Working with insulin, carbohydrates, ketones and exercise to manage diabetes: exploration of potential for implementation into clinical practice

CLAHRC Diabetes theme - WICKED course (Working with Insulin, Carbs, Ketones, and Exercise to manage Diabetes) from NIHR CLAHRC YH on Vimeo.

What are the aims of this project?

WICKED is based on constructivist learning incorporating differentiated learning objectives and outcomes linked to assessment for learning. Young people construct new knowledge and understanding using what they already know. WICKED aims to use terminology which is understood and used by young people

Why is this important?

The structured education programme WICKED is specifically designed to meet the needs of young people with type 1 diabetes transitioning from paediatric to adult care. WICKED covers important key concepts such as think, act and results like a pancreas, carbohydrate counting and calculation, adjusting insulin doses and regimens, management of short and long term health complications, what care to expect and exercise. Additional concepts important to young people such as managing diabetes whilst eating out, drinking alcohol and potential risk taking behaviours such as using recreational drugs, smoking, sexual health, preconception advice and pregnancy, driving, travel, employment, leaving home, relationships and sharing their experiences of living with diabetes are discussed and shared in a confidential and peer supported environment.

How will the research be carried out?

There have been 8 WICKED courses, each course is delivered over 5 days (as the DAFNE course and the KICk-OFF course do) the WICKED courses were run in May, June, July, August and October of 2012, February and August of 2013 and February 2014. In 2014 we conducted a further 3 courses in May, August and November in Sheffield followed by 4 courses a year following. For each course every participant has been given a key worker. Each course has had group follow up at 3,6 and 9 weeks each participant has been followed up by their key worker at these follow ups and again at 12 weeks and also in adolescent clinic. In addition, a qualitative study is being conducted to test the potential for implementation of the course into routine clinical practice, through direct observations of the course, followed by focus groups with participants and interviews with the young adults and the trainers (diabetic nurses, dieticians, youth worker). This is being carried out at Sheffield, Leeds and Harrogate. The course are also being evaluated through QA, and the participants’ social, psychological and clinical outcomes are being evaluated using a regular survey for 12 months after the course to explore their experiences of the course and impact on diabetes management and control.


The courses, observations and interviews will continue until middle of 2016.

Who is undertaking the research?

The research is led by Professor Simon Heller.

How are stakeholders being engaged?

Diabetes teams in Harrogate, Leeds and Sheffield have been engaged to deliver the course at these three sites to investigate if the course can be rolled out to multiple healthcare settings.

What will be the outputs from the study?

We hope that the main outcome will be the adoption of the course by diabetes teams across the country, and in the medium term we hope that the course can be run alongside routine clinic appointments for young adults with type 1 diabetes. Other outputs will include conference presentations and publication of peer reviewed articles.

Presentations and papers from the project will be listed here.