Diabetes Education in Children and Adolescents with Type 1 Diabetes in China
Background: The prevalence of Type 1 Diabetes is increasing in pediatrics and diabetes education plays one of the most important role in the management of diabetes, especially in children. However, the related evidence concerned diabetes education is rare in children and adolescents. Therefore, we aimed to investigate the status of diabetes education in hospital, which could help us know the reality of diabetes education.
Methods: We choose a nurse who is mainly responsible for diabetes education and management in each hospital to fill out the questionnaire. Overall, 98 nurses were enrolled from tertiary children's specialized hospitals and pediatric wards of general tertiary hospitals from Jan 2018 to Dec 2019.
Results: Of 98 nurses enrolled, 61 (63.3%) nurses from 98 hospitals responded, 39 (63.9%) of them received specialized training in diabetes. There were no differences in education characteristics among regions of China. There were 26(42.6%) hospitals have a full-time nurse for diabetes education or nurses with endocrinology training increased with the number of cases/year (P=0.02 and P=0.009). The use of game-based education, knowledge assessment at discharge did not vary among hospital volumes, and the presence of a psychiatrist (P=0.41, P=0.65, and P=0.85, respectively). Diet management education is the most common (23.0%) difficulty in children diabetes education.
Conclusion: The level of diabetes education in children and adolescents varied among hospitals, but not among regions in China. There was a lack of resources provided for children and adolescents diabetes education in terms of training and specialized services.
2. Weng J, Zhou Z, Guo L, Zhu D, Ji L, Luo X, Mu Y, Jia W, Group TDCS (2018). Incidence of type 1 diabetes in China, 2010-13: population based study. BMJ, 360: j5295.
3. International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels: International Diabetes Federation, 2019.
4. Swift PG, International Society for P, Adolescent D (2007). ISPAD clinical practice consensus guidelines 2006-2007. Diabetes education. Pediatr Diabetes, 8 (2): 103-9.
5. Mayer-Davis EJ, Lawrence JM, Dabelea D, et al (2017). Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012. N Engl J Med, 376 (15): 1419-29.
6. (2020). Introduction: Standards of Medical Care in Diabetes-2020. Diabetes Care, 43 (Suppl 1): S1-S2.
7. Petersmann A, Muller-Wieland D, Muller UA, et al (2019). Definition, Classification and Diagnosis of Diabetes Mellitus. Exp Clin Endocrinol Diabetes, 127 (S 01): S1-S7.
8. American Diabetes A (2014). Diagnosis and classification of diabetes mellitus. Diabetes Care, 37 Suppl 1: S81-90.
9. Roglic G, Norris SL (2018). Medicines for Treatment Intensification in Type 2 Diabetes and Type of Insulin in Type 1 and Type 2 Diabetes in Low-Resource Settings: Synopsis of the World Health Organization Guidelines on Second- and Third-Line Medicines and Type of Insulin for the Control of Blood Glucose Levels in Nonpregnant Adults With Diabetes Mellitus. Ann Intern Med, 169 (6): 394-97.
10. Sinclair A, Morley JE, Rodriguez-Manas L, et al (2012). Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes. J Am Med Dir Assoc, 13 (6): 497-502.
11. DiMeglio LA, Acerini CL, Codner E, et al (2018). ISPAD Clinical Practice Consensus Guidelines 2018: Glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes, 19 Suppl 27: 105-14.
12. Hattersley AT, Greeley SAW, Polak M, et al (2018). ISPAD Clinical Practice Consensus Guidelines 2018: The diagnosis and management of monogenic diabetes in children and adolescents. Pediatr Diabetes, 19 Suppl 27: 47-63.
13. Silverstein J, Klingensmith G, Copeland K, et al (2005). Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care, 28 (1): 186-212.
14. Thorpe CT, Fahey LE, Johnson H, et al (2013). Facilitating healthy coping in patients with diabetes: a systematic review. Diabetes Educ, 39 (1): 33-52.
15. Pillay J, Armstrong MJ, Butalia S, et al (2015). Behavioral Programs for Type 1 Diabetes Mellitus: A Systematic Review and Meta-analysis. Ann Intern Med, 163 (11): 836-47.
16. McGuire HC, Ji L, Kissimova-Skarbek K, et al (2017). Type 1 diabetes mellitus care and education in China: The 3C study of coverage, cost, and care in Beijing and Shantou. Diabetes Res Clin Pract, 129: 32-42.
17. Ma RCW (2018). Epidemiology of diabetes and diabetic complications in China. Diabetologia, 61 (6): 1249-60.
18. Hu C, Jia W (2018). Diabetes in China: Epidemiology and Genetic Risk Factors and Their Clinical Utility in Personalized Medication. Diabetes, 67 (1): 3-11.
19. Lou Q, Wu L, Dai X, Cao M, Ruan Y (2011). Diabetes education in mainland China- a systematic review of the literature. Patient Educ Couns, 85 (3): 336-47.
20. Yang D, Deng H, Luo G, et al (2016). Demographic and clinical characteristics of patients with type 1 diabetes mellitus: A multicenter registry study in Guangdong, China. J Diabetes, 8 (6): 847-53.
21. Beliard R, Muzykovsky K, Vincent W, et al (2016). Perceptions, Barriers, and Knowledge of Inpatient Glycemic Control: A Survey of Health Care Workers. J Pharm Pract, 29 (4): 348-54.
22. Lin K, Yang X, Wu Y, et al (2016). Impact of disease-management programs on metabolic control in patients with type 1 diabetes mellitus: A cohort study in Shantou, China. Medicine (Baltimore), 95 (52): e5681.
23. Riordan F, McHugh SM, Murphy K, et al (2017). The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services. BMJ Open, 7 (8): e015049.
24. Kovacs M, Goldston D, Obrosky DS, Bonar LK (1997). Psychiatric disorders in youths with IDDM: rates and risk factors. Diabetes Care, 20 (1): 36-44.
25. Abdul-Rasoul M, Hajiyya J, Alshawaf F (2010). Psychological status of children with type 1 diabetes in Kuwait. Kuwait Med J, 42: 139-45.
26. Hood KK, Huestis S, Maher A, et al (2006). Depressive symptoms in children and adolescents with type 1 diabetes: association with diabetes-specific characteristics. Diabetes Care, 29 (6): 1389-91.
27. Cameron FJ, Northam EA, Ambler GR, Daneman D (2007). Routine psychological screening in youth with type 1 diabetes and their parents: a notion whose time has come? Diabetes Care, 30 (10): 2716-24.
28. Tiberg, Hansson, Hallstrom, et al (2019). Implementation of discharge recommendations in type 1 diabetes depends on specialist nurse follow-up. Acta Paediatr, 108(8):1515-1520.
|Issue||Vol 51 No 9 (2022)|
|Children Type 1 diabetes mellitus Patient education China|
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