Evaluation of a treatment and teaching refresher programme for the optimization of intensified insulin therapy in type 1 diabetes

ObjectiveEvaluation of an ambulatory diabetes teaching and treatment refresher programme (DTTP) for the optimization of intensified insulin therapy in patients with type 1 diabetes (refresher course).Methods85 outpatients took part in this prospective multicentre trial. Metabolic and psychosocial data were analyzed at baseline (V1), 6 weeks (V2) and 12 months after DTTP (V3).ResultsIn patients with baseline HbA1c > 7% (88%), HbA1c decreased by 0.36% (p = 0.004). The percentage of patients with HbA1c ≤ 7% increased from 21.3 to 34.9% and with HbA1c above 10% decreased from 6.6 to 1.6% at V3. The incidence of hypoglycaemia decreased significantly: non severe hypoglycaemia from 3.31 to 1.39 episodes/pat/week (p = 0.001) and severe hypoglycaemia from 0.16 to 0.03 episodes/pat/year (p = 0.02). The treatment satisfaction increased by +10 of maximal ±18 points. The negative influence of diabetes on quality of life decreased from −1.93 to −1.69 points (p = 0.031).ConclusionIn a group of patients with moderately controlled diabetes type 1 who were already treated with intensified insulin therapy, metabolic control, treatment satisfaction and quality of life were improved after participation in an ambulatory DTTP without increasing insulin dosage, number of injections or insulin species.Practice implicationsThis DTTP is effective for the optimization of intensified insulin therapy.