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Carbohydrate counting and insulin dose adjustment group sessions for type 1 diabetes: a pilot of their effectiveness at a primary care diabetes centre
Author(s) -
Taplin Julie,
Allen Nicola
Publication year - 2013
Publication title -
practical diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.205
H-Index - 24
eISSN - 2047-2900
pISSN - 2047-2897
DOI - 10.1002/pdi.1812
Subject(s) - medicine , diabetes mellitus , type 2 diabetes , insulin , type 1 diabetes , intervention (counseling) , physical therapy , endocrinology , nursing
It is recommended that a structured group education programme such as DAFNE (Dose Adjustment For Normal Eating) is offered to all adults with type 1 diabetes. Such programmes teach the skills of carbohydrate counting and insulin dose adjustment with the aim of improving glycaemic control (HbA 1c ) without increasing the risk of hypoglycaemia. South West Essex Community Services adult diabetes service was finding that individuals were not accessing the DAFNE programme for various reasons. A diabetes specialist dietitian and nurse decided to pilot the delivery of two 3‐hour group sessions to teach some of the basic carbohydrate counting and insulin dose adjustment skills. Changes in HbA 1c pre‐ and post‐intervention were reported for 68 subjects. The four different intervention arms compared were: those who attended just the carbohydrate counting session (n=14), those who attended both sessions (n=24), those who had attended one or both sessions and then went on to attend DAFNE (n=10), and those who had received no carbohydrate counting education (n=20). Those who had attended one or both of the 3‐hour sessions had a mean and absolute reduction in HbA 1c compared with the group that had not received any education, although this was not statistically significant. The group that had attended one or both of the 3‐hour sessions and DAFNE did achieve a statistically significant reduction in HbA 1c compared with the group that had not received any education. Despite several identified limitations to the pilot, it was felt that the delivery of the two 3‐hour carbohydrate counting and insulin dose adjustment sessions demonstrated some clinically (if not statistically) significant improvement in HbA 1c . Copyright © 2013 John Wiley & Sons.