Evaluation of a treatment and teaching refresher programme for the optimization of intensified insulin therapy in type 1 diabetes

Objective: Evaluation of an ambulatory diabetes teaching and treatment refresher programme (DTTP) for the optimization of intensified insulin therapy in patients with type 1 diabetes (refresher course). Methods: 85 outpatients took part in this prospective multicentre trial. Metabolic and psychosocial data were analyzed at baseline (V1), 6 weeks (V2) and 12 months after DTTP (V3). Results: In patients with baseline HbAl c > 7% (88%), HbAl c decreased by 0.36% (p = 0.004). The percentage of patients with HbAl c < 7% increased from 21.3 to 34.9% and with HbAl c above 10% decreased from 6.6 to 1.6% at V3. The incidence of hypoglycaemia decreased significantly: non severe hypoglycaemia from 3.31 to 1.39 episodes/pat/week (p = 0.001) and severe hypoglycaemia from 0.16 to 0.03 episodes/pat/year (p = 0.02). The treatment satisfaction increased by +10 of maximal 18 points. The negative influence of diabetes on quality of life decreased from 1.93 to 1.69 points (p = 0.031). Conclusion: In a group of patients with moderately controlled diabetes type 1 who were already treated with intensified insulin therapy, metabolic control, treatment satisfaction and quality of life were improved after participation in an ambulatory DTTP without increasing insulin dosage, number of injections or insulin species. Practice implications: This DTTP is effective for the optimization of intensified insulin therapy. (C) 2013 Elsevier Ireland Ltd. All rights reserved.