Efficacy of an Education Program for People With Diabetes and Insulin Pump Treatment (INPUT): Results From a Randomized Controlled Trial

Faculty/Professorship: Clinical Psychology and Psychotherapy  
Author(s): Kulzer, Bernhard ; Schipfer, Melanie; Lippmann-Grob, Bernhard; Haak, Thomas; Hermanns, Norbert  ; Ehrmann, Dominic  
Title of the Journal: Diabetes Care
ISSN: 0149-5992
Corporate Body: American Diabetes Association
Publisher Information: Alexandria, Va.
Year of publication: 2018
Volume: 41
Issue: 12
Pages: 2453-2462
Language(s): English
DOI: 10.2337/dc18-0917
OBJECTIVE Continuous subcutaneous insulin infusion (CSII) is the most advanced form of insulin delivery, but it requires structured education to provide users with the necessary knowledge/skills and to support their motivation. Currently, no structured education program designed to provide this training has been evaluated. We developed a CSII-specific, structured education program (Insulin Pump Treatment [INPUT]) and evaluated its impact on glycemic control, behavior, and psychosocial status.

RESEARCH DESIGN AND METHODS This was a multicenter, randomized, parallel trial with a 6-month follow-up. Eligible participants (age 16–75 years) currently were treated with insulin pump therapy. Participants were randomly assigned (1:1) to the INPUT program or to usual care using a computer-generated algorithm, with study center as the stratification factor. The primary outcome was HbA1c change from baseline to 6 months. Secondary outcomes were incidence of severe hypoglycemia and changes in behavioral and psychosocial measures.

RESULTS Between 1 April 2016 and 26 April 2016, 268 people with diabetes and a mean duration of CSII therapy of 9.5 years were randomly assigned to the INPUT group (n = 135) or control group (n = 133). At 6 months, HbA1c improved in the INPUT group (8.33 ± 0.8 vs. 8.04 ± 0.9; P < 0.0001) but not in the control group (8.33 ± 1.0 vs. 8.27 ± 1.0; P = 0.11). The between-group difference in HbA1c reduction was significant, favoring INPUT (−0.28% vs. −0.06%, Δ −0.22%, 95% CI −0.38 to −0.06; P = 0.0029). The incidence rate ratio of severe hypoglycemia was 3.55 times higher for participants in the control group than for those in the INPUT group (95% CI 1.50–8.43; P = 0.0041).

CONCLUSIONS The INPUT education program led to a significant improvement in glycemic control and incidence of severe hypoglycemia in insulin pump users.
Keywords: Diabetes, Psychoedukation, Education
Peer Reviewed: Ja
International Distribution: Ja
Type: Article
URI: https://fis.uni-bamberg.de/handle/uniba/45111
Year of publication: 7. January 2019