Endocrine Abstracts

Abstract

The psychosocial impact of diabetes in childhood is ubiquitous and involves the entire family, as well as schools and society as a whole. The International Society for Pediatric and Adolescent Diabetes (ISPAD) developed guidelines in 2000 to assist health professionals in the management of young people with diabetes. These guidelines are based on the St. Vincent Declaration, the Declaration of Kos, and the Declaration of the Americas, which define the rights of all people with diabetes and focus on significant areas of responsibility for those involved in the care of diabetic children and adolescents. We, at our trust, undertook a prospective, observational, quantitative study in order to get an idea about the nature and intensity of major psychological issues faced by the patients and families with DM1.

Aim: • to formulate a template for ‘meeting-the-threshold’ criteria; in term of major psychological issues affecting the patient/family.

• to determine the top three major psychological issues in the study group.

• to design the (psy) services in such a way as to target the specific psychological issues, during follow ups.

Study: • recruting patients from DM1 clinics over 6 months

• segregated them according to age groups - pre-school/school/adolescents

Main Findings: • PRE-SCHOOL - Major Psy factor is anxiety-depression in parents from the fear of Hypoglycaemia (3.3 times relative-risk)

• SCHOOL - Major Psy factor is ‘PEER-PRESSURE/BULLYING’ (2.9 time RR)

• ADOLESCENT - Major psy factor was ‘Eating-disorder’(2.3 times RR)

Action: • AS a part of BPT, psy services are offered to all the patients.

• After the study, the follow-ups were more ‘targetted’ and ‘focussed’

• Data is being collected to see the impact of this intervention.

Misc: • Some of the other psy issues, prevalent (but not making in to the top three causes) were also innumerated and discussed.

• However the cost-benefit-analysis did not support the specific/targetted psy sessions for those psy issues, and rather the standard general psy sessions were continuted.