Long-term biomedical and psychosocial outcomes following DAFNE (Dose Adjustment For Normal Eating) structured education to promote intensive insulin therapy in adults with sub-optimally controlled type 1 diabetes.
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Authors
Oliver, Lindsey
Roberts, Sue
Issue Date
2010
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Abstract
Aims: To explore long-term outcomes of participation in a Dose Adjustment For Normal Eating (DAFNE) training course, which provided one-off exposure to structured education in intensive insulin therapy to people with established Type 1 diabetes.
Methods: A cohort design follow-up of original trial participants at a mean of 44 months (range: 37–51 months) in hospital diabetes clinics in three English health districts. 104 (74%) original participants provided biomedical data; 88 (63%) completed questionnaires including the ADDQoL, measuring impact of diabetes on quality of life (QoL).
Results: At 44 months, mean improvement in HbA1c from baseline was 0.36% (9.32 ± 1.1% to 8.96 ± 1.2%, p < 0.01) remaining significant but deteriorated from 12 months (p < 0.05). Improvements in QoL seen at 12 months were sustained at 44 (e.g. impact of diabetes on dietary freedom: −1.78 ± 2.33 at 44 months versus −4.27 ± 2.94, baseline, p < 0.0001; versus 1.80 ± 2.32 at 12 months, ns). Similar results were obtained using last observation carried forward for patients not supplying follow-up data.
Conclusions: The impact of a single DAFNE course on glycaemic control remains apparent in the long term, although further interventions will be required to achieve recommended HbA1c. In contrast, improvements in QoL and other patient-reported outcomes are well maintained over approximately 4 years.
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Speight, J. Amiel, S. Bradley, C. et al. (2010) Long-term biomedical and psychosocial outcomes following DAFNE (Dose Adjustment For Normal Eating) structured education to promote intensive insulin therapy in adults with sub-optimally controlled Type 1 diabetes. Diabetes Research and Clinical Practice; 89 (1) : 22-29.
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Diabetes Research and Clinical Practice
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0168-8227