Related Experiment Videos
Hub-and-spoke model for a 5-day structured patient education programme for people with Type 1 diabetes
H Rogers1, E Turner, G Thompson
1Diabetes Centre, King's College Hospital, London, UK. helenrogers@nhs.net
Aims:
Structured education programmes for people with Type 1 diabetes can deliver improved diabetes control (including reduced severe hypoglycaemia) and quality of life. They can be cost-effective but are resource intensive. We tested the ability to deliver an evidence-based 5-day programme in diabetes centres too small to deliver the courses.
Methods:
Specialist medical and nursing staff from three district general hospital diabetes services (the 'spokes') were trained in all aspects of the education programme, except those directly related to course delivery, by a larger centre (the 'hub'). The hub staff delivered the 5-day patient education courses, but all other patient education and management was managed locally. Diabetes control and quality of life were assessed at 1 year post-course.
Results:
In 63 patients with follow-up data, glycated haemoglobin (HbA(1c)) fell by 0.42 +/- 1.0% (P = 0.001), with a greater fall in those with high HbA(1c) at baseline, and no mean weight gain. Emergency call-out for severe hypoglycaemia fell from 10 episodes in seven patients the year before to one episode in one patient (P = 0.03). Quality-of-life measures improved, with reduced negative impact of diabetes on diabetes-related quality of life (P < 0.00004) and 'present quality of life' improving (P < 0.001).
Conclusions:
The benefits of a 5-day structured education programme can be provided to patients with Type 1 diabetes attending centres without the resources to provide the teaching course itself, by a 'hub-and-spoke' methodology.
Related Concept Videos
Type I Diabetes I: Introduction
Type II Diabetes I: Introduction
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
Diabetes Mellitus: Introduction