Takeaway
- In children with type 1 diabetes (T1D) initiating treatment, whether they follow a hospital-based or home-based care plan seems to have no effect on outcomes.
Why this matters
- Findings of this multicentre, randomised controlled trial suggest acceptability of either care pathway.
- These authors say that the home-based model would need to be updated to reflect practice changes in the UK.
Key results
- Mean HbA1c at 24 months with initiation at:
- Home: 72.1 mmol/mol.
- Hospital: 72.6 mmol/mol.
- With adjustment for baseline measures, these values did not differ (P=.863).
- No adverse events or hospital admissions for home-based group during initiation.
- Children who initiated at home had better reported self-esteem at 24 months, although they had lower self-esteem at 1 month (P<.001).
Study design
- Trial ran from January 2008 to October 2013 in Wales, England, Northern Ireland.
- 203 children (age <17 years) included: 102 in hospital group, 101 in home group.
- Primary outcome: mean HbA1c at 24 months.
- Funding: Diabetes UK.
Limitations
- Practices for insulin regimes changed while trial was in progress.
References
References