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Structured education from diagnosis of type 1 diabetes leads to improvement in HbA1c levels, reveals NHS Grampian

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New data presented at the Diabetes UK Professional Conference 2024 has shown that the Scottish Type 1 Education Programme equips people with newly diagnosed type 1 diabetes with skills to self-manage their condition.  

Keeping blood sugar levels within a target range is crucial to help people living with type 1 diabetes stay healthy and reduce the risk of diabetes-related complications, such as heart attack and stroke. 

In Scotland, the national target for HbA1c levels - average blood sugar levels for the last two to three months - is below 58 mmol/mol, to reduce the risk of diabetes complications. Developing models of diabetes care in Scotland to support people living with type 1 diabetes to meet this target has been a priority. 

NHS Forth Valley developed the Scottish Type 1 Education Programme (STEP) to provide structured education for people newly diagnosed with type 1 diabetes. Prior to STEP, structured education programmes were designed for people who had already lived with diabetes for some time.  

NHS Grampian’s approach 

A multi-disciplinary team from the diabetes service within NHS Grampian modified and introduced STEP into clinical practice in their service and analysed HbA1c levels before and after the programme was introduced.  

Between February 2019 and August 2022, 206 people with type 1 diabetes in NHS Grampian were enrolled in STEP.  

STEP consists of 8-10 sessions designed to equip people with the knowledge and tools they need to navigate the complexities of self-managing the condition. Training starts on the day of diagnosis and support is delivered by a team of experts, including diabetes doctors, specialist nurses and dietitians face to face to patients. 

The findings 

The team found that prior to STEP, only 42% of people had an HbA1c level that met Scotland’s national target range of below 58 mmol/mol a year from diagnosis.

After STEP was introduced, the percentage of people meeting the target increased significantly, with 60% on average meeting target range 12 months after their diagnosis. This compares to 48% achieving this HbA1c range in Scotland as a whole.  

Dr Alasdair Cooper, Diabetes Speciality Registrar from Diabetes Department at Aberdeen Royal Infirmary, said: 

“Type 1 diabetes is a life-changing diagnosis.  As a team we are delighted at the impact that STEP has made in supporting those with newly diagnosed type 1 diabetes in NHS Grampian. We feel that the success of the introduction of this programme - pioneered by NHS Forth Valley - is due collaborative working across our talented team.” 

John Kinnear, National Director, Diabetes Scotland, said: 

“Structured education is key to helping people with type 1 diabetes effectively manage their blood sugar levels. 

“These findings provide real world evidence suggesting that introducing diabetes education courses, such as STEP, at the start of someone's diabetes journey can lead to substantial improvements in blood sugar levels, which in turn reduces people’s risks of devastating diabetes-related complications. 

“We want to make sure people with type 1 diabetes get support to live well with the condition at the point of diagnosis.” 

This important study is one of hundreds shared at Diabetes UK's Professional Conference 2024.  

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