|
Winners of the 2003 DESG Awards |
|
|
|
|
Page 3 of 3
Best abstract on Therapeutic Patient Education presented during the 2003 FEND Conference, Budapest, 2002:
M. Vidal, M. Jansà, C. Anguita*, M. Torres*, E. Aguilera, E. Esmatjes, I. Levy, R. Gomis, I. Conget. Impact of a therapeutic education programme (TEP) in patients transfered from paediatric to adult diabetes units (Abstract No 376)
Endocrinology and Diabetes Unit. Hospital Clinic i Universitari. Hospital Sant Joan de Déu*. Barcelona, Spain
Background: The control of type 1 diabetes (DM1) in young subjects is especially troublesome in adolescence. Usually in this period, young DM1 subjects are transfered to adult diabetes units. Transfer conditions could be a determinant factor in order to achieve an adequate treatment compliance and an optimal metabolic control.
Aims: To evaluate the impact of a specifically-designed TEP on glycemic control, self-management and quality of life after 12 months of the transfer of young subjects with DM1 from a paediatric to an adult diabetes unit.
Patients: 80 DM1 patients (age:19.0+1.3years, 39 female, DM1 duration: 7.3+1.5 years) transfered from a paediatric to an adult diabetes unit between 2000-2002 were included. Methods: The TEP included: 1) Coordinated transfer between Paediatric and Adult Diabetes Unit 2) Initial evaluation of the patient/family: A) Insuline schedule adapted to their daily life.B) Metabolic control C) Self-management abilities and knowledge (DKQ2 test): D) Weight. E) Quality of life score. 3) Pact about insulin therapy schedule and goal-setting. 4) Group sessions: 4 sessions (8 h) 5) Follow-up: 3-5 visits during 3-6 months. 6) Evaluation: Initially and after 12 months.
Results: 72/80 subjects completed the TEP. We observed an improvement of metabolic control (HbA1c 8.5+ 1.7 vs. 7.4+1.5, p<0.001) with a decrease in the number of hypoglycemic episodes (severe: 0.39 vs 0.14 episodes/patient/year, p <0.001; > 5 non-severe /week: 15 vs 0 % pacients, p=0.004). There were not differences in terms of total daily insulin dose, however an increase in the proportion of rapid-acting insulin was observed (23 vs 52%, p<0.001). After 12 months of TEP, a higher proportion of subjects were able to perform a self-adjustment of insulin doses (13 vs 48%, p<0.001). Likewise, TEP improved their knowledge in DM1 management (DKQ2. 25/35 vs 29/35, p< 0.001) without worsening the Quality of life score.
Conclusions: The use of a specifically-designed TEP achieves an improvement of metabolic control and self-management abilities without worsening the quality of life of subjects transfered from paediatric to adult diabetes units.
|
