Education is considered essential for success with insulin-pump therapy but literature in the field is limited. We systematically reviewed the literature to study re-training programs and their effects in adults (16+) with type 1 diabetes using an insulin pumps with or without continuous glucose monitoring.
Systematic searches were carried out in MEDLINE, Embase, CINAHL and ERIC. All primary studies reporting an effect of insulin pump retraining education programs were included if they were published in English between January 1999 and May 2019. Results reported here are preliminary and descriptive.
988 studies were identified as potentially relevant; 48 were assessed in full text. Nine studies fulfilled the inclusion criteria including one randomised controlled study. Educational approaches and settings were sparsely described. Content was usually reported as teaching points. One study tested web-based versus face-to face teaching, the remaining compared usual care with an added educational intervention. Studies reported a broad variety of outcomes, e.g. HQoL, diabetes distress, hypoglycaemic events and diabetic ketoacidosis. Four studies reported on knowledge and application skills, all demonstrated improvements. Four studies measured metabolic outcomes by HbA1c before and after re-training, a significant reduction was seen in three. Two studies measured severe hypoglycaemic events before and after re-education intervention, a significant reduction was seen.
Preliminary evaluation indicate that re-education have beneficial effects, but evidence is heterogeneous across study designs and outcomes. Critical appraisal and systematic analyses are in progress to provide substantial recommendations for future education, practice and research.