Initiation of insulin adjustment for carbohydrate at onset of diabetes in children using a home-based education programme with a bolus calculator

摘要

Improved glycaemic control following diagnosis of type 1 diabetes is associated with improved control in the longer term. This study reports on the experience of a paediatric diabetes service that introduced insulin adjustment for blood glucose and carbohydrate meal content from the first day of diagnosis. This is provided via a newly-designed home education programme, using multiple daily injections of insulin, supported by a bolus calculator blood glucose meter.Glycaemic control was compared between patients who received the new programme (those diagnosed July 2012 to March 2014) to two historical cohorts: January 2000 to December 2009 and January 2010 to June 2012. The primary outcome was HbAk at 4-6 months post-diagnosis. Secondary outcomes were HbAk at 10-12 months post-diagnosis and the percentage of patients achieving HbAic of <58mmol/mol in the first 12 months.