Pilot study of a novel education programme for 11-16 year olds with Type 1 Diabetes Mellitus: the KICk-OFF course

Helen Waller ¹, Christine Eiser ^1*, Julie Knowles ², Nicola Rodgers ³, Sally Wharmby ³, Simon Heller ², Hall Catherine ⁴, Sue Greenhalgh ⁴, Tracey Tinklin ⁵, Carol Metcalfe ⁵, Elaine Millard ¹, Vanessa Parkyn ³, Mark Denial ³ and Katherine Price ³

¹ University of Sheffield, United Kingdom
² School of Medicine and Bioscience, University of Sheffield, United Kingdom
³ Sheffield Children’s Foundation NHS Trust, United Kingdom
⁴ Royal Manchester Children’s Hospital, United Kingdom
⁵ Derbyshire Children’s Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: c.eiser{at}sheffield.ac.uk.

Accepted 26 February 2008

Abstract

Aims: To pilot an education programme (KICk-OFF) for children and adolescents with Type 1 diabetes mellitus (DM). Evaluation included i) independent assessment of curriculum quality, ii) acceptability to families; and iii) possible impact on standardised outcome measures (HbA1c, BMI, diary reports of hypoglycaemia, quality of life (QOL)).

Methods: 48 children, aged 11-16 years (mean age = 13.60 "b 1.36 years), were recruited from 3 UK centres. Six 5-day outpatient courses were conducted teaching the skills of carbohydrate counting and insulin dose adjustment. Semi-structured interviews were conducted with children and parents pre- and post-course. Glycaemic control (HbA1c), body mass index (BMI) and frequency of hypoglycaemia were assessed at pre-course, 3- and 6-months post-intervention. QOL was assessed at pre-course, 2 weeks, 3- and 6-months.

Results: Educational evaluation indicated course format was appropriate and consistent. Parent and child interviews suggested that pre-course expectations were largely met. There were no changes in HbA1c, BMI or episodes of hypoglycaemia, but children and parents reported improved QOL (p<0.05).

Conclusions: KICK-OFF was well-received by children and parents and was associated with improved QOL. In this small pilot study glycaemic control did not change but findings provide justification for a future randomised controlled trial (RCT) involving a revised curriculum, larger study population including a control group and longer follow-up.