What happens after FlexIT education? Looking at and beyond clinical data. — ASN Events
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What happens after FlexIT education? Looking at and beyond clinical data. (#28)

Rebecca Stiegler 1 , Dianna Magliano 1 , Sonia Middleton 1 , Enisa Kasar 1 , Hanan Derraz 1 , Lisa Engel 1 , Tanith Lamaro 1 , Cameron Johnson 1 , Michele Mack 1
  1. Baker IDI Heart & Diabetes Institute, Prahran, VIC, Australia

Background: Baker IDI conducts a group education program called ‘FlexIT – Flexible Insulin Therapy’ for people with type 1 diabetes on MDI. FlexIT principles include insulin adjustment for carbohydrate intake and lifestyle factors..

Aim: To evaluate changes in post-program patient clinical outcomes, hypoglycaemia, knowledge, behaviours and self-perception of control and confidence in diabetes management.

Method: Data collection included background data and three time points; pre, post-program and 12 months post. Participants completed a questionnaire including questions around diabetes knowledge (adapted from the MDRTC Diabetes Knowledge Test1), self-management behaviours (carbohydrate counting and insulin adjustment), and rating their confidence (Self-Efficacy Scale²). Hypoglycaemia was self-reported. HbA1c, weight and BMI was collected via clinical records. Time series regression analysis assessed differences between pre, and post and 12 month results.

Results; 68 participants attended the program. Participants mean age was 44.7 years and 53% were male. Mean duration of diabetes was 15.6 years. HbA1c was decreased from baseline post intervention (p=0.001), however by 12 months had increased and was not different from baseline (p=0.972). Weight, BMI and self-reported hypoglycaemia was unchanged from baseline at either post or 12 months. Knowledge improved post intervention and was maintained at 12 months (p=0.000 and 0.015 respectively) as was confidence (p=0.000 and 0.000 respectively). Consistency with carbohydrate counting improved post intervention and was maintained at 12 months (p=0.000 and 0.008 respectively). Monitoring and managing ketones improved post intervention (p=0.001 and 0.007 respectively) but at 12 months returned to baseline (p=0.409 and 0.365 respectively).

Conclusion; Participants in the FlexIT program showed improvements in HbA1c, knowledge, confidence and improvements in some self-management behaviours without changes to weight, BMI or self-reported hypoglycaemia post intervention. However these improvements in HbA1c and ketone monitoring and management were not maintained at 12 months. Ongoing support may continue program principles and maintain initial program benefits.

  1. 1. Fitzgerald JT, Funnell MM, Hess GE, Barr PA, Anderson RM, Hiss RG & Davis WK. The reliability and validity of a brief diabetes knowledge test. Diabetes Care; 21, 706-710, 1998
  2. 2. Engel L. Psychological Impact of DAFNE Training in Adults with Type 1 Diabetes. Deakin University, 2009.