Endocrine Abstracts

Background: Type 1 diabetesmellitus (T1DM) isthe most widespread metabolic/endocrine condition among children/adolescents in Georgia. T1DM patients aged 0–18 yrs are treated both in– and outpatiently. In 2015–2019 totally 533 patients were hospitalized, 211 of them had fresh T1DM. Special attention is paid to interactive diabetes education (IDE) of patients/their caregivers, thatis very important for adequate diabetes management. IDE is initiated from the day of admission.

Our aim was to assess the effect of continuous, structured IDE on quality of metabolic control and acute complication incidence in children/adolescentswith T1DM. Goals of IDE are– teaching about signs/symptoms, progression, acute complications (causes, signs/ symptoms, prevention and treatment) of T1DM; developing insulin injecting, self–monitoring/self–controlskills (result interpretation; bread–units; physical activity, etc).

Methods: Patients treated/supervised at our Hospital were separated into 3 groups (Gr.): 211 patients with fresh T1DM (Gr.1); 150 patients with poor (Gr.2) and 361 patients with satisfactory (Gr.3) glycemia control. Following parameters: HbA1c, hyper–/hypoglycemic coma and ketoacidosis incidence, insulin doseswere studied and compared before/after IDE course and psychologist counseling.

Results: Data obtained before IDE for Gr. 1, 2, 3: HbA1c (%) – 13.5 ± 2.1; 12.5 ± 2.3;7.0 ± 2.5, respectively; hyperglycemic coma (%) – 17; 30; 5, respectively; ketoacidosis (%) – 78; 20;0, respectively; hypoglycemic coma (%) –22; 35; 0, respectively; insulin doses (U/kg) – 1.7 ± 0.1; 1.3 ± 0.4;0.7 ± 0.4, respectively; QOL/Relation to Condition Questionnaire/RCQ (%) scores were 100; 80;35, respectively. Post–education data: HbA1c (%) – 7.0 ± 2.1; 8.0 ± 2.2;6.4 ± 0.8, respectively; hyperglycemic coma (%) – 0; 4;0, respectively; ketoacidosis (%) – 3; 8; 0, respectively; hypoglycemic coma (%) –0; 0;0, respectively; insulin doses (U/kg) – 0.7 ± 0.1; 0.9 ± 0.4; 0.7 ± 0.12, respectively; QOL/RCQ (%) scores – 95; 87;97, respectively.

Conclusion: IDE, initiated at the moment of diagnosis, that lasts throughout in–hospital period, is regularly repeated out–patiently and tailored to individual patient needs gives knowledge, develops skills, creates motivation, helps to achieve good diabetes control, reduces and/or avoids acute complications and improvesQOL of children and adolescents with T1DM. Lately the first book for children, adolescents and their caregivers “Diabetes Mellitus for Children and Adolescent“ was published in Georgian, it discusses all aspects of life with diabetes and management of the condition in a simple and attractive way. The book is delivered free of charge.