Structured education using Dose Adjustment for Normal Eating (DAFNE) reduces long-term HbA_1c and HbA_1c variability.

Area of Science:

• Endocrinology
• Metabolic Diseases
• Diabetes Management

Background:

• Type 1 diabetes (T1D) management aims to optimize glycemic control and minimize complications.
• Increased HbA1c variability is linked to higher morbidity and mortality in T1D.
• The impact of structured education programs on HbA1c variability in T1D remains underexplored.

Purpose of the Study:

• To assess the long-term effects of the Dose Adjustment for Normal Eating (DAFNE) program on HbA1c levels and variability in individuals with T1D.
• To determine if structured diabetes education can reduce HbA1c variability.

Main Methods:

• Utilized the Scottish Care Information-Diabetes dataset to identify T1D patients who completed the DAFNE program.
• Calculated HbA1c median and variability (coefficient of variation, CV) pre- and post-DAFNE participation.
• Analyzed data from 687 eligible participants.

Main Results:

• DAFNE participation led to a significant reduction in median HbA1c at 12 months (-3.5 mmol/mol) and sustained reduction at 60 months (-1.5 mmol/mol).
• HbA1c variability, measured by CV, significantly decreased post-DAFNE (0.08 to 0.07; P = 0.002).
• This study is the first to demonstrate reduced HbA1c variability following structured diabetes education.

Conclusions:

• The DAFNE program effectively improves and sustains glycemic control in T1D for up to 5 years.
• Structured education, specifically DAFNE, demonstrably reduces HbA1c variability in T1D patients.
• These findings highlight the beneficial impact of DAFNE on the overall glycemic profile in T1D management.