Substantial reductions in the number of diabetic ketoacidosis and severe hypoglycaemia episodes requiring emergency treatment lead to reduced costs after structured education in adults with Type 1 diabetes.
Bottom Line: Emergency treatment costs were calculated for associated paramedic assistance, Accident and Emergency department attendance and hospital admissions.Complete baseline and 1-year data were available for 939/1651 participants (57%).Structured training in flexible intensive insulin therapy is associated with a 61% reduction in the risk of ketoacidosis and with 64% lower emergency treatment costs for ketoacidosis and severe hypoglycaemia.
Affiliation: Academic Unit of Diabetes, Endocrinology and Metabolism, Department of Human Metabolism, The University of Sheffield, Sheffield, UK.Show MeSH
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Mentions: The estimated relative risk of ketoacidosis for a 1-year increase in diabetes duration was 0.96, (95% CI: 0.94 to 0.98); therefore, for every 1-year increase in duration, the risk of a ketoacidosis hospital admission decreased by 4% and, for every 5-year increase in duration, the risk of a ketoacidosis hospital admission decreased by 20%. In our model, the equation for a ketoacidosis hospital admission dependent on duration of diabetes before DAFNE training is shown as equation 3, and after DAFNE training, as equation 4, below. This is shown graphically in Fig.2 (shaded areas indicate 95% CI bands).
Affiliation: Academic Unit of Diabetes, Endocrinology and Metabolism, Department of Human Metabolism, The University of Sheffield, Sheffield, UK.