Trial of 3-day kids in control of food (KICk OFF) format in Kuwait

ABSTRACT

Introduction: Kids In Control Of Food (KICk OFF) has been conducted in Kuwait since 2015. The Kuwait team adapted and modified the course to a 3-day format instead of a 5- day, due to the attendees preferences. Objectives: To pilot a modified educational program KICk-OFF for children and adolescents (11-16 years old) with T1D and to evaluate the HbA1C and weight change, when compared with usual care Methods: The team successfully conducted 4 modified courses from July- September 2019 at Damsan diabetes institute (DDI). Prior to the trial courses that were conducted;the team responded to the requests of the previous graduates by piloting a shorter format (3-day). Also, the following modifications were made 1)Ongoing follow up individual sessions, 2) Group booster sessions 4 weeks post course,3) Sending biweekly text messages, 4) Fasting Ramadan sessions and 5) Flash glucose monitoring devices were distributed throughout the courses instead of the classical SMBG. Glycaemic control measured by HbA1c and body weight calculated by body mass index (BMI) were taken at baseline, 6, and 12 months for intervention groups and compared with controls. Results: Due to the Covid-19 pandemic, the trail outcomes were tracked up to 6months instead of 12months. For the intervention group, there was a significant reduction in mean HbA1c (n =22, pre 9.6 ± 2.0%vs. post 8.6 ± 0.9%;P = 0.01), whereas, there was no significant BMI differences (n=22, pre 23.52±4.6 vs. post-I 23.74±4.2;P =0.8). Moreover, no episodes of severe hypoglycemia, DKA, or hospitalization occurred after 6 months for all graduates. In addition, three graduates started insulin pump therapy. Finally, there were no changes in HbA1c (n=21, pre 9.6 ±1.9% vs. post 9.2 ±1.2%;P= 0.19) and BMI (n=21 pre22.7 ±5.6 vs. post23.1 ±5.9, P=0.37) in the control group. Conclusions: Joining a 3-day KICk-OFF Kuwait format was associated with significantly improved in Glycaemic control at 6 months compared with control group. These outcomes need to be confirmed in a study with a longer duration.