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What people reported… All attendees reported that they found the course either 'Excellent‘,

TIM: A Dundee lad improving diabetes outcomes. ok. good. excellent. Programme Delivery Four days of structured education, delivered by trained diabetes specialist nurses and dietitians to groups of 8-10.

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What people reported… All attendees reported that they found the course either 'Excellent‘,

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  1. TIM: A Dundee lad improving diabetes outcomes ok good excellent • Programme Delivery • Four days of structured education, delivered by trained diabetes specialist nurses and dietitians to groups of 8-10. • Delivered one day a week over four weeks to allow the opportunity for learning to be put into practice between sessions. • Person-centered and uses education principles which promote active learning. • Conclusions • TIM improves diabetes control in our participants. • This improvement equates to a 15-20% reduction in diabetes-related complications, such as blindness and renal disease, at 5 years (2). • This along with reduction in admissions due to DKA and severe hypoglycaemic episodes brings cost as well as individual benefits. • More cost effective than the more widely used national programme DAFNE. L.V.M. Jordan, Mary Robertson, Lesley Grant, Rhona E.L. Peters, Jayne T. Cameron, Susan Chisholm, Debbie J. Voigt, Lesley Matheson, Elinor J. Kerr, Alison Hodgson, Kirsten MacLean, Ritchie R. MacAlpine, Elaine Wilson, Alasdair D. R. Mackie, Nicola M. Summers, Thenmalar Vadiveloo, G.P. Leese Background TIM: The Tayside Insulin Management programme is a locally developed education programme for adults with type 1 diabetes. Scottish Diabetes Action Plan: All people with diabetes in Scotland to have access to appropriate information and education. NHS QIS Diabetes Standards: All people with diabetes have equitable access to information and multidisciplinary programmes for education. NICE: Every patient should be offered structured education. • Other benefits • Methods. Subjects completed pre and post course questionnaires gathering information about aspects of their diabetes management. • Results. • A reduction in hypoglycaemia unawareness from 25% of participants to 6%. • A significant reduction in severe hypoglycaemia episodes. • Number of participants who had at least 1 episode of DKA (diabetic ketoacidosis) in 1 year, improved from 15% to 0%. • Programme Objectives • Enable people with Type 1 diabetes to learn the principles of matching their insulin dose to the amount of carbohydrate (CHO) eaten and thus self-manage their diabetes – vital too for those considering insulin pump therapy. • Provide an environment where people can ask questions and learn from each other. What people reported… All attendees reported that they found the course either 'Excellent‘, 'Good‘ or ‘Okay’. TIM effectiveness Between May 2006 and March 2010, 216 people with Type 1 diabetes attended. Does TIM improve diabetes control? Methods. To quantify control, HbA1c was collected pre and at 6 and 24 months post TIM course. Data was available in 97% of our participants. Results. Participants had a mean reduction in HbA1c of 4mmol/mol (0.4%) at 6 months and 5mmol/mol (0.5%) at 2 years post course. Does TIM impact on quality of life? Methods.Quality of life was assessed using the standardised ADDQoL questionnaire. This was completed both pre and post course. Results.There was a reduction in the negative impact of diabetes in all 18 questions of the ADDQoL questionnaire. What people said…. “…I feel that for the first time in 41 years my life is not ruled by insulin.” “…this course will be invaluable for my diabetes control for the rest of my life …” “Changed the thought process of someone who’s had diabetes for 30 years (all for the better) thanks.!” “I now feel in control of my diabetes again - for a few years I felt I was on treadmill, but through this course I learnt a lot more about diabetes”. References Bradley C et al., (1999) The development of an individualised questionnaire measure of perceived impact of diabetes on quality of life: the ADDQoL. Quality of Life Research, 8: 79-91. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977-986. Contact:DrLaura Jordan: Specialist Registrar in Diabetes and Endocrinology. Ninewells Hospital, Dundee. DD1 9SY. Email: laurajordan@nhs.net.

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