title: Evaluation of a treatment and teaching refresher programme for the optimization of intensified insulin therapy in type 1 diabetes.
abstract: OBJECTIVE
  Evaluation of an ambulatory diabetes teaching and treatment refresher programme (DTTP) for the optimization of intensified insulin therapy in patients with type 1 diabetes (refresher course).
  
  
  METHODS
  85 outpatients took part in this prospective multicentre trial. Metabolic and psychosocial data were analyzed at baseline (V1), 6 weeks (V2) and 12 months after DTTP (V3).
  
  
  RESULTS
  In patients with baseline HbA1c>7% (88%), HbA1c decreased by 0.36% (p=0.004). The percentage of patients with HbA1c≤7% increased from 21.3 to 34.9% and with HbA1c above 10% decreased from 6.6 to 1.6% at V3. The incidence of hypoglycaemia decreased significantly: non severe hypoglycaemia from 3.31 to 1.39 episodes/pat/week (p=0.001) and severe hypoglycaemia from 0.16 to 0.03 episodes/pat/year (p=0.02). The treatment satisfaction increased by +10 of maximal ±18 points. The negative influence of diabetes on quality of life decreased from -1.93 to -1.69 points (p=0.031).
  
  
  CONCLUSIONS
  In a group of patients with moderately controlled diabetes type 1 who were already treated with intensified insulin therapy, metabolic control, treatment satisfaction and quality of life were improved after participation in an ambulatory DTTP without increasing insulin dosage, number of injections or insulin species.
  
  
  CONCLUSIONS
  This DTTP is effective for the optimization of intensified insulin therapy.
authors.affiliation: Department of Internal Medicine III, University Hospital, Jena, Germany. nicolle.mueller@med.uni-jena.de
authors.forename: Nicolle
authors.initials: N
authors.lastname: Müller
authors.forename: Christof
authors.initials: C
authors.lastname: Kloos
authors.forename: Alexander
authors.initials: A
authors.lastname: Sämann
authors.forename: Gunter
authors.initials: G
authors.lastname: Wolf
authors.forename: Ulrich Alfons
authors.initials: UA
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy* / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015994:Incidence; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: ADDQoL; BMI; DAFNE; DCCT; DTSQ; DTTP; Diabetes Control and Complications Trial; Diabetes Treatment Satisfaction Questionnaire; Diabetes Treatment and Teaching Programme; Diabetes mellitus type 1; HbA1c; Hypoglycaemia; NPH; Neutral Protein Hagedorn insulin; Patient education; Treatment satisfaction; Type 1 DM; Type 1 diabetes mellitus; V; audit of diabetes-dependent quality of life; body mass index; visit