Participants learn advanced skills to manage their diabetes and insulin dosing which takes time and practice. Each lunchtime and snack is an opportunity to practice carb counting and calculating insulin doses with the help of a dietitian and diabetes nurse educator. Teens learn from their experiences and from the other group members. They use their blood glucose diaries to reflect on what happens over the week as they trial using ratios and correction doses to keep blood glucose levels in target in a safe and supportive environment.
In a life-time of diabetes five days is a worthwhile investment of time. People who are completing the week of the DAFNE and TEAM T1 programs often say they want more time and are disappointed not to be coming back the following week.
There is a perception that people will not want to attend for five days, however over 2000 people with type 1 diabetes have attended a DAFNE program in Australia. TEAM T1 is held during school holidays so that teens don’t miss school.
For people having a lot of hypos or who don’t always know when they are hypo (impaired hypo awareness), learning how to manage and avoid hypos can help to restore symptoms and confidence to go out and be active. By learning appropriate insulin dosing and ratios, and by practicing carb counting, participants also learn how to reduce hypos.
The TEAM T1 program is based on evidence from studies and systematic reviews that make the following recommendations:
- Education alone doesn’t change behaviour. Interventions that address psychosocial aspects of living with diabetes, in addition to improving knowledge are likely to be more effective.
- Programs that include coping skills in addition to intensive insulin management have been more effective.
- Structured education is recommended and is considered the cornerstone of diabetes self-management. Structured education has a written curriculum, is quality assured and audited.
TEAM T1 is a structured education program based on the DAFNE program. Evidence supporting the efficacy of the DAFNE program can be found on the DAFNE website.
TEAM T1 was adapted for teenagers with input from a multi-disciplinary expert reference group, including psychologists, dietitians, diabetes nurse educators, paediatric endocrinologist, secondary school teacher, a parent and young person with type 1 diabetes.
A pilot study conducted in 2010 with 19 teenagers showed that the program was acceptable and helpful for teenagers and their parents, and most participants had improved HbA1c levels three months after the program. They also reported improved confidence to manage their diabetes and less diabetes-related distress.
The program is being evaluated to measure changes in HbA1c, quality of life, treatment satisfaction, diabetes-related distress, and confidence to self-manage before and after the program.
Health professionals, teenagers or their parents can refer. The program is for young people with type 1 diabetes aged between 14–18 years. To attend a TEAM T1 program participants need to:
- have had type 1 diabetes for at least six months (no longer in the honeymoon phase)
- take multiple daily injections or be using an insulin pump
- be willing to inject & monitor blood glucose at least four times a day
- be willing to attend a five day program during school holidays
- have at least one parent attend the two day parent support program
- be proficient in English
There is currently no fee for participants to attend. Morning tea and lunch are provided each day, however participants are asked to pay for lunch when eating out on one day of the program ($10–20).