Structured Type 1 Diabetes Education Delivered Within Routine Care

Impact on Glycemic Control and Diabetes-Specific Quality of Life

  1. for the U.K. NIHR DAFNE Study Group
  1. Department of 1School of Health & Social Care, University of Surrey, Guildford, Surrey, U.K.; the
  2. 2School of Psychology, University of Sussex, Brighton, U.K.; the
  3. 3Centre for Population Health Sciences, Edinburgh University, Edinburgh, U.K.; the
  4. 4Academic Unit of Diabetes, University of Sheffield, Sheffield, U.K.;
  5. 5Epidemiology & Public Health, University College London, London, U.K.;
  6. 6AHP Research, Hornchurch, U.K.
  7. 7The Australian Centre for Behavioural Research in Diabetes, Melbourne, Victoria, Australia; the
  8. 8Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, Burwood, Victoria, Australia
  1. Corresponding author: Debbie Cooke, debbie.cooke{at}


OBJECTIVE To determine whether improvements in glycemic control and diabetes-specific quality of life (QoL) scores reported in research studies for the type 1 diabetes structured education program Dose Adjustment for Normal Eating (DAFNE) are also found when the intervention is delivered within routine U.K. health care.

RESEARCH DESIGN AND METHODS Before and after evaluation of DAFNE to assess impact on glycemic control and QoL among 262 adults with type 1 diabetes.

RESULTS There were significant improvements in hemoglobin A1c from baseline to 6 and 12 months (from 9.1 to 8.6 and 8.8%, respectively) in a subgroup with suboptimal control. QoL was significantly improved by 3 months and maintained at both follow-up points.

CONCLUSIONS Longer term improved glycemic control and QoL is achievable among adults with type 1 diabetes through delivery of structured education in routine care, albeit with smaller effect sizes than reported in trials.

  • Received January 13, 2012.
  • Accepted August 2, 2012.

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  1. Diabetes Care
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