The Effect Of Functional Insulin Therapy On Glycaemic Parameters In Type 1 Diabetes Mellitus

Education of patients with diabetes is essential in every programme, because it has important role in making the patient an active participant in achieveing key therapeutic goals of the treatment of type 1 diabetes. Th erapeutic education programme need to be structured taking into account therapeutic scheme and need to be adapted to patients needs and at the same time showing its effectiveness. This study was designed to evaluate the eff ect on glycated hemoglobin (A1C) and glycaemic profile of a structured intervention in type 1 diabetes patients. We prospectively conducted interactive 5-day education programme based on Dusseldorf model of functional insulin therapy for type 1 diabetic patients on Clinic for endocrinology, diabetes and metabolic diseases. Education programme was conducted in 7 groups of 6 patients. We analized 42 type 1 diabetes patients, mean 32,7 years of age,28 female and 14 male patients. The programme was lead by trained team of Diabetes Specialist and Nourse. All subjects complited knoweldge test about diabetes at beginning and at the end of education (40 questionare). Subjects were evaluated for 6 point glycaemic profile (7h, 9h, 13h, 15h, 18h, 20h); total daily insulin, and HbA1c at baseline, and 3, 6, 9and 12 months after the education programme. At the end of education programme the results have showen significant decrease of average blood glucose concentrations in daily profile on first and fifth day of education (10,4-11,9- 9,5- 8,8- 8,5- 8,7 mmol/l : 7,3-8,4- 8,3- 7,0- 6,8-7,3 mmol/l) (p<0,005); Average total daily insulin dose was significantly lower (39,8 : 36,5 ij, p<0,005);). Results of knowledge test after education have showen higher FIT knowledge at baseline. There was a 1,8 % reduction in HbA 1c over 6 month, and 1,2% over 12 months in comparison to baseline values. (p<0,005). HbA1C values have increased by 0,6% compared to HbA1c values aft er 6 month. Structured education programme of functional insulin therapy is associated with improved glycaemic control in type 1 diabetes patients. It motivates patient in improving glycaemic control. One year aft er there is worsening of glycaemic control due to lack of patient motivation which implies the need for yearly reeducation.