The Influence of Initial Management and Family Stress on Metabolic Control in Children with Type 1 Diabetes

作     者：Irén Tiberg Inger Hallstrom Annelie Carlsson 

作者机构：Division of nursingDepartment of Health ScienceLund UniversityLundSweden The Swedish Institute for Health SciencesLundSweden Department of PediatricsLund University HospitalLundSweden 

出 版 物：《International Journal of Clinical Medicine》 (临床医学国际期刊（英文）)

年 卷 期：2010年第1卷第2期

页      面：41-47页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Type 1 Diabetes Disease Management Patient Admission Life Stress Hemoglobin A1c 

摘      要：The aim was to assess whether temporal changes in the initial management for children diagnosed with type 1 diabetes over a ten year period affected metabolic control two years after diagnosis. A further aim was to investigate if social factors, registered at diagnosis, had an impact on metabolic control two years after diagnosis. During the years 1997-2006, 247 children and adolescents were diagnosed with type 1 diabetes at a University Hospital in Sweden. The analysed data included HbA1c, pH at diagnosis, initial intravenous insulin infusion and length of hospital stay at diag?nosis, subcutaneous insulin type, number of diabetes check-up visits, emergency visits, re-admissions and social factors. Length of hospital stay decreased significantly over the ten year period. Neither hospital stay nor differences in insulin treatment was significantly correlated with children’s metabolic control over time. Length of hospital stay was not re?lated with families’ social stress situation. However, girls in families with more family stress at the time of diagnosis had higher HbA1c during follow-up than girls with less family stress or boys. Factors of importance for the child’s long-term metabolic control need to be further investigated so the initial management can be tailored to each individual family’s needs. This would imply an effective utilization of both families’ and health care resources.