BERTIE forecast 2010:
HbA1c moderate to good;
life good to improving;
outlook confident and liberated
DEN Conference 3rd November 2010
Jacqueline Ryder
Diabetes Specialist
p
Nurse
Bournemouth Diabetes and Endocrine
Centre
www.b-dec.co.uk
Aim
To report qualitative and quantitative outcomes for the
BERTIE course from baseline to follow up at 12
months after completion from January 2005-July 2009
BERTIE : the course
y course runs 1 day a week for 4 weeks
y led by diabetes specialist nurse (DSN) & diabetes
dietitian,
y contributions from consultant physician & clinical
psychologist
y HbA1c
HbA1 and
d Problem
P bl
A
Areas iin Di
Diabetes
b t scale
l (PAID)
were collected prior to the course and at 12 months
y participants completed a course evaluation form on
the final day
What are you hoping to achieve?
How do you want things to be different?
Goal settingg
What frustrates you most about your diabetes?
How will you know when you have achieved this?
C
Core Themes
Th
THOUGHTS
I’m not very good
Not confident
Controlled
THREAT
Hypos
BEHAVIOUR
Test too much
Miss injections
FEELINGS
Anxious
Frustrated
THOUGHTS
It works
I’m more confident
I’m in control
BEHAVIOUR
CHO counting
Adjust insulin
Test regularly
FEELINGS
Happy
Not so worried
R l d
Relaxed
Less hypos
Outcomes (1)
O
(1)
Audit population:
Audit population:
n=189, 107 female (57%)
Mean Range
Age (yrs)
41
18‐84
Duration of diabetes (yrs)
17
1‐51
Outcomes (2)
( )
Mean Pre course
12 months post course
Significant Difference
HbA1c
8.7%
72mmol/mol
8.6%
70mmol/mol
p=0.05
21.4
16.8
p<0.001
29 (15%)
13 (7%)
PAID score
Number of people having hypos requiring assistance
Outcomes (3)
( )
Participant evaluations recorded satisfaction with:
y increased dietary freedom
y reduced blood glucose variability
y indicated that the course met the needs and
goals of the participants
F db k
Feedback
..…I found the course y
extremely helpful‐I wish I had known all this years ago
…I feel I have control of my life and can eat a y
variety of foods‐ feel far less fatigued
…t s was a
…this was an excellent course –very supportive and caring to each others personal needs
Conclusion
In addition to small reductions in HBA1c, the results
suggest that diabetes related emotional distress is
significantly reduced with:
y increased
i
d fl
flexibility
ibilit off ffood
d choice
h i
y reduction in hypoglycaemia
yp g y
requiring
q
g assistance.
BERTIE is clinically effective and well received by
participants