Endocrine Abstracts

JOINT3808

Objective: Has the focus on technology in diabetes care influenced the type and frequency of diabetes education programs for children and adolescents with type 1 diabetes (T1D) in Germany and do we see general differences in age and sex regarding the participation of educational programs over the last years?

Methods: This analysis is based on data from the German DPV registry (status of 03/2024), including 42,975 paediatric patients with T1D aged 0–18 years from 364 centres in Germany. Patients with a diabetes duration of <6 months and those from centres without documented education were excluded (<1%). The frequency and type of education for multiple age groups and sexes were analysed for 2010–2023 using multivariable regression models to assess temporal trends (SAS 9.4, SAS Institute Inc., USA).

Results: International guidelines recommend regular education every 2 years. However, only 54.7% of patients attended structured diabetes re-education programs within five years after diagnosis. Those with belated re-education showed higher HbA1c levels across all groups. While the frequency of individual education remained relatively stable over time, with a temporary decrease during the pandemic, the group education programs significantly declined from 46.4% (2015) to 28.9% (2020) and could only slightly recovery to 31.3% in 2023 (P< 0.0001 respectively). Adolescents >12 years (46.3%) were less likely to receive education than families of younger children <6 years (56%, P<0.0001). Girls (56.8%) participated in educational programs more frequently than boys (52.8%, P<0.0001). Their attendance in group education was also significantly higher (P<0.0001). The share of patients receiving individual insulin pump training increased from 36.6% (2015) to 51.0% (2023), reflecting the growing role of technology in diabetes management and need for resources in clinics and doctors’ offices.

Conclusion: Diabetes education for children and adolescents with T1D has undergone visible changes in recent years. There is a shift towards more individual and technology-focused education, requiring more personnel and neglecting the essential understanding of basics and personal development with T1D. Later re-education showed associations with higher HbA1c. Where younger children and girls received more structured diabetes education, adolescents and boys participated less frequently. Additionally, with the substantial decline in group education children lose secondary benefits like peer contact. These disparities highlight the need for targeted strategies to ensure adequate education for all. Innovative approaches, such as the "GaDiaKi" program for group education and telemedicine-based interventions, may help address these gaps and improve long-term diabetes care.