Recurrent education: A promising strategy for enhancing diabetes management and reducing hypoglycemia in children with type 1 diabetes

Abstract

Background: This study aimed to assess the impact of recurrent individualized education on the management of hypoglycemia, hypoglycemia awareness, and metabolic control of diabetes in children and adolescents living with type 1 diabetes (T1D). Methods: A prospective quantitative study involving participants aged 8 to 18 years with T1D was conducted. Three established hypoglycemia screening tools were employed: the Hypoglycemia Fear Survey (HFS), the Gold Hypoglycemia Awareness Questionnaire, and the Edinburgh Hypoglycemia Symptoms Scale. The participants used blinded continuous glucose monitoring (b-CGM) devices to document glucose values, meals, insulin doses, exercise periods, symptomatic hypoglycemia episodes, and glucose levels during hypoglycemia, experienced symptoms, and treatment approaches for hypoglycemia. Following this initial phase, the participants received education from healthcare professionals. The same procedures were repeated six weeks after the educational intervention. Results: Prior to education, approximately half (n = 21) of the 47 participants were present with impaired hypoglycemia awareness (IHA), and half of the IHA group applied the appropriate hypoglycemia self-treatment. After education, almost all participants demonstrated an improved ability to manage hypoglycemia effectively. Following education, improvements in the frequency of fingerstick glucose measurement per day, time spent within the target glucose range (70–180 mg/dL), glycemic variability (GV), hypoglycemia perception, appropriate hypoglycemia self-treatment, and hypoglycemia fear were observed, both in participants with hypoglycemia awareness and those with IHA. Conclusions: The results indicate that children and adolescents living with T1D benefit from recurrent self-management education. The benefits were observed in both participants with hypoglycemia awareness and those with IHA. Education positively impacts diabetes management and enhances hypoglycemia awareness.