Introduction: Ongoing structured education for children and young people with type 1 diabetes and their families is considered essential by ISPAD (2014) and NICE (2015), because there is a lot of education and skills that need to be reinforced.
In 2016 the majority of the self-management education was provided at our trust by diabetes self-management education (DSME) sessions, which are two hour sessions designed to improve self-management. This format of education is comprehensive in nature, however, only 6% of the 350 families attended in 2016. Patient feedback consistently reported attending extra hospital appointments as a major barrier.
It was agreed by the team in late 2016 to try a complementary educational approach with the aim of reaching a larger number of families. The suggested complementary approach is a bite size 510 minute education session delivered during clinic waiting time, covering a different topic every 3 months. The intended design is to allow self-assessment of knowledge, identify gaps, and finally to fill the gaps with interactive education.
Method: From January 2017 to March 2017 in the adolescent clinic, the first bite size topic was piloted. The session aim was to improve knowledge regarding HbA1c, including what is the Hba1c test measuring and the importance of using average blood glucose to identify if interventions and therapy changes have been successful. A session specific audit questionnaire was developed, along with a poster for interactive teaching.
Results: Of the 88 adolescents who attended clinic in the 3 months, 76% completed the bite size session. Before the session only 30% knew the target HbA1c, this improved to 98% after the session. After the session, 98% of patients could use average blood glucose to predict HbA1c, and 55% felt confident they would check average blood glucose in the next 2 weeks.
Conclusion: This audit has ascertained in clinic bite size education reached over two thirds of the cohort, which was a massive improvement on 6% achieved by DSME in 2016. Also diabetes knowledge can be improved in ten minutes of interactive education. Further validation of this approach for the whole cohort is our next step.