儿科1型糖尿病患者的碳水化合物计数和胰岛素剂量计算知识

Natalie Finner , Anne Quinn , Anna Donovan , Orla O'Leary , Clodagh S. O'Gorman
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引用次数: 12

摘要

背景:1型糖尿病(T1DM)患者如果能够根据膳食中碳水化合物的含量以及他们的血糖来调整胰岛素的剂量,那么他们的血糖控制可能会得到改善(Silverstein et al., 2005)。随着血糖控制的改善,患者发生与T1DM相关的长期微血管并发症的风险降低(糖尿病控制和并发症试验研究小组,1993)。为了评估在利默里克大学医院(UHL)儿科糖尿病门诊就诊的患者的碳水化合物和胰岛素知识,我们对门诊人群应用了经过验证的PedCarbQuiz (PCQ)。方法:本研究采用一份名为PedCarbQuiz (PCQ)的问卷,对在UHL儿科糖尿病诊所就诊的儿童进行调查。在诊所的220名患者中,有81人参加了这项研究。结果连续皮下胰岛素输注组(CSII)的平均总PCQ评分(%)高于每日多次胰岛素(MDI)注射组(79.1±12.1比65.9±6.6 p = 0.005)。CSII组的平均碳水化合物评分(%)也高于MDI组(79.4±12.4比66.3±16.2,p = 0.004)。结论本研究表明,在具有代表性的爱尔兰地区儿科T1DM诊所中,与MDI相比,CSII治疗的患者对碳水化合物和胰岛素的了解更好。然而,这两组人的知识都比最初的美国样本少。本研究表明,在具有代表性的爱尔兰地区儿科T1DM诊所中,碳水化合物和胰岛素的知识比美国样本要差,尽管与MDI相比,CSII治疗的患者对这方面的知识更好。这突出了改善T1DM患者的糖尿病资源和碳水化合物计数教育的必要性。
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Knowledge of carbohydrate counting and insulin dose calculations in paediatric patients with type 1 diabetes mellitus

Background

Patients with type 1 diabetes mellitus (T1DM) who are able to adjust their insulin doses according to the carbohydrate content of a meal, as well as their blood glucose, are likely to have improved glycaemic control (Silverstein et al., 2005). With improved glycaemic control, patients have a lower risk of developing long-term microvascular complications associated with T1DM (Diabetes Control and Complications Trial Research Group, 1993).

To assess the carbohydrate and insulin knowledge of patients attending our paediatric diabetes clinic at the University Hospital Limerick (UHL), the validated PedCarbQuiz (PCQ) was applied to our clinic population.

Methods

This study was completed by applying a questionnaire called the PedCarbQuiz (PCQ) to children exclusively attending our paediatric diabetes clinic at UHL. Of the clinic's 220 patients, 81 participated in the study.

Results

The average total PCQ score (%) was higher in the continuous subcutaneous insulin infusion (CSII) group compared with the multiple daily insulin (MDI) injection user group (79.1 ± 12.1 versus 65.9 ± 6.6 p = 0.005). The CSII group also had a higher average carbohydrate score (%) compared with the MDI group (79.4 ± 12.4 versus 66.3 ± 16.2, p = 0.004).

Conclusions

This study demonstrates that in a representative Irish regional paediatric T1DM clinic, knowledge of carbohydrates and insulin is better among patients treated with CSII compared with MDI. However, knowledge in both groups is poorer than in the original US sample.

General significance

This study demonstrates that in a representative Irish regional paediatric T1DM clinic, knowledge of carbohydrates and insulin is poorer than in a US based sample, although this knowledge is better among patients treated with CSII compared with MDI. This highlights the need for improved resources for diabetes and carbohydrate counting education for patients with T1DM.

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