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The insulin clock: A new teaching tool
$24
Poster Session 1
II. Education components IV. Goals of therapy V. Obstacles of education VI. Troubleshooting blood glucose results Successful implementation of CSII requires a motivated patient with a range of technical skills and self-management capabilities. Patients develop this expertise through an ongoing program of education and the support that a healthcare team knowledgeable in insulin pump therapy can provide.
P172
Video Programs for Home Use as a Complement to Traditional Health Services S. NORDFELDT, C. Johansson, G. Lundstr6m, J.~. Hammersj0.
Division of Pediatrics and Centerfor Medical TechnologyAssessment, Faculty of Health Sciences, Link@ing, Sweden
ing parameters: body mass index (BMI), arterial tension, glycosylated hemoglobin, total cholesterol and triglycerides 1) before the course, 2) at the beginning of the course, 3) 6 months after the course and 4) 12 months post course. Data were analyzed with a MANOVA test for repeated measurements. When statistically significant differences were found, a Newman-Keuls' POST-HOC test was done to determine at what point of follow up they were found. Data were processed by the STATISTICA Statistical Package, Level of significance was set at p: 0.05. Results: glycosylated hemoglobin was shown to go down to a global level (F: 3.39; p: 0.024) (p: 0.05). When the Newman-Keuls test was done, differences between measurements 1 and 3 (F: 8.15; p: 0.039), between measurements 2 and 3 (F: 8.105; p: 0.029) and between measurements 3 and 4 (F: 189.75; p: 0.01) (p: 0.05) were recorded. Conclusions: Until 12 months of post-course follow up were completed, we could observe some improvement in the metabolic control in the group of patients we analyzed. Metabolic control was assessed by the reduction in glycemia and glycosylated hemoglobin.
Aims: We have studied patients' attitudes to diabetes education by video at home and the costs for this type of intervention. Background: In spite of all health service efforts, learning is not always as effective as it needs to be. The major acute complication severe hypoglycemia is common also with modern treatment. Methods: A geographic population of 229 type 1 diabetes patients aged 2-18 years was randomized to receive either two videotapes (17+18 min) where interviewed patients, parents and medical expertise reviewed in detail important skills for selfcontrol and treatment, aiming to prevent severe hypoglycemia (intervention), or a videotape (13 min) with general information about diabetes (controls). Assessment by mailed patient/parent questionnaires after 2 months. Results: Intervention (and control) videos had been seen in the families mean 1.7 times, range 0-5 (2.1, 1-10), and 41% (40%) already had shown the videos to relatives, friends, school staff or others. A wish to see more diabetes videos was declared by 75% (62%). Attitudes were predominantly positive, within wide ranges. Intervention patients to a higher extent replied they had Iearnt something useful (p<0.0001) and indicated higher benefit from the videos, especially regarding hypoglycemia prevention (p=0.0007). Many suggested more video programs on other topics like diabetes and adolescence, sports/exercise or food/meals. The cost for reproducing the intervention videos to 100 patients was lower than the cost for three extra hospital visits. Conclusions: Mass-distributed video programs for home use may be a complement to regular visits to a diabetes team and to other types of education. The findings may have implications also for other ages and diagnosis groups.
P174
The Insulin Clock: A New Teaching Tool E DE LUZY, M. Nguyen-Howles, A. Golay, J.Ph Assal. D.E.T.M.C.,
University Hospital, Geneva, Switzerland Diabetes Mellitus is a chronic disease which requires the self-management of the disease by the patient to achieve a long term glycemic control. This involves the interaction between 4 parameters: diet, treatment drugs, physical activity and daily schedule. For the patient, understanding these interactions and assessing their influences on their daily life is a complex but necessary process. To support the acquisition of this knowledge we have created a simple, friendly user tool. The insulin clock allows the patient to adjust the timing of meals and snacks according to the treatment, to see when to check blood sugar, to visualise duration and intensity of insulin treatment, to schedule particular activities (physical, eating, intercontinental travel etc.). Patients build progressively their day on this 24-hour clock, and modifies it according to their own life style. They will be able to understand their treatment, to analyse the mistakes and to learn from them. The clock has been tested and validated on all patients entering our week long education program during a period of 3 years. This tool is aimed to help the patient to understand throughout the whole life, the links between factors having an impact on the treatment of the disease. It is also useful for all the people involved in diabetic patient education.
