Decoding type 1 diabetes

Structured education programmes for type 1 diabetes are lacking in our country

Type 1 diabetes (T1DM) is increasing in incidence. Due to the autoimmune destruction of the insulin producing beta cells of the pancreas, treatment of T1DM mandates life-long insulin therapy. Since T1DM is usually detected in childhood or early adulthood, patient education is an important part of the management of diabetes.

In the busy out-patient clinics, there is a paucity of time to impart an in-depth knowledge regarding diabetes, its management and long term complications. 

To address these issues, the Apollo Centre for Obesity, Diabetes and Endocrinology, has designed a structured diabetes education programme, called 1-STEP, for patients and their care-givers. 

The interactive educational programme covers the various aspects of type 1 diabetes and its management in three modules. The first module gives an in-depth knowledge about type 1 diabetes — what it is, how it occurs, the associated acute and long term complications, the principles of treating T1DM, need for self monitoring of blood glucose and how to do it, information on frequency of follow up and screening for chronic complications and recognition of diabetic ketoacidosis.

The second module covers diet and lifestyle management in detail, including the components of diet, meal patterns, food exchange lists, knowledge on glycemic index, role of functional foods, addressing dietary issues during school, and how to make healthy choices while socialising and going out. It also includes education on hypoglycaemia in detail— what it is, how to recognise it and corrective measures; as well as information regarding physical activity.

The third module covers all aspects about insulin- types of insulin, types of insulin delivery devices available, practical tips on storage of insulin, insulin administration technique including site rotation, needle changing. It will also empower the patients with knowledge on how to adjust insulin doses on a day to day basis using the blood sugar readings. 

Information regarding insulin pumps in detail, as well as carbohydrate counting is also included.

Structured education programmes for type 1 diabetes are already prevalent in the western world, but are lacking in our country. There still exist many myths and misconceptions related to type 1 diabetes and insulin therapy amongst the general population, which influences the patients and their families; thus hampering the optimal management of T1DM. 

The solution is to clear prevailing myths, empower the patients with knowledge about the disease, involve them actively in managing it, interact with other patients and learn from their experiences, and bridge the gap between the patients and their healthcare providers.

The author is Senior Consultant Endocrinologist and Diabetologist, Apollo Hospital