Professor Simon Heller, a member of JDRF’s Scientific Advisory Committee has just launched a trial to answer some of the questions he discussed in an interview with Type 1Discovery magazine two years ago…
In Type 1 Discovery issue 50, we interviewed Professor Heller about hypoglycaemia and ways people with type 1 can manage their condition to maintain good control and avoid hypos as far as possible.
In the article Professor Heller talked about both the Dose Adjustment For Normal Eating (DAFNE) programme and the role of technology in treating type 1. He also discussed how complex it is for doctors and people with type 1 alike to weigh up the advantages and disadvantages of different ways of treating type 1 for different individuals.
Most research around starting to use an insulin pump in adulthood has been done comparing people who start using a pump with people who continue to use multiple daily injections, without any additional training. This means there is a gap in the research evidence. It is possible that the training people receive when they begin using a pump, particularly around carb counting, may be at least partly responsible for the improvements in control that studies on pump use suggest.
The Relative Effectiveness of Pump Therapy Over MDI and Structured Education (REPOSE) trial seeks to find out if this is the case. Volunteers to the study will be randomly assigned to one of two groups. One group will participate in the DAFNE course, while the other group will participate in DAFNE and begin using an insulin pump. Both groups will be followed up for two years, and the researchers will collect information on how glucose control in both groups changes during the trial. They will also collect a range of information about how people in the trial feel about their type 1 treatment, their quality of life, and importantly their fear of hypoglycaemia.
The results of the trial will help doctors and decision makers within the NHS to understand how information and training can work alongside different technical ways of treating type 1 diabetes. If the trial demonstrates an added benefit of insulin pumps above injections then the hope is that diabetes teams may be more willing to refer people for pump therapy which is relatively underused in the UK.
The trial is completely funded by the NIHR Health Technology Assessment programme. It is currently recruiting volunteers all around the country: if you are over 18, do not use a pump and have never done the DAFNE course, why not get in touch with the REPOSE team to see if a hospital near you is involved in the study?
Diana Papaioannou, REPOSE Trial Manager
email: [email protected] phone: 0114 222 0766
Lucy Wraith REPOSE Trial Support Officer
email: [email protected] phone: 0114 222 0866