Background: High quality structured education is a fundamental part of type 1 diabetes care. To achieve this, the Self-Management and Review of Type 1 Intensive Education (SMaRT1E) programme was developed in West Australia based on DAFNE and similar UK courses.
Aim: Evaluate the effect of SMaRT1E educational programme on glycaemic control, weight gain and psychological wellbeing in patients with type 1 diabetes.
Setting: SMaRT1E is been conducted in Rockingham General Hospital (RGH), a secondary care hospital and Fiona Stanley Hospital (FSH) a tertiary care hospital, both in West Australia.
Method: Data was analysed from patients who attended SMaRT1E at either RGH or FSH. Standard metabolic and psychosocial data are collected at baseline, three months and 12months following course completion.
Results: There were total 324 participants. 143 (44%) were male, mean age was 41 years. All had type 1 diabetes. 248 (77%) attended RGH and 76 (24%) attended FSH. In total 262 (80%) completed the course.
Mean HbA1c improved from 8.7% at baseline to 8.2% at 3months and 8.4% at 12months. There was no increase in hypoglycaemia episodes. A reduction in severe hypoglycaemia requiring hospital admissions was noted. There was no increase in weight: mean weight at baseline 78.4kg, three months 78.7kg and at 12months 78.5kg. There were reductions in mean frequency of hospital admissions with DKA from baseline (0.13) to 3 months (0.04) and 12 months (0). There was reduction in diabetes related distress.
Limitations: Some participants failed to attend all sessions of the programme therefore data is incomplete for some measurements.
Conclusion:
We demonstrated that the SMaRT1E education programme for type 1 diabetes achieved lower HbA1c, decreased hospital admissions for DKA, severe hypoglycaemic episodes and diabetes related distress with no weight gain.