S09B - Impact of DAFNE on Hospital Admission and Glycemic Management in People with Type 1 Diabetes

Key Takeaways of Your Research: 1. Dose Adjustment for Normal Eating, Hypoglycemia, Diabetes Ketoacidosis, People with Type 1 Diabetes.

Background/Purpose: Structured education for type 1 diabetes aims to enable people to effectively manage their condition leading to morbidity and mortality gains: an obvious benefit for the individual and a potential saving for the health care. The long-term impact of structured education on glycemic improvement over the years or hospital admission has been little studied. Research Hypothesis and/or Research Questions and Specific

Aims: To investigate the effect of dose adjustment for normal eating (DAFNE) course on HbA1c, hypoglycemia, and diabetes related ketoacidosis events (DKA) in people with Type 1 diabetes over 10-years since graduating. Methods/Methodology: Longitudinal data of people with Type 1 diabetes who attended the series of DAFNE courses at the Dasman Diabetes Institute were collected between 2009 and 2021.

Results: A total of 632 people with type 1 diabetes attended DAFNE with a mean (SD) HbA1c 70.4 (18.1) mmol/mol. After one year, HbA1c was 64.3 (16.1) mmol/mol and subsequently decreased to 62.6 (13.8) mmol/mol at year 5 and 60.1 (12.3) mmol/mol at year 10 (p= 0.001). At baseline, DKA was reported by 15.7% of attendees and after one year reported by 8.5% and subsequent year reported by less than 3.9% during the 10-year follow-up periods (p= 0.001). Similarly, 7.2% of attendees reported hypoglycemic events needed paramedical help, and 4.2% used emergency services. However, after completing the DAFNE course, most attendees did not use paramedical help or emergency services (p= 0.001). Conclusions (Impact on Diabetes Care and Education): The DAFNE program can lead to a short-term reduction on glycemia and hospital admissions with sustained improvements and benefits up to 10 years. This study confirms that DAFNE structured education is highly cost-effective and should be embedded within health care. Source of Funding for this Research: No outside funding source was used in this research.