Crosnier H, Tubiana-Rufi N
Service de pédiatrie, centre hospitalier intercommunal de Poissy-Saint-Germain-en-Laye, 10, rue du Champ-Gaillard, 78300 Poissy, France.
Service d'endocrinologie et de diabétologie pédiatrique, hôpital Robert-Debré (AP-HP), 48, boulevard Sérurier, 75019 Paris, France.
Arch Pediatr. 2013 Dec;20 Suppl 4:S149-56. doi: 10.1016/S0929-693X(13)71430-1.
There is an increase in the incidence of type 1 diabetes (T1D) in children younger than 5 years of age and continuous subcutaneous insulin infusion (CSII) appears to be an increasingly popular therapeutic option in France. A retrospective self-evaluation questionnaire was distributed to parents of young children with T1D treated by CSII (42 children, age 4.8±1.0 years, 2.3±0.5 years at the onset of TD1, mean± SD). It focused on the quality of diabetes management in daycare centers or with nannies and at school. Parental satisfaction related to the management of their children was overall good (84% for all the parents, 70.5% for the parents of children at nursery-school, from 3 to 6 years. However 93% of the parents experienced and overcame serious difficulties: exclusion of the children on account of DT1 (school trips, daycare centers after school), use of the pump for lunch and snacks, realization of glycemic controls, participation in school trips, survey during school meals. In spite of these difficulties these young children had a normal and safe time at school. The management of the young children with DT1, treated by CSII, in alternate care centers and at school need to be improved; the experience was positive when daycare workers and teachers agreed to be instructed.
5岁以下儿童1型糖尿病(T1D)的发病率有所上升,在法国,持续皮下胰岛素输注(CSII)似乎是一种越来越受欢迎的治疗选择。我们向接受CSII治疗的T1D幼儿家长发放了一份回顾性自我评估问卷(42名儿童,年龄4.8±1.0岁,TD1发病时年龄2.3±0.5岁,均值±标准差)。问卷聚焦于日托中心或保姆照顾以及学校中的糖尿病管理质量。家长对孩子管理的满意度总体良好(所有家长为84%,3至6岁幼儿园儿童的家长为70.5%)。然而,93%的家长经历并克服了严重困难:因T1D导致孩子被排除在外(学校旅行、放学后的日托中心)、午餐和零食时使用胰岛素泵、进行血糖控制、参加学校旅行、学校用餐期间的调查。尽管有这些困难,这些幼儿在学校度过了正常且安全的时光。在替代护理中心和学校中,接受CSII治疗的T1D幼儿的管理需要改进;当日托工作人员和教师同意接受培训时,体验是积极的。