A structured 1-year education program for children with newly diagnosed type 1 diabetes improves early glycemic control

BackgroundThe diagnosis of type 1 diabetes (T1D) brings significant medical, psychosocial, and educational challenges for the child, family, and medical team. We developed a structured certified diabetes educator (CDE) led program spanning the year after diagnosis with the goal of supporting families as their understanding of this chronic disease and its management evolves. ObjectiveThe aim of this study was to determine the effect of this program upon hemoglobin A1c (HbA1c), and how this effect is mitigated by socioeconomic status (SES). MethodsPatients enrolled in the type 1year 1 (T1Y1) program were assigned a CDE who provided intensive coaching, tailored to family lifestyle, and readiness to assume independence. We identified all patients diagnosed with T1D in the 2 years before (controls) and after (T1Y1 group) the start of the T1Y1 program on January 7, 2014. ResultsThere were 675 patients diagnosed with T1D between July 2012 and June 2016 (284 controls, 391 T1Y1). HbA1c was significantly lower in the T1Y1 group at 6 (6.7% vs. 7.1%, P<0.001), 12 (7.3% vs. 7.8%, P<0.001) and 18 (7.6% vs. 7.9%, P=0.01) months, but not 24 (7.8% vs. 8%, P=0.14) months after diagnosis. This effect was not observed in patients with lower SES. ConclusionAdditional structured education and support in the year after diagnosis can improve short-term outcomes in children with T1D, but this effect may not persist after discontinuing intensive coaching. Families of lower SES did not benefit from this approach.