Background
Effective education is considered essential for people with type 1 diabetes mellitus (T1DM) to adhere to a complex and long‐term medical regimen and to delay or prevent the onset of diabetes‐related complications.
Objective
We compared the effect of a compact, cost‐effective, education program (CEPT1) vs a long‐term program on the metabolic control of children and adolescents with T1DM.
Methods
Young people aged 8 to 21 years with T1DM were randomized to a short‐term (experimental) or an extensive education program (control). The experimental group participated in three sessions of 90 minutes, with one session per week, containing five short videos. The control group attended an extended program delivered through 45‐minute PowerPoint lectures, with one class every 3 months. The primary outcome was change in glycated hemoglobin A1c (HbA1c) levels from baseline to endpoint (baseline, 3, 6, 9, and 12 months).
Results
In total, 62 patients were randomized to the experimental (CEPT1) (n = 32) or control (n = 30) groups. Both groups showed comparable improvement in HbA1c levels at the end of 12 months (P = .183). In a per‐protocol analysis, the mean HbA1c level reduction was −2.3% (−2.6, −2.0) in the experimental group and − 1.8% (−2.0, −1.5) in the control group (P = .008).
Conclusion
CEPT1 was comparable with an extensive education program in reducing HbA1c levels. In a per‐protocol analysis, the CEPT1 was more effective than the control program in reducing HbA1c levels. CEPT1 is a simple and cost‐effective tool that can equally be used in settings with limited resources and specialized centers.
The aim of the present study is a literature revision of the contribution of continuous glucose monitoring system (CGMS) in the interpretation of HbA1c levels in type 1 diabetes (T1DM). We performed a revision of the efficacy, benefits, interpretation of methods and experience with this system. The CGMS could be useful in T1DM patients that present great glycemic variability or severe hypoglycemia (mainly nocturnal) and postprandial hyperglycemia. The identification of altered patterns or the glycemic variability allows therapeutic adjustment and improvement of the metabolic control. CGMS is a safe method with a rare occurrence of side effects and it is well-tolerated by patients. The extension of the procedure for more days, over the 72h period recommended by the standard test, allows us to get important data to changes and adjustments on the insulin management of the type 1 diabetes mellitus patients.
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