Abstract
Objectives: To evaluate whether a course teaching flexible intensive insulin adjustment can improve both glycaemic control and quality of life in type 1 diabetes.<br />
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Design: randomized design with participants either attending training immediately (immediate DAFNE) or acting as waiting list controls and attending "delayed DAFNE" training 6 months later.<br />
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Setting: Secondary care diabetes clinics in three English health districts.<br />
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Participants: 169 adults with type 1 diabetes and moderate or poor glycaemic control.<br />
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Main outcome measures: Glycated haemoglobin (HbA 1c), severe hypoglycaemia, impact of diabetes on quality of life (ADDQoL).<br />
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Results: At 6 months, HbA 1c was significantly better in immediate DAFNE patients (mean 8.4%) than in delayed DAFNE patients (9.4%) (t=6.1, P<0.0001). The impact of diabetes on dietry freedom was significantly improved in immediate DAFNE patients compared with delayed DAFNE patients (t= -5.4, P<0.0001), as was the impact of diabetes on overall quality of life (t = 2.9, P<0.01). General wellbeing and treatment satisfaction were also significantly improved, but severe hypoglycaemia, weight, and lipids remained unchanged. Improvements in "present quality of life" did not reach significance at 6 months but were significant by 1 year.<br />
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Conclusion: Skills training promoting dietary freedom improved quality of life and glycaemic control in people with type 1 diabetes without worsening severe hypoglycaemia or cardiovascular risk. This approach has the potential to enable more people to adopt intensive insulin treatment and is worthy of further investigation.
Original language | English |
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Pages (from-to) | 1-6 |
Journal | British Medical Journal |
Volume | 325 |
Publication status | Published - 2002 |
Keywords
- Diabetes
- DAFNE training
- Quality of life
- Insulin Treatment
- Diet
- Glycaemic control