Education programmes for persons with type 1 diabetes using an insulin pump: A systematic review

Abstract

Education is essential in insulin pump therapy, but literature in the field is limited. We systematically reviewed insulin pump education programmes and their effects in two situations as follows: (1) basic education at the start of insulin pump therapy, providing the study design enabled us to separate the effects of insulin pump therapy itself from the effects of education and (2) re‐education of experienced pump users. Population: individuals ≥16 years with type 1 diabetes using insulin pumps with or without continuous glucose monitoring. Systematic searches were run in MEDLINE, Embase, CINAHL and ERIC. Original studies reporting an effect of insulin pump education programmes were included if published in English between January 1999 and May 2019. Of 988 potentially relevant studies, 48 were assessed in full text. Nine studies fulfilled the inclusion criteria, including one randomised controlled trial. Educational approaches and settings were sparsely described in all studies, and the content was usually reported as teaching points. Two studies considered basic education, reporting evaluations of knowledge and application skills, and programme satisfaction. The remaining seven studies referred to re‐education. Two studies measured severe hypoglycaemic events before and after a re‐education intervention, both reporting a significant event reduction. HbA1c decreased significantly in three of four studies. Two studies reported increased knowledge and improved application skills. In conclusion, this review indicates benefits from basic education and from re‐education. The strength of the conclusions is limited by the low number of studies and study designs. High‐quality studies are needed comparing different approaches for insulin pump education.

2021 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association

“…The recommended glycemic target for patients with type 1 diabetes mellitus (T1DM) is an A1C <7.0% (RCT, General). All patients with T1DM should be systematically trained to adjust their insulin dose so that they can have flexible meals (RCT, General) [51][52][53][54]. The level of understanding following education and performance among patients with T1DM should be evaluated, and patients should receive regular feedback following a diagnosis of diabetes (Expert opinion, General).…”

Knowledge and Practices of Insulin Pump among Adults with Type 1 Diabetes Attending a Specialized Center in Saudi Arabia

“…It has been suggested that comprehensive patient education and frequent Blood Glucose Monitoring (SMBG or CGM) are necessary components of successful insulin pump therapy [8,14]. Additionally, several studies confirmed the benefits of patient education in improving the glycemic control [26]. Given the fact that insulin pump is a life-long therapy, education and training should be a continuous and customized process [8,27].…”

Insulin Pump Treatment in Adults with Type 1 Diabetes in the Capital Region of Denmark: Design and Cohort Characteristics of the Steno Tech Survey

“…Questionnaire content was informed by preceding works by the Steno Tech study group, including systematic literature reviews [ 19 , 20 , 33 ] and an interview study with insulin pump users [ 24 ] that explored possibilities and barriers to effective daily insulin pump management. The Steno Tech study group is an interdisciplinary collaboration of researchers and clinicians with extensive experience in type 1 diabetes and insulin pump treatment.…”

“…As such, to ensure safe and effective insulin pump use, it is recommended that people with T1D receive structured and recurring education [11,12,15]. However, there is currently no consensus on the best educational practice for a given patient [15,16], and there is a paucity of high-quality comparative studies regarding the effectiveness of insulin pump education [17][18][19]. Furthermore, psychosocial factors, such as self-efficacy, emotional (diabetes) distress and fear of hypoglycaemia, may also impact the use of technology and treatment outcomes, although the number of quantitative studies analysing the impact of these factors is limited [20,21].…”