An evaluation of the carbohydrate, insulin collaborative education (CHOICE) programme for young people with type 1 diabetes

Abstract

This thesis explores the effectiveness of structured diabetes education for adolescents with Type 1 diabetes.

Aims: A multi-centre pragmatic randomized controlled trial to determine whether structured education can be used to improve glycaemic control, perceived quality of life, perceived empowerment and self-management strategies of adolescents at 1, 3 and 6 months post intervention.

Methods: Adolescents diagnosed with Type 1 Diabetes for at least 1 year were recruited from 7 hospitals within Northern Ireland. Outcome measures included HbA 1 c, QoL, empowerment and self-management strategies. Data were analysed on an intention to treat basis using AN OVA models.

Results: 136 adolescents were randomized, 68 to control group (CG), and68 to structured education group (EG). There was no difference in HbA1cbetween groups post intervention despite the increased dietary freedom of the EG. Those within EG reported significantly higher perception of control (p~ .005). Impact on quality of life was significantly reduced for the EG at months 1 and 3 post intervention (p ~ .05, P ~ .05). Those within the EG reported improved dietary adherence (p = .00) when compared to CG. Although those within the EG reported Significantly increased empowerment from baseline (p ~ .01) this was not group dependent.

Conclusions: This study found that structured education reduced the impact of diabetes on quality of life and increased dietary adherence. These effects reduced over time suggesting the need for further support post education. Issues of numeracy and literacy became apparent during the trial and need to be considered in future studies. Despite the increased dietary freedom no deterioration in HbA 1 c was noted between groups.

Date of Award	Dec 2010
Original language	English
Sponsors	Diabetes UK, Roche Diagnostics GmbH, Research and Development Office (NI) & Royal Belfast Hospital for Sick Children, Belfast
Supervisor	Vivien Coates (Supervisor) & Mark Shevlin (Supervisor)