Royal Bournemouth Hospital's BERTIE structured education programme is
an appropriate means by which people with type 1 diabetes can learn the
knowledge and skills necessary for optimal self-care. Started in 1999, it is
run over four weekly sessions. Effectiveness has been measured since its inception by collecting biomedical
data and a patient satisfaction questionnaire, with a robust quality assurance programme in place.
As a result of continued monitoring of the programme, it has evolved to reflect the needs of patients and improve
our outcomes. It has shown sustained biomedical improvement over five years, reduction in emotional distress and
reduction in hypoglycaemia and hypoglycaemia awareness. Patients also achieve their self-management goals.
People with type 1 diabetes require knowledge and skills to enable them to understand the effects of lifestyle on
their diabetes and vice versa, and how they can manipulate their treatment to enable them to lead the lifestyle
of their choice while maintaining stable blood glucose control. They also need information on the consequences
of poor control of their diabetes so they can make informed choices in setting appropriate personal goals for the
management of their diabetes. In 1997, patients with Type 1 diabetes had little knowledge about carbohydrate
content of food, insulin dose adjustment, management of hypoglycaemia and hyperglycaemia, and the effect of
exercise and other factors on blood glucose levels. There was no structured programme and average HbA1c in
1997 for patients under 40 years was 9.9%. A local survey showed 60% of patients never adjusted their insulin.
To provide support to people with diabetes to enable them to develop realistic short term and long-term
management goals. To help them acquire the knowledge and skills necessary to achieve those goals.
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