Comparison of the effects of diabetes education for patients with MDI vs. CSII therapy
Kulzer, Bernhard; Ehrmann, Dominic; Bergis-Jurgan, Nikola; u. a. (2017): „Comparison of the effects of diabetes education for patients with MDI vs. CSII therapy“. Bamberg: opus.
76th ADA Scientific Sessions, 10 - 14 June 2016 ; New Orleans, Louisiana, U.S.
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Ursprünglich in: Diabetes : the journal of the American Diabetes Association 65 (2016), Suppl 1, A178 (688-P)
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Structured diabetes education for patients with type 1 diabetes is a cornerstone of the therapy. However, it is unclear whether patients with MDI and CSII equally benefit from diabetes education. In a prospective analysis, we investigated the differential effects of diabetes education on patients with MDI and CSII therapy. A total of 409 patients with type 1 diabetes that participated in a diabetes education course were analyzed. The education course consisted of 12 lessons and was conducted as a group program for 3-8 patients. 19% of the patients were treated with an insulin pump. Prior to the education course and six months after the end of the education course, HbA1c was measured and patients completed questionnaires assessing diabetes distress and hypoglycemia unawareness. At baseline, patients with CSII therapy did not differ from MDI patients with regard to age (43.8 ± 14.0 vs. 44.1 ± 13.6 years, p=.86), gender (47% vs. 42% female, p=.42), glycemic control (8.1 ± 1.3 vs. 8.1 ±1.1 %, p=.81), hypoglycemia unawareness (1.6 ± 1.5 vs. 1.7 ±1.8, p=.93), and diabetes distress (1.1 ±0.9 vs. 1.1 ± 10.7, p=.93). CSII patients had a significantly longer diabetes duration than MDI patients (22.0 ±10.8 vs. 11.0 ±12.3 years, p<.01). After 6 months, HbA1c reduction was significantly lower in CSII patients than in MDI patients (-0.0 ±0.7 vs. -0.4 ±1.1%, p=.01). Improvements in hypoglycemia unawareness (0.5 ± 11.4 vs. 0.4 ±1.4, p=.32) and diabetes distress (-0.3 ±0.6 vs.-0.2 ±0.6, p=.13) were comparable. At baseline, glycemic control of CSII patients was not better than that of MDI patients despite the fact that CSII therapy is the best available therapy option for patients with type 1 diabetes. Furthermore, CSII patients did benefit less from diabetes education than MDI patients. Specific interventions are needed to address the special needs of patients performing a CSII therapy. In a group setting, it can be questioned whether CSII and MDI patients should be mixed.
August 3, 2017