| 1. |
- Dahlgren, Lars-Ove, 1946-, et al.
(författare)
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Varför PBI?
- 1993
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Ingår i: Problembaserad inlärning. - Lund : Studentlitteratur. - 9144372612 ; , s. 13-27
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 2. |
- Hanås, Ragnar, et al.
(författare)
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Metabolic Control Is Not Altered When Using Indwelling Catheters for Insulin Inactions
- 1994
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 17:7, s. 716-718
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE To determine if the use of indwelling catheters for insulin injections affects the long- and short-term metabolic control of insulin-dependent diabetes mellitus (IDDM).RESEARCH DESIGN AND METHODS Sixteen children and adolescents 9–20 years of age were included in a randomized 10-week crossover study using indwelling catheters (Insuflon, Pharma-Plast, Lynge, Denmark; CHRONIMED, Minnetonka, Minnesota) for insulin injections. Their diabetes duration was 7.5 ± 3.3 years (range 2–14), and they used multiple injection therapy with 4–5 doses/day. C-peptide was <0.15 nM fasting and ≤0.30 nM postprandial.RESULTS We found no significant difference between those with and without Insuflon in degree of metabolic control reflected by HbA1c (with Insuflon, 7.3 ± 2.6%; without, 7.1 ± 2.2%), 24-h profiles of blood glucose and free insulin, 24-h samples of glucosuria, or ketonuria. Weight, insulin doses per kilogram per 24 h, and insulin antibodies were all the same in the two groups.CONCLUSIONS The long- and short-term metabolic control of IDDM was not altered by the use of indwelling catheters for insulin injections. Insuflon can be offered as an alternative to patients with IDDM who find regular injections uncomfortable.
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| 3. |
- Hedbrant, Johan, et al.
(författare)
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Särimner : a computer model of diabetes physiology for education of physicians and patients.
- 1991
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Ingår i: Diabetes Research and Clinical Practice. - 0168-8227 .- 1872-8227. ; 14:2, s. 113-122
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Tidskriftsartikel (refereegranskat)abstract
- Often diabetic patients have developed their skills by some trial-and-error-like training over a long period of time. To minimize this inconvenience we have made a mathematical model to facilitate diabetes education. The model consists of a number of blocks involved in diabetes physiology: digestion, blood (transport), pancreas, injected insulin absorption, liver, muscles, kidneys, metabolism and insulin sensitivity. The model serves as a demonstration object and the user can change meals, exercise and injections and see the resulting blood glucose level. A more experienced user can search for further explanations of different phenomena deeper in the physiology of the model. The model does not solve any problem for the user, but creates a learning situation in which the user, led by his own curiosity, successively increases his experience of diabetes physiology. Särimner is implemented as an easy-to-use menu driven computer program for IBM PC-clones with Hercules, EGA or VGA graphics.
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| 4. |
- Hedbrant, Johan, 1959-
(författare)
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Särimner : a computer model for diabetes education
- 1993
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In diabetes mellitus pancreas fails to produce insulin enough to maintain tissue utilisation of blood glucose. To maintain a normalised metabolism many diabetic patients have to provide insulin from injections or an infusion pump. The disease affects some percent of western population.The insulin provided by the patient has to be adjusted to food and physical exercise. This may be achieved by following rules from diabetes professionals, but also by self learning how food, insulin and physical exercise interact and influence the blood glucose. It seems that the patients who have this intuitive knowledge of the interactions are the ones who manages their diabetes treatment best and have the highest quality of life. The learning have, however, been performed by trial and error - to the price of severe inconvenience and bad metabolic control.A combination of computer science and diabetes physiology has resulted in the computer program Särimner. It is created to give the user a possibility to experiment with diabetes treatment. Food, insulin and physical exercise may be varied and the blood glucose is calculated. Sarimner provides a short-cut to obtaining knowledge since it allows experiments, stimulates discussions and let the user by himself formulate and test hypotheses regarding experienced problems. Since Särimner may be adjusted to look more alike an individual, the experiments are driven by the user's own curiosity. He may experiment with situations of importance to himself and finally make himself the expert of his own treatment situation.The way Särimner is designed, allows interested users to get "under the skin" of the model and study details in the physiological processes. This transparency makes it possible to search for explanations to treatment phenomena. One drawback with the model is that it is quite complex and requires some knowledge from a user with the ambition to understand all the processes.To measure the impact of Särimner training, 11 diabetic teenagers were evaluated with respect to metabolic control, emotional adjustment, focus of control, self-esteem and ability to discuss treatment phenomena. No control group was possible to recruit.The results indicated that the education had been useful for some individuals. They increased their knowledge and ability to discuss treatment situations, their sense of control over the diabetes treatment, their self esteem and furthermore Särimner education may have caused a reduction of diabetes related stress. However, an increased level of diabetes related guilt did occur in some individuals, possibly due to either increased knowledge or a more internalised focus of control.The models ability to look alike reality is depending on for which purpose it is used. Even though it would be theoretically possible to fit the model to an individual, such an experiment would not be performable in reality since Särimner requires input data from the physiology which is impossible to measure. The properties of the model are, however, adequate for illustrating several treatment situations on a phenomenological level.
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