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- Beraki, Åsa, et al.
(författare)
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Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes : results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS)
- 2014
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Ingår i: Diabetes Research and Clinical Practice. - Clare, Ireland : Elsevier. - 0168-8227 .- 1872-8227. ; 105:1, s. 119-125
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To evaluate the associations between physical activity (PA) and metabolic control, measured by glycated hemoglobin (HbA1c), in a large group of children and adolescents with type 1 diabetes.Methods: Cross-sectional analysis of data from 4655 patients, comparing HbA1c values with levels of physical activity. The data for the children and adolescents were obtained from the Swedish pediatric diabetes quality registry, SWEDIABKIDS. The patients were 7-18 years of age, had type 1 diabetes and were not in remission. Patients were grouped into five groups by frequency of PA.Results: Mean HbA1c level was higher in the least physically active groups (PA0: 8.8% +/- 1.5 (72 +/- 16 mmol/mol)) than in the most physically active groups (PA4: 7.7% +/- 1.0 (60 +/- 11 mmol/mol)) (p < 0.001). An inverse dose-response association was found between PA and HbA1c (beta: -0.30, 95%CI: -0.34 to -0.26, p < 0.001). This association was found in both sexes and all age groups, apart from girls aged 7-10 years. Multiple regression analysis revealed that the relationship remained significant (beta: -0.21, 95% CI: -0.25 to -0.18, p < 0.001) when adjusted for possible confounding factors.Conclusions: Physical activity seems to influence HbA1c levels in children and adolescents with type 1 diabetes. In clinical practice these patients should be recommended daily physical activity as a part of their treatment.
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| 4. |
- Särnblad, Stefan, 1963-, et al.
(författare)
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Diabetes management in Swedish schools : a national survey of attitudes of parents, children, and diabetes teams
- 2014
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Ingår i: Pediatric Diabetes. - Hoboken, USA : Wiley-Blackwell Publishing Inc.. - 1399-543X .- 1399-5448. ; 15:8, s. 550-556
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Tidskriftsartikel (refereegranskat)abstract
- Background: Parents of children with type 1 diabetes often raise complaints about self-care support during school time. The aim of this study was to investigate attitudes to diabetes care in school reported by children with type 1 diabetes, their parents, and their diabetes teams. Method: Children who had completed preschool class or at least one grade in the nine-year compulsory school system were invited to participate. Data were collected using separate questionnaires for the children and their parents. In addition, the members of the diabetes team answered a separate questionnaire. All pediatric diabetes centers in Sweden were invited to participate in the study.Results: All Swedish children and adolescents with diabetes are treated at pediatric diabetes centers. Out of 44 eligible centers, 41 were able to participate. The questionnaires were completed by 317 children and adolescents and 323 parents. The mean age was 11.4 ± 2.7 years and HbA1c was 61.8 ± 12.4 mmol/mol (7.8 ± 1.1%). For 57% of the children, there was no member of staff at the school with principal responsibility to support diabetes self-care. A written action plan for hypoglycemia existed for 60% of the children. Twenty-one percent of the parents regularly gave less insulin than they calculated would be needed at breakfast because of fear of hypoglycemia during school time.Conclusions: Although Sweden has legislation underlining the specific need for diabetes care in school, this nationwide study demonstrates deficiencies in the support of self-care management.
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| 5. |
- Särnblad, Stefan, 1963-
(författare)
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Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes : results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS).
- 2013
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Konferensbidrag (refereegranskat)abstract
- Objectives: Physical activity is an important part of diabetes management. However, studies concerning the relation between physical activity and metabolic control have shown conflicting results. In this study we wanted to evaluate the effect of physical activity (PA) on metabolic control, measured by glycosylated hemoglobin (HbA1c) in a large cohort of children and adolescents with type 1 diabetes. Methods: Cross-sectional analysis of data from 4,655 patients in 2010-2011, comparing HbA1c values with levels of physical activity. Data were obtained from the Swedish pediatric diabetes quality registry, SWEDIABKIDS. The patients were 7–18 years of age, had type 1 diabetes and were out of remission. The patients were grouped by frequency of physical activity lasting at least 30 minutes each week as follows: PA0, none, PA1, less than once a week, PA2, 1-2 times per week, PA3, 3-5 times per week, and PA4, every day.Results: The frequency of physical activity was lower for older children and adolescents (p < 0.001), mean age varying from 13.5 years in PA4 to 15.9 years in PA0.Mean HbA1c level was higher in the least active group (PA0: 70 ± 15 mmol/mol (8.5% ± 1.4)) than in the most active group (PA4: 61 ± 13 mmol/mol (7.8% ± 1.2)) (p<0.001). Linear regression showed an inverse dose-response association between physical activity and HbA1c (β: -2.7, 95% CI: -3.0 to -2.3, p<0.001). This effect was found in both sexes and all age groups, apart from girls aged 7-10 years (p=0.252). Multiple regression analysis revealed that the association remained significant (β: -2.0, 95% CI: -2.4 to -1.7, p<0.001) when adjusted for disease duration, insulin dose, insulin methods, and hypoglycemia.Conclusions: This study indicates that a higher level of physical activity results in better metabolic control. More studies with objective methods in large populations are required to confirm the inverse dose-response relationship between physical activity and HbA1c.
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| 7. |
- Åkesson, Karin, et al.
(författare)
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A Diabetes Resource Nurse Improves the Self-Care of Children with T1D in School
- 2013
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Konferensbidrag (refereegranskat)abstract
- Objectives: Although Sweden has legislation underlining the specific need for diabetes care in school, a nationwide study in 2008 demonstrated deficiencies in the support of self-care management in school-aged children with type 1 diabetes. The aim of this study was to evaluate the effect on support of self-care management in school by a diabetes resource nurse available for school personnel.Methods: A position as a diabetes resource nurse has been tested in Jönköping County Council for three years (2010-2013) to offer the school staff necessary knowledge about diabetes. The diabetes resource nurse visited the schools to give information in the child´s daily environment. After the first study year a questionnaire was answered by 27 parents were the diabetes resource nurse had visited their child´s school and by 58 parents where the nurse had not.Results: Before the visit 60 % of the children had no member of staff at the school with principal responsibility to support diabetes self-care, after the visit the number was 18 %. After the visit 85 % of the children with diabetes had an individually written action plan for hypoglycemia compared to 62 % before the visit (p=0.031). Parents were significantly less worried during their child´s school day after a visit of the diabetes resourse nurse (p=0.015). No differences were seen in HbA1c between the groups in this first analysis but this will be evaluated again after a longer follow up period.Conclusion: The preliminary result of the intervention shows that a diabetes resource nurse can successfully improve the support children with type 1 diabetes receive at school. A new questionnaire is currently being analyzed to evaluate the results after the three years during which the diabetes resourse nurse has performed 180 school visits. Further studies are needed to clarify which grades benefit the most from the support of a diabetes resource nurse and to inquire the school personnel´s experience of the resourse nurse´s work.
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