Effects of diabetes self-management education on glycaemic control in children with insulin-dependent diabetes mellitus.

OBJECTIVE To evaluate the effect of diabetes self-management education (DSME) on glycaemic control (HbA1c) in Pakistani children suffering from type-1 diabetes mellitus. STUDY DESIGN Quasi-experimental study. PLACE AND DURATION OF STUDY This study was conducted at the Diabetic OPD of National Institute of Child Health, Karachi, from April to September 2009. METHODOLOGY Sixty children with a mean age of 9.94 years with type-1 Diabetes mellitus (T1DM) were selected conveniently from the diabetic OPD. The patients along with their parents/caregivers attended a modular series of diabetes self-management education program consisting of 2 sessions. Customized program was designed to educate children regarding general information about the disease, basic insulin therapy, planning for hypoglycaemia, hyperglycaemia, activity, traveling and basic nutritional management. It was conducted by a multidisciplinary paediatric diabetes team including an endocrinologist, general paediatrician, nutritionist and diabetic nurse. The educational sessions were followed by monthly revision exercises. HbA1c levels were measured at baseline and after 3 months and compared using paired sample t-test. RESULTS Out of a total of 60 patients, 50 completed the trial. There was a significant decrease in the HbA1c levels after the DSME program. The mean pre- and postintervention HbA1c levels were 9.67±0.65 and 8.49±0.53 respectively with a p-value < 0.001. CONCLUSION In the studied group, DSME programs helped to improve glycaemic control. It should be an integral part of patient treatment in diabetic care setups.