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: Complete baseline and 1-year data were available for 939/1651 participants (57%).For every 1 mmol/mol unit increase in HbA1c concentration, the risk of a ketoacidosis episode increased by 6% (95% CI: 5 to 7%; 88% for a 1% increase), and for each 5-year increase in diabetes duration, the relative risk reduced by 20% (95% CI: 19 to 22%).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
Related in: MedlinePlus
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.