensified insulin therapy with a differential substitution of prandial and basal insulin needs (MDI or CSII) and in child psychology is required to initiate and maintain lifelong diabetes self-management. In Germany an education program for children aged 6–12 years, another program for adolescents and young adults and one for their parents have been evaluated in multicenter studies. Programs were considered with respect to applicability, acceptance by target groups and efficacy (knowledge, competence, quality of life, social integration and glycaemic control). Contents, modular structures, developmental psychological background and didactic concepts of all programs will be presented. Apart from teaching principles of insulin therapy special emphasis is laid on translating this knowledge into everyday self-management behaviour and positive parent–child communication. In addition, emotional coping with the chronic disease and its psychosocial consequences is supported. In the context of the Disease-Management-Program for Type 1 Diabetes in Germany these programs for young people were certified and reimbursed nationwide by health insurances. Currently published data of the nationwide prospective dpv-program reported of slightly decreasing HbA1c and normal quality of life of young people with diabetes. Compared to this a survey run by the European SWEET project on established diabetes education concepts in several countries pointed to a significant lack of evaluated concepts that are integrated into holistic care of young people with type 1 diabetes in the majority of European countries. Furthermore, there is a lack of quality assured education of the multidisciplinary paediatric team members on introducing such programs and tools to patients and caregivers. New concepts of sourcing of quality assured paediatric diabetes education in Europe should therefore become one goal of the SWEET initiative towards improving the equality and access to modern diabetes care across the continent.