Intensive structured education for type 1 diabetes management using BERTIE: Long-term follow-up to assess impact on glycaemic control and quality of life indices.

AIMS

Bournemouth Type 1 Intensive Education (BERTIE) is a structured education course delivered 1 day a week for 4 weeks for self-management of type 1 diabetes. BERTIE outcomes were analysed to assess long-term effectiveness: primary outcome assessed impact of BERTIE on glycaemic control, secondary outcomes assessed impact on Problem Area in Diabetes (PAID) scale, severe hypoglycaemia and diabetic ketoacidosis incidence (DKA).

METHODS

Prospectively collected outcome data from attendees included glycated haemoglobin (HbA1c), PAID, severe hypoglycaemia and DKA incidence recorded pre-course, 6 months and 1 year post-attendance, with HbA1c assessed annually at subsequent clinic visits.

RESULTS

Between 1999 and 2015, 524 people attended BERTIE with 5 year follow-up in 316 (60.3%) attendees. HbA1c was reduced from 74 ± 17 mmol/mol (8.9 ± 1.6%) at baseline to 71 ± 15 mmol/mol (8.6 ± 1.4%) at 1 year and 70 ± 15 mmol/mol (8.6 ± 1.3%) at 5 years (p < 0.0001); severe hypoglycaemia incidence reduced from 0.8 ± 2.1 to 0.4 ± 2.2 episodes/person/year at 1 year (p < 0.0001); PAID scale reduced from 23 ± 16 to 15 ± 12 (p < 0.0001) at 1 year; DKA incidence was 0.06 ± 0.34 episodes/person/year pre-course and 0.03 ± 0.21 at 1 year (p = 0.5271).

CONCLUSIONS

BERTIE outcome data demonstrate favorable biochemical and psychological outcomes supporting recommendations that structured education be provided to adults with type 1 diabetes.