Abstract
Aims
To explore long-term outcomes of participation in a Dose Adjustment For Normal Eating
(DAFNE) training course, which provided one-off exposure to structured education in
intensive insulin therapy to people with established Type 1 diabetes.
Methods
A cohort design follow-up of original trial participants at a mean of 44 months (range:
37–51 months) in hospital diabetes clinics in three English health districts. 104
(74%) original participants provided biomedical data; 88 (63%) completed questionnaires
including the ADDQoL, measuring impact of diabetes on quality of life (QoL).
Results
At 44 months, mean improvement in HbA1c from baseline was 0.36% (9.32 ± 1.1% to 8.96 ± 1.2%, p < 0.01) remaining significant but deteriorated from 12 months (p < 0.05). Improvements in QoL seen at 12 months were sustained at 44 (e.g. impact of
diabetes on dietary freedom: −1.78 ± 2.33 at 44 months versus −4.27 ± 2.94, baseline, p < 0.0001; versus 1.80 ± 2.32 at 12 months, ns). Similar results were obtained using last observation carried
forward for patients not supplying follow-up data.
Conclusions
The impact of a single DAFNE course on glycaemic control remains apparent in the long
term, although further interventions will be required to achieve recommended HbA1c. In contrast, improvements in QoL and other patient-reported outcomes are well maintained
over approximately 4 years.
Abbreviations:
ADDQoL (Audit of Diabetes-Dependent Quality of Life), ANOVA (analysis of variance), BMI (body mass index), DAFNE (Dose Adjustment For Normal Eating), DCCT (Diabetes Control and Complications Trial), DTSQ (Diabetes Treatment Satisfaction Questionnaire), HbA1c (haemaglobin A1c), HDL (high-density lipoprotein), QoL (quality of life), STTP (Structured Teaching and Treatment Programme)Keywords
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Article info
Publication history
Published online: April 20, 2010
Accepted:
March 16,
2010
Received:
February 26,
2010
Footnotes
☆For access to questionnaires used, please visit www.healthpsychologyresearch.com.
Identification
Copyright
© 2010 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
