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DICE Diabetes, Insulin & Carbohydrate Education

DICE Diabetes, Insulin & Carbohydrate Education. Denise Morrison PDSN Stephanie Howe DSD Luton & Dunstable Hospital. Background. 150 children on PDSN caseload Very limited paediatric dietetic service for diabetes 74 children on Basal bolus (increased from 50 over past 6/12)

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DICE Diabetes, Insulin & Carbohydrate Education

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  1. DICEDiabetes, Insulin & Carbohydrate Education Denise Morrison PDSN Stephanie Howe DSD Luton & Dunstable Hospital

  2. Background • 150 children on PDSN caseload • Very limited paediatric dietetic service for diabetes • 74 children on Basal bolus (increased from 50 over past 6/12) • Mean Hba1cs 10.15%(12-16years) 9.06%(9-11years) 9.14%(<9years) • Education Programmes developed as part of project funded by Novo Nordisk to offer enhanced dietetic service to children on basal bolus & their parents

  3. Key Objectives • To improve self-management skills • To improve glycaemic control • To improve nutritional/Diabetes knowledge • To audit the project

  4. Our Education Programmes • DICE (Diabetes, Insulin & Carbohydrate Education) aged 12-16 years 5 hours delivered over one day • Mini-DICE for those aged 9-11 years 3 hours delivered as one session

  5. Baseline Knowledge & Behaviour Questionnaires • 60% (12-16y) & 86%(9-11y) only adjusted background insulin dose when advised to do so by DSN/Doctor • 40%(12-16y) & 28%(9-11y) only adjusted short acting insulin dose infrequently/when advised by DSN/Dr • Food knowledge was poor: 12/24 foods (12-16y) & 10/24 foods (9-11y) wrongly categorised by >40

  6. Evaluation • Self reflection: parent /child dynamics variable (DICE) so aim to increase time for children to work separately • Self reflection: aim to improve attendance, particularly boys • Self reflection: aim to improve follow up & on going education • Participants: 86% (DICE) and 100% (mini-DICE) rated course as whole very useful, although 36% found DICE too long • Participants: sections on basic carbohydrate portions, weighing own portions, estimating carbs in meals, snacks, hypos and correction doses all rated very highly

  7. Pre & Post Group Hba1c Results

  8. What Next? • Assess post group knowledge & self management skills/behaviour (awaiting results) • Trial a group follow up session • Trial reviewed format of DICE to reduce potential for parent/child tensions • Long term: Funding!

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