Living with type 1 diabetes imposes a considerable burden on the individual to continuously self‐manage their condition. As part of an ongoing audit, the psychological outcomes of insulin pump therapy were evaluated over a three‐year period. Adult patients completed self‐report questionnaires at initiation and after 12 months of pump therapy. Diabetes emotional distress was assessed using the Problem Areas in Diabetes Scale (PAID) and cognitive and behavioural aspects of fear of hypoglycaemia using the Hypoglycaemia Fear Survey (HFS‐W, HFS‐B). HbA1c and demographic data were obtained from the clinical record. Data were collected from 190 adults, age mean (SD) years 39.6(13.9), duration of diabetes 21.0(14.1). Outcomes improved significantly from baseline to 12 months for all variables (mean [SD]): HbA1c mmol/mol 73.4(14.9), 64.6(13.1), p<0.000; PAID 23.0(14.4), 16.9(13.3), p<0.000; HFS‐W 24.1(16.3), 15.0(12.9), p<0.000; HFS‐B 19.1(9.7), 13.4(8.1), p<0.000. Paired data analysis did not indicate an association between HbA1c reduction and reduced PAID and HFS scores. It was concluded pump therapy is associated with improvements in medical and psychological variables. While a reduction in both diabetes emotional distress, and worries and behaviours related to fear of hypoglycaemia appear to be unrelated to a reduction in HbA1c, the overall burden of diabetes indicated by diabetes distress and fear of hypoglycaemia is reduced significantly 12 months after initiation of insulin pump therapy. Copyright © 2017 John Wiley & Sons.

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or monitoring blood glucose excessively, result in suboptimal diabetes control. Therefore, it is essential, that treatment interventions reduce body image distress by integrating both psychological and diabetes-related factors. Do not be afraid to ask patients about the role they believe diabetes plays in their relationships. Conflicts of interestNone.

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The first year following diagnosis is a critical time for those newly diagnosed with type 1 diabetes and is likely to influence long‐term glycaemic control.This paper describes a group education programme, Living with Diabetes (LwD), and reports the outcome data at one year and three years after diagnosis. HbA1c was compared with outcomes from the cohort diagnosed during the four years prior to the inception of LwD.We have demonstrated that, in terms of HbA1c, the programme achieved outcomes similar to the traditional model with similar staff resources. The LwD pathway required an additional 2.9 hours per patient but HbA1c values were consistently lower in those who attended all sessions.The data suggest the need for more concerted attention to engage patients in an ongoing care pathway during the early years following diagnosis. An evaluation of the programme suggested that patients valued the relaxed non‐hierarchical nature of the group and the opportunity to share with and ask questions of their peers. Copyright © 2013 John Wiley & Sons.