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- Forsander, Gun, 1951, et al.
(författare)
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Metabolic control in children with insulin-dependent diabetes mellitus 5 y after diagnosis. Early detection of patients at risk for poor metabolic control.
- 1998
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 87:8, s. 857-64
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Tidskriftsartikel (refereegranskat)abstract
- Children (n = 38) aged 3-15 y were randomly chosen, at the time of diabetes diagnosis, for conventional management at a hospital ward, or for treatment partly in a training apartment where the family was offered problem-based education and special therapeutic support. HbA1c, blood glucose stability, urinary C-peptide excretions and incidence of hypoglycaemic attacks and diabetes ketoacidosis (DKA) were monitored and some standardized, self-estimated psychological tests were performed during the first 2 y after diagnosis. During the 3 y thereafter, HbA1c, presence of DKA, microalbuminuria, retinopathy and hypertension were monitored. None of the patients demonstrated signs of diabetes microangiopathy or DKA. The overall mean HbA1c level was 7.2% 5 y after diagnosis and 30% of the children had HbA1c values <6.3%. There were no differences in the HbA1c values for the patients treated by the different management regimens. Blood glucose variability (SD) was also similar, with 75% of the values in the range of 3-10 mmol/l. Patients with poor glycaemic control (mean HbA1c >8.3%) year 5 after diagnosis had already the second year after diagnosis significantly higher HbA1c values and blood glucose variability. The fathers of these patients demonstrated a higher degree of maladjustment. On the basis of increasing HbA1c values, high blood glucose variability and psychosocial risk factors such as their fathers' emotional responses, patients at risk for poor metabolic control in the future can be identified within 2 y after diagnosis. Efforts and resources can thus be focused at an early stage on this group.
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- Sundelin, J, et al.
(författare)
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Family-oriented support at the onset of diabetes mellitus: a comparison of two group conditions during 2 years following diagnosis.
- 1996
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 85:1, s. 49-55
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- As part of a prospective, randomized study, the psychological effects of two different treatment regimens on the diagnosis of children and adolescents aged 3-15 years with insulin-dependent diabetes insipidus were evaluated. Conventional treatment was compared to a new regimen with a crisis programme which included a milieu therapeutic setting. A total of 38 families were randomly assigned to the 2 groups and followed over a period of 2 years after initial treatment. Parents' experiences of family climate and function over this period were registered and a test battery for the children was administered on five separate occasions. No decisive difference between the two groups was found. Few significant differences were found. Further investigation of the effects of the new treatment regimen on selected groups of families with defined extra needs is suggested.
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