P175
The Impact of an Educational Program on Diabetics Patients in Syria P173
N. EL-BACHE, N. Afiouni. Aleppo University Hospital
Educational Program for Type 2 Diabetic Patients in the Division of Diabetulogy of Hospital of Clfnicas Jose de San Martin (Preliminary Report)
Introduction: The prevalence of diabetes Syria is 9.4% among people
NORA MARQUEZ, Ofelia Sszyskowsky, Celia Berezan, Estrella Mentndez, Maximino Ruiz. Education of patients in diabetology offers them knowledge and techniques that allow them to introduce changes in their life style, everyday habits and behavior to reach the best possible metabolic control. Objectives: To assess the favorable impact of education on the metabolic control in type 2 diabetic patients. Population: As a pilot experience, preliminary results were analyzed in 20 patients who completed the follow up period set at one year after the course. Patients' average age was 65.4 4- 6.01. Average evolution time of diabetes was 10.05 4- 7.25. Method: An Educational Program for type 2 diabetic patients was developed. The program was made up of 4 modules with a 2 hour per week frequency. Total duration: 8 hours. The aim was to establish the follow-
over 20 years of age. Serious complication of the disease such as, retinopathy, nephropathy and amputations are common among diabetics in Syria. Objectives: In particular we tried to;l- To test the acceptability of this program by our patients. 2- To assess the effect of this program on patients' knowledge about their disease. 3- To assess the short-term impact of education on diabetic control. Study's population: A sample of 216 diabetic patients (mean age 43.2 years, female/male ratio: 2/1) with a disease duration from 0-26 years, was recruited from our center to participate in the study. Methods: An integrated team of doctors and health workers conducted a simple, culturally compatible educational program with the help of simple illustrative visual aids. A follow-up visit was arranged for participants within one month. Level of patients' knowledge & glycated Hb was tested prior and after the program using a special questionnaire.
Poster Session 1
II. Education components IV. Goals of therapy V. Obstacles of education VI. Troubleshooting blood glucose results Successful implementation of CSII requires a motivated patient with a range of technical skills and self-management capabilities. Patients develop this expertise through an ongoing program of education and the support that a healthcare team knowledgeable in insulin pump therapy can provide.
P172
Video Programs for Home Use as a Complement to Traditional Health Services S. NORDFELDT, C. Johansson, G. Lundstr6m, J.~. Hammersj0.
Division of Pediatrics and Centerfor Medical TechnologyAssessment, Faculty of Health Sciences, Link@ing, Sweden
ing parameters: body mass index (BMI), arterial tension, glycosylated hemoglobin, total cholesterol and triglycerides 1) before the course, 2) at the beginning of the course, 3) 6 months after the course and 4) 12 months post course. Data were analyzed with a MANOVA test for repeated measurements. When statistically significant differences were found, a Newman-Keuls' POST-HOC test was done to determine at what point of follow up they were found. Data were processed by the STATISTICA Statistical Package, Level of significance was set at p: 0.05. Results: glycosylated hemoglobin was shown to go down to a global level (F: 3.39; p: 0.024) (p: 0.05). When the Newman-Keuls test was done, differences between measurements 1 and 3 (F: 8.15; p: 0.039), between measurements 2 and 3 (F: 8.105; p: 0.029) and between measurements 3 and 4 (F: 189.75; p: 0.01) (p: 0.05) were recorded. Conclusions: Until 12 months of post-course follow up were completed, we could observe some improvement in the metabolic control in the group of patients we analyzed. Metabolic control was assessed by the reduction in glycemia and glycosylated hemoglobin.
