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德国和奥地利1型糖尿病儿童及青少年的糖尿病教育现状:基于德国/奥地利糖尿病患者数据库的分析

Current practice of diabetes education in children and adolescents with type 1 diabetes in Germany and Austria: analysis based on the German/Austrian DPV database.

作者信息

Konrad K, Vogel C, Bollow E, Fritsch M, Lange K, Bartus B, Holl R W

机构信息

Department of Pediatric and Adolescent Medicine, University of Cologne, Cologne, Germany.

Department of Pediatric and Adolescent Medicine, Elisabeth-Hospital Essen, Essen, Germany.

出版信息

Pediatr Diabetes. 2016 Nov;17(7):483-491. doi: 10.1111/pedi.12330. Epub 2015 Nov 4.

DOI:10.1111/pedi.12330
PMID:26530288
Abstract

BACKGROUND

Diabetes education of patients and/or parents is an essential part of diabetes care with effects on diabetes outcome. The objective of our study was to describe the current practice of diabetes education in Germany and Austria with regard to training frequency, patient age, migration background and diabetes therapy in a large cohort of pediatric patients with diabetes mellitus type 1 (T1DM).

METHODS

We analyzed data from pediatric T1DM patients with diabetes training in 2013 and complete data available for treatment year in the multicenter Diabetes Patienten Verlaufsdokumentation (DPV) registry using sas 9.4.

RESULTS

In 2013 21 871 pediatric patients with T1DM were documented [52.4% male, age: 12.70 (9.35-15.30) yr (median (interquartile range)], diabetes duration: 3.80 (1.45-7.00) yr, migration background: 21.4%, twice daily injections: 5.5%, multiple daily injections: 52.5%, insulin-pump therapy: 42%. Of these 32.31% were trained in 2013. Younger patients and their parents were trained more intensely and more frequently as inpatients compared with older patients (0-6 vs. 6-12 and 12-18 yr: teaching units: 13.07 vs. 12.05 and 9.79; inpatient: 79% vs. 72% and 70%). There was also a difference in training frequency with regard to migration background. Severe hypoglycemia or ketoacidosis resulted in intensification of training (4.0 vs. 2.0%; 7.8 vs. 3.1%). Centre-specific education tools were used frequently alone or in combination with published, standardized education programs.

CONCLUSION

Training frequency was highest in younger patients and during the first year of diabetes. Acute complications resulted in more frequent diabetes training, indicating that currently many education sessions take place in consequence to these complications.

摘要

背景

对患者和/或家长进行糖尿病教育是糖尿病护理的重要组成部分,会影响糖尿病治疗结果。我们研究的目的是在一大群1型糖尿病(T1DM)儿科患者中,描述德国和奥地利目前在糖尿病教育方面关于培训频率、患者年龄、移民背景和糖尿病治疗的做法。

方法

我们使用SAS 9.4分析了2013年接受糖尿病培训的儿科T1DM患者的数据,以及多中心糖尿病患者病程记录(DPV)登记处中可获得的完整治疗年份数据。

结果

2013年记录了21871例儿科T1DM患者[男性占52.4%,年龄:12.70(9.35 - 15.30)岁(中位数(四分位间距)),糖尿病病程:3.80(1.45 - 7.00)年,移民背景:21.4%,每日两次注射:5.5%,多次每日注射:52.5%,胰岛素泵治疗:42%]。其中32.31%在2013年接受了培训。与年龄较大的患者相比,年龄较小的患者及其家长作为住院患者接受培训的强度更大、频率更高(0 - 6岁与6 - 12岁和12 - 18岁:教学单元:13.07对12.05和9.79;住院患者:79%对72%和70%)。在培训频率方面,移民背景也存在差异。严重低血糖或酮症酸中毒导致培训强化(4.0对2.0%;7.8对3.1%)。各中心特定的教育工具经常单独使用或与已发表的标准化教育项目结合使用。

结论

年龄较小的患者以及糖尿病病程第一年的培训频率最高。急性并发症导致糖尿病培训更频繁,这表明目前许多教育课程是因这些并发症而开展的。

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