title: The Tayside insulin management course: an effective education programme in type 1 diabetes.
abstract: OBJECTIVE
  The Tayside insulin management (TIM) course is an intensive insulin management programme for adults with type 1 diabetes. The aim was to assess its effectiveness.
  
  
  METHODS
  Haemoglobin A1c (HbA1c) and body mass index (BMI) from individuals with type 1 diabetes were collected 3 months before, and 6 and 24 months after the programme. The programme involved a full day of education per week for 4 weeks in a row. Quality of life was assessed using the standardised Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire completed both before and 3 months after the course. Subjects were also asked to complete a pre- and postcourse questionnaire gathering information about aspects of their diabetes management. In addition, individual satisfaction with course content and delivery was recorded.
  
  
  RESULTS
  Participants had a median reduction in haemoglobin A1c (HbA1c) of 4 mmol/mol (0.4%) after 6 months and 5 mmol/mol (0.5%) 2 years after the course (p < 0.001). Mean daily dose of short-acting insulin decreased from 31.5 (1.9) units to 27.3 (1.9, p < 0.001). There was no significant change in BMI. There was an improvement in all 18 domains of the ADDQoL questionnaire. There was a decrease in hypoglycaemia unawareness from 34.3 ± 47.8% of patients to 8.6 ± 28% (p < 0.001), and a decrease in self-reported lipohypertrophy from 27.8% to 11.1% (p = 0.001). There was a significant reduction in the mean number of diabetic ketoacidosis and severe hypoglycaemic episodes. The number of blood glucose checks changed from 2.8 ± 2.1 to 3.2 ± 1.1 (p = 0.058) per day. Participant satisfaction with all aspects of course content and delivery was high.
  
  
  CONCLUSIONS
  TIM is an effective intensive education programme for patients with type 1 diabetes.
authors.affiliation: Department of Diabetes, Ninewells Hospital, Dundee, UK. laurajordan@nhs.net
authors.forename: L V M
authors.initials: LV
authors.lastname: Jordan
authors.forename: M
authors.initials: M
authors.lastname: Robertson
authors.forename: L
authors.initials: L
authors.lastname: Grant
authors.forename: R E L
authors.initials: RE
authors.lastname: Peters
authors.forename: J T
authors.initials: JT
authors.lastname: Cameron
authors.forename: S
authors.initials: S
authors.lastname: Chisholm
authors.forename: D J
authors.initials: DJ
authors.lastname: Voigt
authors.forename: L
authors.initials: L
authors.lastname: Matheson
authors.forename: E J
authors.initials: EJ
authors.lastname: Kerr
authors.forename: K
authors.initials: K
authors.lastname: Maclean
authors.forename: R R
authors.initials: RR
authors.lastname: Macalpine
authors.forename: E
authors.initials: E
authors.lastname: Wilson
authors.forename: A D R
authors.initials: AD
authors.lastname: Mackie
authors.forename: N M
authors.initials: NM
authors.lastname: Summers
authors.forename: T
authors.initials: T
authors.lastname: Vadiveloo
authors.forename: G P
authors.initials: GP
authors.lastname: Leese
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D061266:Insulin, Short-Acting / Q000008:administration & dosage*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D061266:Insulin, Short-Acting