Abstract
Objective Several studies evaluated inpatient diabetes teaching and treatment programmes (DTTP)
in diabetes type 1 (DM1) many years ago, but in these studies insulin treatment was
not yet intensified before the DTTP. Today, most patients are already on intensified
insulin treatment before entering a DTTP. The aim of this trial was to evaluate the
outcome one year after participation in an inpatient intervention including a DTTP
in a longitudinal study.
Methods 109 patients participated in an inpatient intervention in 2014. All individuals were
invited to participate in an outpatient follow-up visit after one year.
Results Ninety participants (52.2% female, age 48.0 y, diabetes duration 19.1 y, 31.1% CSII,
HbA1c 7.9% / 63.3 mmol/mol) were followed-up after 1.2±0.3 y [1 died, 18 declined / were
not available]. 83 / 90 individuals participated to optimise diabetes therapy, 7 / 90
had newly-diagnosed DM1. In the optimisation group, HbA1c decreased by 0.4% (p=0.009)
without change of insulin dose (54 IU/day before and after) or BMI (26 kg/m2 before and after). In people with baseline HbA1c ≥7.5% (n=26 / 83), HbA1c decreased
by 0.9%. The frequency of severe hypoglycaemia decreased from 0.22 to 0.05 events / year
(p=0.045). In people with frequent non severe hypoglycaemia (n=8), events decreased
from 4.5±2.0 to 2.8±0.9 / week (p=0.358). Systolic (−6.5 mmHg, p=0.035) and diastolic
(−3.4 mmHg, p=0.003) blood pressure improved without change of number of antihypertensive
medication (1.9±2.1 vs. 1.8±2.0, p=0.288).
Conclusions In people with DM1, metabolic control improved after the inpatient intervention without
increasing insulin dosage or BMI. The inpatient intervention remains effective to
substantially improve metabolic control under the present circumstances of care.
Key words
diabetes type 1 - diabetes treatment and teaching programme - hypoglycaemia - patient
education
