Type 1 Diabetes Mellitus Clinical Trial
Official title:
Improving Management of Type 1 Diabetes in the UK: The DAFNE Programme as a Research Test-bed - 5 x 1 Day RCT
The best format for the delivery of structured education for adults with Type 1 diabetes is unclear. Currently some hospitals invite their patients to attend a 5 day outpatient course run over one week (Dose Adjustment For Normal Eating (DAFNE)). Other centres offer 1 day a week for 3 to 5 weeks. We aim to find out whether or not the benefit of benefits are the same then it would mean that the course could routinely be offered to patients in either format, thus allowing more patient choice and flexibility.
The DAFNE (Dose Adjustment for Normal Eating) course is a 1-week structured education course
teaching skills in insulin use and dietary freedom to individuals with Type 1 diabetes. At
the moment, we do not understand enough about why some people get more out of the DAFNE
programmes than others. Currently DAFNE is always taught over 1 week. We aim to find out
whether or not the benefit of DAFNE is the same whether it is delivered over 5 consecutive
days, or one day a week for 5 consecutive weeks. If the benefits are the same then it would
mean that the course could routinely be offered to patients in either format, thus allowing
more patient choice and flexibility. At present there have been no RCTs to address
Approximately 170 people will take part in this study over the next 2 years. Half the people
who participate will be allocated to attend a DAFNE course over 5 consecutive days, and the
other halfwill attend one day a week for 5 consecutive weeks. We will perform routine
biomedical assessments as part of the DAFNE programme and normal diabetes care (e.g. HbA1c
(a measure of long-term blood glucose control), weight, blood pressure, blood biochemistry),
and ask patients to recall hypoglycaemic (low blood sugar) events. We will also ask
participants to fill in some research questionnaires, they will take 45-60 minutes to fill
in each time. They will include questions about their diabetes, quality of life, well-being
and diabetes knowledge. These assessments will be made at 3 time points; baseline, 6 and 12
months.
The main outcome measure is change in HbA1c, with the other biomedical and psychosocial
parameters being of secondary importance. These evaluations will help us develop the DAFNE
programme further and inform us how best to deliver the course in the future.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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