Clinical effectiveness of a brief educational intervention in Type 1 diabetes: results from the BITES (Brief Intervention in Type 1 diabetes, Education for Self-efficacy) trial

Aims Intensive 5‐day educational interventions for people with Type 1 diabetes have shown improved outcomes in a number of European studies. The aim was to assess the effectiveness of a brief (2.5 days) psycho‐educational intervention. Methods Our randomized trial in a secondary‐care setting had 5...

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Published in:	Diabetic medicine Vol. 25; no. 12; pp. 1447 - 1453
Main Authors:	George, J. T., Valdovinos, A. P., Russell, I., Dromgoole, P., Lomax, S., Torgerson, D. J., Wells, T., Thow, J. C.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-12-2008 Blackwell
Subjects:	Adult Biological and medical sciences Diabetes Mellitus, Type 1 - pathology Diabetes Mellitus, Type 1 - therapy diabetes treatment satisfaction Diabetes. Impaired glucose tolerance educational intervention Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology glycaemic control Glycated Hemoglobin A - chemistry Glycated Hemoglobin A - metabolism Humans Hypoglycemia - pathology Hypoglycemia - therapy Male Medical sciences Middle Aged Original Patient Education as Topic Risk Reduction Behavior self-efficacy Treatment Outcome Type 1 diabetes Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology Endocrinopathy Bite Satisfaction Autoimmune disease Brief intervention Teaching Result Education self-efficacy Self efficacy Clinical trial Nutritional status Immunopathology Obesity Nutrition diabetes treatment satisfaction Nutrition disorder Metabolic diseases educational intervention Treatment Surveillance Type 1 diabetes glycaemic control Endocrinology Glycemia
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Summary:	Aims Intensive 5‐day educational interventions for people with Type 1 diabetes have shown improved outcomes in a number of European studies. The aim was to assess the effectiveness of a brief (2.5 days) psycho‐educational intervention. Methods Our randomized trial in a secondary‐care setting had 54 and 60 participants allocated to intervention and control groups, respectively. Primary outcomes were HbA1c and severe hypoglycaemia. Secondary outcomes were blood pressure, weight, height, lipids and psychometric profile. Results HbA1c showed no statistically significant change at 3 months [difference = 0.01, 95% confidence interval (CI) –0.23, 0.26, P = 0.92], 6 months (difference = –0.06, 95% CI –0.32, 0.20, P = 0.67) and 12 months (difference = 0.01, 95% CI –0.30, 0.32, P = 0.94). Incidence of severe hypoglycaemia (per patient per year) in the intervention group (0.41) and control group (0.48) was not statistically different. Treatment satisfaction improved at 3 months (difference = 9.4, 95% CI 5.2, 13.6, P = 0.0005), 6 months (difference = 10.4, 95% CI 6.0, 14.8, P = 0.0005) and 12 months (difference = 7.1, 95% CI 2.1, 12.1, P = 0.006). The ‘Managing psychological aspects’ and ‘Setting and achieving goals’ dimensions of the Diabetes Empowerment Scale also showed significant improvement at 3, 6 and 12 months. Diabetes Knowledge Test, Illness Perception Questionnaire, Hypoglycaemia Fear Scale and Short Form 36 showed no significant change. Conclusions This brief intervention had no significant impact on HbA1c or severe hypoglycaemia, but improved diabetes treatment satisfaction and patient empowerment. Current Controlled Trials ISRCTN75807800.
Bibliography:	istex:8239481E1FAC71F262F3A113726E6FE46F22D373 ark:/67375/WNG-XLXZ5T6F-K ArticleID:DME2607 Re‐use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23 Diabet. Med. 25, 1447–1453 (2008)
ISSN:	0742-3071 1464-5491
DOI:	10.1111/j.1464-5491.2008.02607.x