Aims: We have studied patients' attitudes to diabetes education by video at home and the costs for this type of intervention. Background: In spite of all health service efforts, learning is not always as effective as it needs to be. The major acute complication severe hypoglycemia is common also with modern treatment. Methods: A geographic population of 229 type 1 diabetes patients aged 2-18 years was randomized to receive either two videotapes (17+18 min) where interviewed patients, parents and medical expertise reviewed in detail important skills for selfcontrol and treatment, aiming to prevent severe hypoglycemia (intervention), or a videotape (13 min) with general information about diabetes (controls). Assessment by mailed patient/parent questionnaires after 2 months. Results: Intervention (and control) videos had been seen in the families mean 1.7 times, range 0-5 (2.1, 1-10), and 41% (40%) already had shown the videos to relatives, friends, school staff or others. A wish to see more diabetes videos was declared by 75% (62%). Attitudes were predominantly positive, within wide ranges. Intervention patients to a higher extent replied they had Iearnt something useful (p<0.0001) and indicated higher benefit from the videos, especially regarding hypoglycemia prevention (p=0.0007). Many suggested more video programs on other topics like diabetes and adolescence, sports/exercise or food/meals. The cost for reproducing the intervention videos to 100 patients was lower than the cost for three extra hospital visits. Conclusions: Mass-distributed video programs for home use may be a complement to regular visits to a diabetes team and to other types of education. The findings may have implications also for other ages and diagnosis groups.
P174
The Insulin Clock: A New Teaching Tool E DE LUZY, M. Nguyen-Howles, A. Golay, J.Ph Assal. D.E.T.M.C.,
University Hospital, Geneva, Switzerland Diabetes Mellitus is a chronic disease which requires the self-management of the disease by the patient to achieve a long term glycemic control. This involves the interaction between 4 parameters: diet, treatment drugs, physical activity and daily schedule. For the patient, understanding these interactions and assessing their influences on their daily life is a complex but necessary process. To support the acquisition of this knowledge we have created a simple, friendly user tool. The insulin clock allows the patient to adjust the timing of meals and snacks according to the treatment, to see when to check blood sugar, to visualise duration and intensity of insulin treatment, to schedule particular activities (physical, eating, intercontinental travel etc.). Patients build progressively their day on this 24-hour clock, and modifies it according to their own life style. They will be able to understand their treatment, to analyse the mistakes and to learn from them. The clock has been tested and validated on all patients entering our week long education program during a period of 3 years. This tool is aimed to help the patient to understand throughout the whole life, the links between factors having an impact on the treatment of the disease. It is also useful for all the people involved in diabetic patient education.
P175
The Impact of an Educational Program on Diabetics Patients in Syria P173
N. EL-BACHE, N. Afiouni. Aleppo University Hospital
Educational Program for Type 2 Diabetic Patients in the Division of Diabetulogy of Hospital of Clfnicas Jose de San Martin (Preliminary Report)
Introduction: The prevalence of diabetes Syria is 9.4% among people
NORA MARQUEZ, Ofelia Sszyskowsky, Celia Berezan, Estrella Mentndez, Maximino Ruiz. Education of patients in diabetology offers them knowledge and techniques that allow them to introduce changes in their life style, everyday habits and behavior to reach the best possible metabolic control. Objectives: To assess the favorable impact of education on the metabolic control in type 2 diabetic patients. Population: As a pilot experience, preliminary results were analyzed in 20 patients who completed the follow up period set at one year after the course. Patients' average age was 65.4 4- 6.01. Average evolution time of diabetes was 10.05 4- 7.25. Method: An Educational Program for type 2 diabetic patients was developed. The program was made up of 4 modules with a 2 hour per week frequency. Total duration: 8 hours. The aim was to establish the follow-
over 20 years of age. Serious complication of the disease such as, retinopathy, nephropathy and amputations are common among diabetics in Syria. Objectives: In particular we tried to;l- To test the acceptability of this program by our patients. 2- To assess the effect of this program on patients' knowledge about their disease. 3- To assess the short-term impact of education on diabetic control. Study's population: A sample of 216 diabetic patients (mean age 43.2 years, female/male ratio: 2/1) with a disease duration from 0-26 years, was recruited from our center to participate in the study. Methods: An integrated team of doctors and health workers conducted a simple, culturally compatible educational program with the help of simple illustrative visual aids. A follow-up visit was arranged for participants within one month. Level of patients' knowledge & glycated Hb was tested prior and after the program using a special questionnaire.