Understanding Artificial Pancreas Systems: Results from a 24-Month Trial

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Non-randomized (moderate): Randomization not used or not reported

No control group (high): Single-arm or uncontrolled design

Open-label or unblinded (moderate): No blinding reported

High risk of bias (high): Overall bias rated high

High dropout (moderate): 34.9253731343% dropout

Mean total knowledge score increased from 9.66 to 10.32 out of 11 after the intervention, indicating better short-term diabetes knowledge among participants who completed both assessments.

Self-rated ability in diabetes management improved from 5.01 to 6.85, with a large effect size (d=0.99), suggesting substantial short-term confidence gains.

Self-rated ability to recognize low blood glucose symptoms improved from 5.06 to 6.91, with a large effect size (d=0.97).

Responses showed reduced uncertainty and less endorsement of inaccurate beliefs across several attitude and belief items after training, indicating short-term reduction in misconceptions.

Single 1-hour synchronous online module via Google Meet, led by a diabetologist and psychologist, covering T1D signs, school management, emergencies, and psychosocial inclusion topics.

Positive: 4; Negative: 0; No effect: 0; Mixed: 0

Extracted 4 outcome signals across the study

Most measured educational and confidence outcomes improved after intervention, though design limitations reduce certainty about causality.

↑ Type 1 diabetes knowledge score increased from 9.66 to 10.32/11

↑ Self-perceived diabetes management ability increased (d=0.99)

A brief synchronous online psychoeducational session can improve short-term diabetes literacy among school staff

Staff confidence-related outcomes improved alongside objective knowledge score gains

Findings support school-health collaboration models but need confirmation with controlled long-term studies

Caldarelli G, Troncone A, Chianese A, et al. Evaluation of the Impact of a Psychoeducational Program on Type 1 Diabetes in Italian Schools: A Pre-Post Study. J Sch Health. 2026;96(5):e70141. doi:10.1111/josh.70141

No control group, so causal inference is limited

Outcomes measured immediately post-session without long-term retention data

High noncompletion rate from enrollment to paired analysis

Several outcomes are self-reported and may be affected by social desirability

In a pre-post study of 436 Italian school staff, a 1-hour synchronous online psychoeducational session improved type 1 diabetes knowledge, confidence in diabetes management, and recognition of hypoglycemia symptoms immediately after training.

↑ Ability to recognize hypoglycemia symptoms improved (d=0.97)

This podcast discusses the growing prevalence of Type 1 Diabetes (T1D), the importance of autoantibody screening, the different stages of T1D, screening guidelines, patient counseling, and how early intervention can help delay progression and reduce complications.

Episode 59: Early Detection of Type 1 Diabetes | American Association of Clinical Endocrinology

The ISPAD position statement outlines international recommendations for integrating children with type 1 diabetes in school settings, including staff education and emergency response readiness, which aligns with this intervention's goals.

ISPAD Position Statement on Type 1 Diabetes in Schools

Listen to podcast episode 41 to learn about a clinical case report on two patients with Wolfram syndrome who were initially diagnosed with type 1 diabetes but negative for islet autoantibodies. Key topics include the importance of distinguishing between Wolfram syndrome and type 1 diabetes, the significance of the homozygous vs. compound heterozygous pathogenic variants in WFS1 gene, how the management and treatment for Wolfram syndrome differs from that of type 1 diabetes, the current status of therapeutic interventions, and much more.

Episode 41: AACE Clinical Case Report on Wolfram Syndrome | American Association of Clinical Endocrinology

This ADA statement provides practical guidance for diabetes safety, emergency preparedness, and school-based support processes. It is directly relevant to staff training programs designed to improve care for students with type 1 diabetes.

Diabetes Care in the School Setting: A Statement of the American Diabetes Association

Type 1 diabetes is often mistakenly thought of as a childhood disease. However, it is estimated that half of all new type 1 diagnoses develop after the age of 20.

Individuals with type 1 diabetes and those with type 2 diabetes at risk for low blood glucose should take steps to avoid lows when driving.

American Association of Clinical Endocrinology resource matched by keyword relevance (type 1 diabetes)

Episode 47: AACE Clinical Case Report Special Diabetes Issue: MODY5 and Serous Ovarian Carcinoma in 17q12 Recurrent Deletion Syndrome; ABCC8-Related Monogenic Diabetes Presenting Like Type 1 Diabetes in an Adolescent | American Association of Clinical Endocrinology

CDC school diabetes resources describe practical actions schools can take to support students, reduce preventable emergencies, and coordinate care with families and healthcare teams.

Changes in HbA1c and diabetes-specific quality of life following structured type 1 diabetes education: Exploratory latent profile analysis of outcomes in the DAFNEplus trial.

Supporting Parents of Young Children With Type 1 Diabetes Through Telehealth: Randomized Controlled Trial of the Reducing Emotional Distress for Childhood Hypoglycemia in Parents Intervention.

The Glucagonotropic Effect of GIP Is Negated During Insulin-Induced Hypoglycemia in Type 1 Diabetes: A Randomized, Placebo-Controlled, Crossover Study.

GLP-1 Receptor Agonist Therapy and Cardiorenal Outcomes in Type 1 Diabetes: A Propensity-Matched Real-World Analysis.

Glucose-lowering effects of physical activity in type 1 diabetes: A causal modelling and matched-pair analysis approach

No control group (high): No parallel control group reported

High dropout rate (moderate): 34.9253731343% dropout

Includes self-reported outcomes (moderate): Self-reported outcomes used

Online school staff training improved type 1 diabetes knowledge and confidence

This study tested a 1-hour live online training session for school staff on type 1 diabetes. Staff knowledge and confidence scores improved right after the session, and participants reported better ability to recognize low blood sugar symptoms. Because there was no control group and only immediate follow-up, longer-term effects are uncertain.

The intervention was short and measured only immediate effects. Results may not reflect sustained behavior change. Because schools volunteered and staff self-selected participation, findings may overrepresent people already motivated to learn about diabetes care.

A 1-hour synchronous online psychoeducational program for school staff on type 1 diabetes.

School staff members (teachers, principals, and nonteaching personnel) in schools attended by children with type 1 diabetes, primarily in Southern Italy.

Intervention	Outcome	Measured Change	Study Effect
T1D education (Behavioral & Lifestyle)	Diabetes-related misconceptions (Patient-Reported)	Decrease	Mixed
T1D education (Behavioral & Lifestyle)	Hypoglycemia sign recognition (Adherence & Engagement)	Increase	Strong
T1D education (Behavioral & Lifestyle)	Perceived diabetes management competence (Patient-Reported)	Increase	Strong
T1D education (Behavioral & Lifestyle)	Type 1 diabetes knowledge score (Adherence & Engagement)	Increase	Mixed

Online school staff training improved type 1 diabetes knowledge and confidence

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