Department of Diabetes and Endocrinology, John Hunter Children's Hospital, Newcastle, NSW, Australia.
Pediatr Diabetes. 2012 Dec;13(8):647-51. doi: 10.1111/j.1399-5448.2012.00896.x. Epub 2012 Jul 23.
To evaluate the effect of a diabetes awareness campaign on the incidence of diabetic ketoacidosis (DKA) at the first presentation of type 1 diabetes in children (0-18 yr).
This study was a controlled population intervention study with a 2-yr baseline period and a 2-yr intervention period. Data were collected on all children presenting with their initial diagnosis of type 1 diabetes [pH, bicarbonate, base excess, blood glucose level (BGL), urea, and creatinine] at Gosford, Newcastle, and Sydney (Sydney Children's Hospital and Royal North Shore Hospital). During the intervention period, diabetes education occurred in the intervention region (Gosford). Child care centers, schools, and doctor's offices were offered education and posters about the symptoms of type 1 diabetes. Doctor's offices were given glucose and ketone testing equipment. The control regions (Newcastle and Sydney) did not receive any educational intervention or test equipment. DKA was defined as pH < 7.3 or bicarbonate < 15 mmol/L.
In Gosford, the proportion of children presenting in DKA decreased from 37.5% (15/40) during the 2-yr baseline period to 13.8% (4/29) during the 2-yr intervention (p < 0.03). There was no significant change in the control regions during the same time periods, 37.4% (46/123) and 38.6% (49/127), respectively. In Gosford, the average BGL at presentation was 27.5 mmol/L during the baseline and 21.2 mmol/L during the intervention (p < 0.01).
During the diabetes awareness campaign, the rate of DKA at initial diagnosis of type 1 diabetes in children decreased by 64%.
评估糖尿病意识运动对儿童（0-18 岁）1 型糖尿病初次发病时糖尿病酮症酸中毒（DKA）发生率的影响。
这是一项对照人群干预研究，有 2 年的基线期和 2 年的干预期。在戈斯福德、纽卡斯尔和悉尼（悉尼儿童医院和北岸皇家医院），对所有初次诊断为 1 型糖尿病的儿童（pH 值、碳酸氢盐、碱剩余、血糖水平（BGL）、尿素和肌酐）进行数据收集。在干预期间，在干预区（戈斯福德）进行糖尿病教育。儿童保健中心、学校和医生办公室提供了有关 1 型糖尿病症状的教育和海报。医生办公室配备了血糖和酮体检测设备。对照区（纽卡斯尔和悉尼）未接受任何教育干预或测试设备。DKA 定义为 pH 值<7.3 或碳酸氢盐<15mmol/L。
在戈斯福德，DKA 患儿的比例从基线期 2 年内的 37.5%（15/40）降至干预期 2 年内的 13.8%（4/29）（p<0.03）。同期对照区没有明显变化，分别为 37.4%（46/123）和 38.6%（49/127）。在戈斯福德，基线期时初次就诊的平均 BGL 为 27.5mmol/L，干预期时为 21.2mmol/L（p<0.01）。
在糖尿病意识运动期间，儿童 1 型糖尿病初次诊断时 DKA 的发生率下降了 64%。
