Extrait

Background and study aims Studies of diabetes care in Ireland suggest that good blood sugar control is being achieved only by a minority of patients. Medical care for a person with type 1 diabetes is usually delivered in hospital outpatient clinics and frequently involves healthcare professionals telling patients how much to adjust their insulin doses. Patients frequently lack good self-management skills. The Dose Adjustment for Normal Eating (DAFNE) programme was developed in the UK and is delivered to groups of patients with type 1 diabetes. In an evaluation in the UK the programme led to a marked improvement in blood sugar control at 6 months but this improvement diminished considerably by 12 months, probably because patients were unable to maintain the skills that they acquired. This study aims to introduce a new model of group education after patients have completed the DAFNE programme, emphasising self-management. The study will compare this new model of group education support with traditional one-to-one clinic visits. The group support model will be based on peer support and ‘expert patient’ input. This study has the potential to change the way that diabetes care is delivered and to introduce a new model of chronic disease management in Ireland. Who can participate? Patients who are already on waiting lists to complete a DAFNE course in Diabetes Centres in Ireland and Northern Ireland are able to take part. Patients must be over 18 years old, with type 1 diabetes and with a HbA1c of less than 13%. What does the study involve? Patients will be randomly allocated to receive either DAFNE and group support follow-up or DAFNE and one-to-one clinic visits. We will measure blood sugar control, frequency of hypoglycaemia (low blood sugar reactions), patient well-being and satisfaction with care (assessed using questionnaires). We will undertake in-depth interviews with some of the patients to explore how the programme influences a person’s life with diabetes. We will do a health economic analysis to ensure that the extra cost of delivering DAFNE pays for itself in terms of improvement in health outcomes. What are the possible benefits and risks of participating? Studies have reported that patients usually enjoy being involved in research. People who take part will help to answer the important question of how best to support patients after they complete a structured education programme like DAFNE. Where is the study run from? The study will be run from the Diabetes Centre in University Hospital Galway (Ireland). When is the study starting and how long is it expected to run for? The study started in January 2007 and finished in September 2011. Who is funding the study? The Health Research Board (Ireland). Who is the main contact? Mary Clare O’ Hara [email protected]

Critère d'inclusion

• Type 1 Diabetes

Liens

• ictrp
• isrctn