Impact of a special therapeutic education programme in patients transferred from a paediatric to an adult diabetes unit

Authors

  • M Vidal
  • M Jansa
  • C Anguita
  • M Torres
  • M Giménez
  • E Esmatjes
  • I Levy
  • I Conget

DOI:

https://doi.org/10.1002/edn.5

Keywords:

type 1 diabetes mellitus, young adults and adolescence, transition to adult diabetes units

Abstract

Abstract

The control of type 1 diabetes (T1D) in young subjects is especially troublesome in adolescence. In this period, young T1D subjects are usually transferred to adult diabetes units. Transfer conditions could be a determinant factor to achieve adequate treatment compliance and optimal metabolic control.

The aim of this study was to evaluate the impact of a specifically designed transition therapeutic education programme (TEP) on glycaemic control, self-management and quality of life, 12 months after the transfer of young subjects with T1D from a paediatric to an adult diabetes unit.

The study included 80 young T1D subjects (aged 19.0±1.3 years, 39 females, T1D duration 7.3±1.5 years) transferred from a paediatric to an adult diabetes unit during 2000–2002. The transition TEP included the following. (1) Co-ordinated transfer between the paediatric and adult diabetes unit. (2) Initial evaluation of the patient/family regarding: (a) insulin schedule; (b) metabolic control; (c) self-management abilities and knowledge (DKQ2 test); (d) weight; and (e) quality of life score. (3) Pact about the insulin therapy schedule and goal-setting. (4) Group sessions: four sessions (two hours each). (5) Follow up: three to six visits during three to six months. (6) Evaluation: initially and 12 months after the transfer.

In all, 72 out of 80 subjects completed the TEP. We observed an improvement in metabolic control (HbA1c 8.5±1.7 vs 7.4±1.5, p<0.001) with a decrease in the number of hypoglycaemic episodes (severe: 0.39 vs 0.14 episodes/patient/year, p<0.001; >5 non-severe/weak: 15% vs 0% patients, p<0.005). There were no differences in terms of total daily insulin dose. However, an increase was observed in the proportion of rapid-acting insulin (23% vs 52%, p<0.001). After 12 months of TEP, a higher proportion of subjects were able to perform self-adjustment of insulin doses (13% vs 48%, p<0.001). Likewise, TEP improved their knowledge in T1D management (DKQ2 25/35 vs 29/35, p<0.001) without worsening the quality of life score.

In conclusion, the use of a special transition TEP achieves an improvement in metabolic control and self-management abilities without worsening the quality of life of young T1D subjects transferred from a paediatric to an adult diabetes unit.

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References

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Published

2004-04-01

How to Cite

Vidal, M., Jansa, M., Anguita, C., Torres, M., Giménez, M., Esmatjes, E., Levy, I., & Conget, I. (2004). Impact of a special therapeutic education programme in patients transferred from a paediatric to an adult diabetes unit. International Diabetes Nursing, 1(1), 23–27. https://doi.org/10.1002/edn.5

Issue

Vol. 1 No. 1 (2004)

Section

Research Article

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