Aim Are newly diagnosed children and/or parents competent in managing diabetes after a 6 week education package?
Method This prospective pilot study used a new competency assessment tool to assess the knowledge of children and/or their parents following a new diagnosis of type 1 diabetes mellitus. Patients were recruited from a district general hospital diabetes clinic over 1 year. All newly diagnosed diabetics received a standard education package based on the International Society of Paediatric Adolescent Diabetes consensus guidelines and Diabetes UK recommendations. The key competencies assessed included physiology of insulin deficiency, insulin devices, blood testing, awareness of hypoglycaemia and dietary advice; these were assessed using a combination of skills demonstrations and short answer questions and the outcomes quantified. Satisfactory completion of all key competencies achieved a 100% score. Patients over 16 years, those with non-type 1 diabetes and those referred from other hospitals were excluded.
Results 20 patients were recruited and assessed at 6 weeks postdiagnosis during 2008–2009. Mean age 8.9 years (range 2.3–14.85 years). 19/20 patients were commenced on a basal bolus regimen. Only 1/20 of patients scored 100%. The mean score achieved was 84.3% with 5/20 patients scoring less than 80%. The practical applications of diabetes management were well understood with 97.9% scored on key competencies relating to devices and 96.4% on blood testing. Poorer understanding was demonstrated around the management of severe hypoglycaemia and basic carbohydrate counting skills.
Conclusion This study presents a new tool that assesses the basic competencies required for one to manage their diabetes on a day-to-day basis soon after diagnosis. In our cohort, this allowed us to arrange individual targeted education for deficiencies identified. More importantly it caused us to reflect and ultimately modify our teaching practices at diagnosis.