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- Hanås, Ragnar, 1951, et al.
(författare)
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Indwelling catheters used from the onset of diabetes decrease injection pain and pre-injection anxiety
- 2002
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Ingår i: J Pediatr. - : Elsevier BV. - 0022-3476 .- 0022-3476 .- 1097-6833. ; 140:3, s. 315-20
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate the use of indwelling catheters as injection aids at diabetes onset to reduce injection pain and pre-injection anxiety. STUDY DESIGN: Forty-one patients aged 8.1 +/- 3.7 years (range, 1-15) participated in this open, controlled randomized study. A 10-cm VAS with faces was used for scoring. A local anesthetic cream was used before all insertions. The control group used insulin pens with standard needles. After one week, the indwelling catheter group could choose regular injections but were included in the "intention to treat" analysis. RESULTS: Injection pain and anxiety decreased from day 1 to 15 in both groups (average, 4.1 injections/day). Pain was significantly lower for indwelling catheter injections when scored by parents (median, 1.2 cm vs 2.7 cm; P =.002), children/teenagers (0.8 cm vs 1.5 cm; P =.006), and nurses (1.4 cm vs 3.0 cm; P =.002). Parental pre-injection anxiety was also lower (1.2 cm vs 2.9 cm; P =.016). Taking injections, including inserting catheters, was found to be less problematic with an indwelling catheter (1.6 cm vs 3.3 cm;P =.009). During the 6-month follow-up, injection pain and injection problems were significantly lower in the catheter group. Mean catheter indwelling time was 3.7 days. Median pain for catheter insertion was 2.1 cm and for glucose testing was 0.9 cm. Sixteen of 20 patients continued to use indwelling catheters after 2 weeks, and 9 of 20 after 6 months. CONCLUSIONS: We found an evident relief of pre-injection anxiety and injection pain when using indwelling catheters for introducing insulin injections at the onset of diabetes.
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- Ludvigsson, Johnny, et al.
(författare)
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Stressful life events, social support and confidence in the pregnant woman and risk of coeliac disease in the offspring
- 2003
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 38:5, s. 516-521
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stressful life events just before conception or during pregnancy can affect fetal development and increase the risk of disease in the offspring. The purpose of our study was to examine stressful life events, maternal social support and confidence during pregnancy and the risk of coeliac disease in the offspring. Methods: Prospective cohort study of 16,286 children born between 1 October 1997 and 1 October 1999 in southeast Sweden. The study was part of the ABIS study (ABIS = All Babies In Southeast Sweden). Data on independent variables were obtained through questionnaires distributed at birth. The questionnaire included questions about parental disease, socio-economic factors, smoking, alcohol intake but also infections during pregnancy. Eight paediatric departments prospectively recorded all children with coeliac disease (confirmed through biopsy). Results: Exposure to stressful life events (OR = 0.48, 95% CI OR = 0.12-2.01, P = 0.318), lack of social support (OR = 3.17, 95% CI OR = 0.43-23.22, P = 0.257) and lack of confidence (OR = 0.04, 95% CI OR = 0.00-2.48 x 10(9), P = 0.794) in the pregnant woman were not linked to coeliac disease in the offspring. Conclusion: The study indicates that stressful life events, lack of social support and lack of confidence during pregnancy play no role in the development of coeliac disease in the offspring.
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- Ortqvist, E., et al.
(författare)
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Temporary preservation of beta-cell function by diazoxide treatment in childhood type 1 diabetes
- 2004
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 27:9, s. 2191-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We examined the effect of diazoxide, an ATP-sensitive K(+) channel opener and inhibitor of insulin secretion, on beta-cell function and remission in children at clinical onset of type 1 diabetes. RESEARCH DESIGN AND METHODS: A total of 56 subjects (21 girls and 35 boys, age 7-17 years) were randomized to 3 months of active treatment (diazoxide 5-7.5 mg/kg in divided doses) or placebo in addition to multiple daily insulin injections and were followed for 2 years. RESULTS: Diazoxide decreased circulating C-peptide concentrations by approximately 50%. After cessation of the treatment, basal and meal-stimulated C-peptide concentrations increased to a maximum at 6 months, followed by a decline. Meal-stimulated C-peptide concentration was significantly higher at 12 months (0.43 +/- 0.22 vs. 0.31 +/- 0.26 nmol/l, P = 0.018) and tended to fall less from clinical onset to 24 months in the diazoxide- vs. placebo-treated patients (-0.05 +/- 0.24 vs. -0.18 +/- 0.26 nmol/l, P = 0.064). At 24 months, the meal-stimulated C-peptide concentrations were 0.24 +/- 0.20 and 0.20 +/- 0.17 nmol/l, respectively. Side effects of diazoxide were prevalent. CONCLUSIONS: This study demonstrates that partial inhibition of insulin secretion for 3 months at onset of childhood type 1 diabetes suspends the period of remission and temporarily preserves residual insulin production. Further evaluation of the full potential of beta-cell rest will require compounds with less side effects as well as protocols optimized for sustained secretory arrest.
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- Samuelsson, U, et al.
(författare)
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Blood glucose peaks give high HbA1c
- 2004
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Ingår i: International Society for Pediatric and Adolescent Diabetes ISPAD,2004.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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