1. Structured Education for Type 1 Diabetes Ruth Miller Lead Diabetes Nurse Royal Free Hospital

2. background DCCT 1993 (Diabetes control & complications trial)
Conclusions could be interpreted that higher level of educational input supported improved Hba1c

3. German Education Model
In 1990’s Several UK centres visited Germany to see how the German diabetes education model worked. Their results demonstrated:
Improved hba1c
Reduced hypoglyceamia
This led to DAFNE and programmes for T2DM with strong evidence base

4. Types of courses
T1DM
dafne & bertie
T2DM
desmond & Xpert

5. UCLH Have 408 patients DAFNE trained at UCLH.
2014: have trained 35 and running 11 courses.

6. RFH Have 350 patients trained on Type 1 Course 5 courses per year
Structured education course for patients on insulin pump therapy
2 courses per year
40 patients annually

7. structured education courses
What are they and how do they differ from one to one consultations?
Curriculum
Group effect and learning from peers
Cost effective

8. objectives
To create an open and non judgemental space where individuals can ask questions and learn from peers
To question negative feelings associated with T1DM
Teach the principles of matching insulin doses to meals by counting carbohydrate
Provide real life experience to support people to manage diabetes in their own lives

9. RFH Audit 2012 140 patients audited
Around 40 patients complete course annually
59% reduced HbA1c 6/12 post course average reduction 1.1%
19% Had no significant change in HbA1c
Many patients referred to RFH with hypo unawareness

10. Audit continued..
Many patients reported improved hypo awareness post course
14% increase in HbA1c ( most of these had psychological barriers e.g depression, eating disorder, recent death of a relative or significant illness) 
Quality of life scores showed significant improvements in well being and satisfaction with treatment

11. DOH/DUK key criteria Learning theory philosophy Curriculum
Trained educators
Quality assured (peer review)
Audited
QISMET ratification/validation quality institute for self management educating and training