Benefits of an insulin dosage calculation device for adolescents with type 1 diabetes mellitus
| Autor: | Dayna Green-Burgeson, Karen Hood-Johnson, Dennis M. Styne, Nicole Glaser, Claire Bennett, Sultanna B. Iden, Beth Goodlin-Jones |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism medicine.medical_treatment Hypoglycemia law.invention Endocrinology Randomized controlled trial Quality of life law Diabetes mellitus Internal medicine medicine Humans Insulin skin and connective tissue diseases Child Type 1 diabetes Cross-Over Studies Dose-Response Relationship Drug business.industry medicine.disease Surgery Regimen Diabetes Mellitus Type 1 Patient Satisfaction Metabolic control analysis Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Journal of pediatric endocrinologymetabolism : JPEM. 17(12) |
| ISSN: | 0334-018X |
| Popis: | Objective: Multiple daily injection insulin regimens (MDI) and continuous subcutaneous insulin infusion (CSII) allow adolescents with type 1 diabetes mellitus (DM) meal flexibility, and may improve metabolic control. The insulin dosage calculations, however, involve ratios of insulin to carbohydrate and corrections for high blood glucose values, and are labor-intensive and prone to error. We evaluated the impact of an insulin dosage calculation device (IDC) on metabolic control, treatment satisfaction, regimen adherence and quality of life in adolescents using MDI or CSII. Research Design and Methods: We conducted a randomized control trial using the IDC in 83 adolescents on MDI or CSII. At enrollment, patients received training on dosage calculation using either the IDC or conventional methods, and performed sample calculations. At enrollment, 6 months and 12 months, we recorded HbA 1 c and frequency of hypoglycemia, and patients completed questionnaires assessing treatment satisfaction, regimen adherence and quality of life. After 6 months, patients in the control group were also given the IDC. Results: We observed a higher frequency of errors with conventional calculations (53-67% incorrect calculations) than with the IDC (25-32% incorrect). At 6 months, there was a trend toward improved HbA 1 c in the IDC group overall (9.3 vs 8.9, p = 0.07) and a significant improvement in the subset (42%) who used the IDC consistently (9.7 vs 8.8, p = 0.03). There was no change in HbA 1 c in the control group during this interval (9.0 vs 8.9, p = 0.90). During months 6-12, when both groups were combined, there was a significant increase in HbA 1 c in patients using the IDC inconsistently or not at all (8.9 vs 9.4, p = 0.005), but no change in HbA 1 c in those using the IDC consistently (9.1 vs 8.9, p = 0.57). Treatment satisfaction, adherence and quality of life improved throughout the study in both groups. Conclusions: Errors in calculation of insulin dosage by adolescents occur frequently. Consistent use of an insulin dosage calculation device may help to improve metabolic control in adolescents using MDI or CSII. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|