Review: unclear evidence about education for type 1 diabetes using pump therapy

Insulin Pump with sensor

This systematic review set out to establish the effectiveness and optimal delivery of educational interventions to help adults with type 1 diabetes who are using insulin pump therapy.

Clinical question:

In adults with type 1 diabetes using or starting insulin pump therapy, what is the effectiveness of educational interventions?

The review included both patients starting pump therapy as well as those who had been using it for a while. It did not focus on a particular type of intervention.

The evidence:

Only five papers were found that met the inclusion criteria.  These were very heterogeneous in terms of the interventions studied and were of poor methodological quality.

However, the reviewers conclude:

It is clear that type 1 diabetes patients initiating and utilising IPT need a comprehensive range of advice, education and training.

On the basis of the descriptive data they gathered, they recommend:

  • a mix of group and individual teaching,
  • use of multidisciplinary teams of educators and
  • long-term training with multiple sessions.

Appraisal hints:

Users of this research should consider:

  • It would appear that the review did not address a clearly focused question (see above).
  • However, they may have excluded or missed important studies, as they found so few.  Was their search strategy up to scratch?
  • The reviewers included poor quality studies in their review.
  • You might be better to look for randomised trials that focus on your patient population or setting, likely interventions and patient-important outcomes.
  • More and better quality research is needed in this area.

Reference:

Jayasekara RS, Munn Z, Lockwood C. Effect of educational components and strategies associated with insulin pump therapy: a systematic review. Int J Evid Based Healthc. 2011 Dec;9(4):346-61.

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Badenoch

Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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