Type 1 diabetes from adolescence to adulthood: is there a permanent need for nutrition education and re-education?
BACKGROUND
The transition for type 1 diabetes patients from pediatric to adult diabetology care is challenging process for both medical team and patients. Adult diabetology usually insists on stricter goals and focuses on increased empowerment and self-care. We set to find a more practical and effective way to determine patient knowledge and skills during the transition. The aim of the study was to identify screening questions which best represent knowledge in management of type 1 diabetes and to explore the differences in the effect of a structured educational program for type 1 diabetes patient diagnosed in childhood versus adulthood.


METHODS
It was an observational study exploring effect of a structured educational program for 39 participants diagnosed with type 1 diabetes in childhood (group 1) vs. 20 patients diagnosed in adulthood (group 2). Main outcome measures were A1C and knowledge questionnaire results change before and after education.


RESULTS
The effect of education was equal in both groups, with higher basal level of knowledge in group 1. There was a significant correlation between questions regarding carbohydrate counting and A1C after 3 and 6-12 months in group 1. We found that questions regarding carbohydrate counting may predict glycemic control and represent general knowledge.


CONCLUSIONS
Carbohydrate counting is crucial in predicting glycemic control and representing general knowledge about diabetes. Patients diagnosed in childhood may be more knowledgeable in diabetes management, but their practical skill in matching insulin dose and carbohydrate content is poor. Both groups improved their knowledge in similar proportion with same educational program.
Internal Clinic, Department of Endocrinology, University Hospital Centre Zagreb, Zagreb, Croatia - maja.simek@zg.t-com.hr.
Maja
M
Baretić
Internal Clinic, Department of Endocrinology, University Hospital Centre Zagreb, Zagreb, Croatia.
Martina
M
Matovinović Osvatić
Department of Nutrition and Dietetics, University Hospital Centre Zagreb, Zagreb, Croatia.
Eva
E
Pavić
Internal Clinic, Department of Endocrinology, University Hospital Centre Zagreb, Zagreb, Croatia.
Nada
N
Rabađija
Department of Nutrition and Dietetics, University Hospital Centre Zagreb, Zagreb, Croatia.
Valentina
V
Uroić
School of Medicine, University of Zagreb, Zagreb, Croatia.
Carolina
C
Koletić
Department of Pediatric Endocrinology and Diabetes, University Hospital Centre Zagreb, Zagreb, Croatia.
Nataša
N
Rojnić Putarek
Internal Clinic, Department of Endocrinology, University Hospital Centre Zagreb, Zagreb, Croatia.
Ivana
I
Pavlić Renar
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011209:Power, Psychological; D012648:Self Care; D055815:Young Adult