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The effect of functional insulin therapy on glycaemic parameters in children with diabetes mellitus type 1
Diana Štimjanin-Koldžo1, Salem Alajbegović2, Ena Štimjanin2
1Department of Paediatrics, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina.
Insights
A 5-day education program improved type 1 diabetes management, significantly reducing HbA1c and insulin doses. However, motivation waned after a year, highlighting the need for ongoing education to maintain glycaemic control.
Area of Science:
- Pediatrics
- Endocrinology
- Diabetes Management
Background:
- Type 1 diabetes requires continuous management and education for patients and families.
- The Düsseldorf model offers a structured approach to diabetes education.
Purpose of the Study:
- To assess the impact of a 5-day interactive education program on type 1 diabetes management.
- To evaluate changes in glycated haemoglobin (HbA1c) and insulin dosage.
- To determine the long-term effectiveness of the educational intervention.
Main Methods:
- A prospective study involving 67 type 1 diabetes patients (mean age 11 years).
- A 5-day education program led by diabetes specialists.
- Assessment of patient and parent knowledge, HbA1c, and total daily insulin dose at baseline and follow-up points (3, 6, 9, 12 months).
Main Results:
- Significant reduction in total daily insulin dose post-program.
- HbA1c decreased by 3.17% at 9 months and 1.8% at 12 months compared to baseline (p<0.001).
- Knowledge scores improved, but glycaemic control declined after 12 months due to decreased motivation.
Conclusions:
- Structured education on functional insulin therapy improves glycaemic control in type 1 diabetes.
- Patient and parental motivation are key to sustained glycaemic control.
- Yearly re-education is necessary to maintain long-term benefits and combat declining motivation.
Abstract:
Aim The aim of the study is to evaluate the effect of a prospectively conducted interactive 5-day education programme based on Düsseldorf model on glycated haemoglobin (A1C), and total daily dose of insulin in type 1 diabetes patients. Methods A total of 67 type 1 diabetes patients was analysed; mean age of 11±0.68 years, 43 females and 24 males. The programme was led by a trained team of diabetes specialist doctors and nurses. All subjects and their parents completed a knowledge test about diabetes at beginning, and at the end of education, and after 12 months (30 questions). Subjects were evaluated for total daily insulin, and HbA1c at baseline, as well as 3, 6, 9 and 12 months after the end of the education programme. Results Results of the knowledge test after the education have shown higher knowledge at baseline. At the end of the education programme an average of total daily insulin dose was significantly lower. There was a 3.17% reduction in HbA1c values over 9 months, and 1.8% over 12 months in the comparison to the baseline values (p<0.001). Conclusions Structured education programme of functional insulin therapy was associated with improved glycaemic control in type 1 diabetes patients and their parents. It motivated patients and parents to improve glycaemic control. One year after the follow up, glycaemic control was worsening, due to lack of patients' motivation, therefore, there is a need for yearly re-education.
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