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

To evaluate the effect of diabetes self-management education [DSME] on glycaemic control [HbA1c] in Pakistani children suffering from type-1 diabetes mellitus. Quasi-experimental study. This study was conducted at the Diabetic OPD of National Institute of Child Health, Karachi, from April to September 2009. 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. 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. In the studied group, DSME programs helped to improve glycaemic control. It should be an integral part of patient treatment in diabetic care setups