Endocrine Abstracts

Background: Education is a basic component – to assess achievement of compensation in children and adolescents with type 1 diabetes mellitus within a 3-year period after training.

Aim: The work was initiated to assess level of knowledge and compensation degree in children and adolescents with type 1 diabetes mellitus in ‘Type 1 Diabetes School’.

Materials and methods: A five-day training course was conducted in ‘Type 1 Diabetes School’ at the Almaty regional children’s clinical hospital, Kazakhstan Republic. The training was conducted by means of a structured program containing all appropriate sections. Before and after training course all participants were tested with a questionnaire containing 30 key questions for self-control. On the basis of the findings children and adolescents with type 1 diabetes mellitus were divided into groups, trained and untrained. 18 of 68 children and 20 of 36 adolescents were preliminary trained, 14 children and 16 adolescents got no training. DCA Vantage Siemens (USA) was used to measure glycated hemoglobin (HbA1c) by means of latex agglutination inhibition. Certified by the National Glycohemoglobin Standardization Program this method became the reference one. It helps demonstrate the predicting role of HbA1c level as a criterion for assessment of compensation.

Results and discussion: Before training children gave right answers to 25% of questions only. In 3 years they could give right answers to 75% of questions, mean HbA1c in trained and untrained children was 7.7% and 9.8%, respectively. Children who got no training, those with low level of knowledge and motivation both in them and their parents were hospitalized at the intensive care units more frequently both before and after training. Within follow-up period they gave right answers to 15% of questions only. The trained adolescents with type 1 diabetes mellitus initially could give right answers to 25% of questions, in 3 years there were 70% of right answers. In the untrained adolescents, level of knowledge remained as low as it was before and after 3-year follow-up, mean HbA1c level was 8.4 and 10.3% in the trained and untrained adolescents, respectively.

Conclusions: In the group of children trained for 3 years HbA1c mean level was 7.7%, in those untrained it was 9.8%. In the groups of trained and untrained adolescents mean HbA1c was 8.4% and 10.3%, respectively. Better compensation and level of knowledge in children as compared with those among adolescents confirm the role of family in the type 1 diabetes mellitus control.