Over the past two decades, the approach to managing type 1 diabetes in the UK has undergone a significant transformation. This shift is clearly reflected in the guidance from the National Institute of Health and Care Excellence (NICE), which recognizes that successful glucose control hinges on individuals with type 1 diabetes effectively employing flexible intensive insulin therapy. This guidance underscores that mastering the complexities of self-management is crucial and is best facilitated through participation in comprehensive structured education programs.
Research, including controlled trials, has consistently demonstrated that self-management education programs can lead to improved glucose levels alongside a reduction in hypoglycaemia incidents. Furthermore, these programs have been shown to enhance psychological well-being and are highly cost-effective. A cornerstone principle of these successful initiatives is therapeutic education, fostering a collaborative learning environment between healthcare professionals and individuals with diabetes. This partnership empowers individuals to integrate diabetes management seamlessly into their daily routines. Key components of recommended programs include a well-defined written curriculum, group education delivered by a multidisciplinary team of professionals, and robust quality assurance measures.
Despite these advancements and the recognized benefits of structured education, many individuals face challenges in consistently applying and maintaining learned skills after completing these programs. Consequently, overall HbA1c levels, particularly in the UK, remain considerably above target goals. Recent studies have shed light on the obstacles hindering sustained effective self-management, revealing that even high-quality programs often lack crucial elements. These include the integration of insights from behaviour change research, leveraging the potential of emerging technologies to alleviate the burden of self-management, and the provision of ongoing, structured professional support beyond the initial training period. Current research is actively evaluating enhanced structured training courses incorporating these vital components to determine if they can achieve glucose levels closer to target without compromising the individual’s quality of life.
