liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Self-study material to prevent severe hypoglycaemia in children and adolescents with type 1 diabetes: A prospective intervention study
Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
2002 (English)In: Practical Diabetes International, ISSN 1357-8170, Vol. 19, no 5, 131-136 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to evaluate use of self-study material in diabetes education aimed at prevention of severe hypoglycaemia. Targeted self-study brochures (and video programs) regarding diabetes self-care and prevention of severe hypoglycaemia were mailed to all patients in early 1997 (and in 1999): a geographic population of 122-139 intensively treated type 1 diabetes patients yearly, aged 1-18 years (mean 12.2, SD 4.3), between 1994 and 1999. Yearly mean HbA1c (1.15% below DCCT level) ranged from 4.1 to 11.6% (mean 6.6, SD 1.1), age at onset 0.5-17.4 years (mean 7.6, SD 4.0) and duration 0.1-16.6 years (mean 4.6, SD 3.7). Main outcomes were patient attitudes to the interventions, perceived benefit, level of use, severe hypoglycaemia, and HbA1c.

Eighty-six percent of responders stated that the video was valuable. Perceived benefit was higher for the hypoglycaemia prevention video than for the brochure (p = 0.016). Those with severe hypoglycaemia the preceding year indicated greater benefit from the hypoglycaemia prevention brochure than others (p = 0.039). Average yearly incidence of severe hypoglycaemia with unconsciousness decreased from 13% in 1994-1996 to 9% (ns) in 1997-1999. The per patient cost of the material was <Euro 10.

Conclusion. Self-study material can reach high dissemination at a low cost. It also seems to have contributed to a decrease in severe hypoglycaemia, but controlled studies are needed. There is a great need for good quality patient/consumer information materials dealing with aspects of general management and risk prevention in diabetes treatment.

Place, publisher, year, edition, pages
2002. Vol. 19, no 5, 131-136 p.
Keyword [en]
children and adolescents, education, pedagogical device, prevention, severe hypoglycaemia, type 1 diabetes
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13559DOI: 10.1002/pdi.363OAI: oai:DiVA.org:liu-13559DiVA: diva2:20951
Available from: 2000-11-29 Created: 2000-11-29 Last updated: 2009-08-20
In thesis
1. On Severe Hypoglycaemia in Children and Adolescents with Type 1 Diabetes
Open this publication in new window or tab >>On Severe Hypoglycaemia in Children and Adolescents with Type 1 Diabetes
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: For people with type 1 diabetes, there is no alternative to treatment with insulin. The major side effect of insulin is severe hypoglycaemia (SH), when the patient needs help or even becomes unconscious.

Material: We have studied a geographic population of yearly 130-140 unselected type 1 diabetes patients aged 1-18 years during 1992-1999. They were intensively treated with 87-96% on 4-7 daily insulin doses, combined with active self-control, psychosocial support and problem-based education from onset. Average HbA1c was 6.5 with Mono-S standard (1.15% beow DCCT level).

Methods: We evaluated use of a prospective patient questionnaire for continuous long-term registration of treatment and outcome data and analysed HbA1c, SH and other variables. Over years, 95-100% response rate was achieved. We used also temporary questionnaries.

Results: We found SH with unconsciousness reported from on average 11% of patients yearly, SH without unconsciousness but needing assistance from on average 36% yearly and weak associations to HbA1c, such as reletive risk of SH 1.24 for yearly mean HbA1c <7.0% compared to ≥7.0% There was a seasonal variation in HbA1c (p=0.023) and incidence of SH. The strongest predictor for SH was SH during the previous year (r=9.38, p<0.0001).

The impact from SH showed great variation, and 20-30% of events led to practical disturbancies for parents and/or other people. Hospital visits took place only at 5% and hospitalisations at 3% of events. Social activities for patients were cancelled after 10% of events. Increased worry for patients was reported after 8% of events, bad sleep after 7%. We estimated the average socio-economic cost for SH at EURO 239 per event of SH with unconsciousness, and EURO 63 per event of SH without unconsciousness but needing assistance.

Mass-distributed self-study material (brochures and videos) aimed at the prevention of SH without compromising metabolic control reached high dissemination and was widely appreciated by patients. The material copy cost was only EURO 7 per patient. It also seems to have contributed to a decrease in SH with unconsciousness from yearly 13% of patients before to 9% after intervention (3-years average), but controlled studies are needed.

Conclusions: We conclude that SH remains a very serious problem of multifactorial aethiology. It causes considerable discomfort and costs. Systematic patient education mgiht reduce the incidence. Interventions using mass-distribution of high quality self-study material such as videos and brochures seem to have a potential to be cost-effective. There is a great patient/consumer interest in high quality- and advanced information/education materials.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2000. 67 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 648
Keyword
Severe hypoglycaemia, SH, diabetes, insulin, HbA1c, aethiology
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-5018 (URN)91-7219-749-8 (ISBN)
Public defence
(English)
Available from: 2000-11-29 Created: 2000-11-29 Last updated: 2012-01-24Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textLink to Ph.D. Thesis

Authority records BETA

Nordfeldt, SamLudvigsson, Johnny

Search in DiVA

By author/editor
Nordfeldt, SamLudvigsson, Johnny
By organisation
Child and Adolescent Psychiatry Faculty of Health SciencesDepartment of Child and Adolescent PsychiatryPediatrics Department of Paediatrics in Linköping
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 274 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf