Štimjanin-Koldžo Diana, Alajbegović Salem, Štimjanin Ena, Mehinagić Jasmina
Department of Paediatrics, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina.
Department for Endocrinology, Diabetes and Metabolic Diseases; Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina.
Med Glas (Zenica). 2017 Aug 1;14(2):164-168. doi: 10.17392/907-17.
Aim The aim of the study is to evaluate the effect of a prospectively conducted interactive 5-day education programme based on Düsseldorf model on glycated haemoglobin (A1C), and total daily dose of insulin in type 1 diabetes patients. Methods A total of 67 type 1 diabetes patients was analysed; mean age of 11±0.68 years, 43 females and 24 males. The programme was led by a trained team of diabetes specialist doctors and nurses. All subjects and their parents completed a knowledge test about diabetes at beginning, and at the end of education, and after 12 months (30 questions). Subjects were evaluated for total daily insulin, and HbA1c at baseline, as well as 3, 6, 9 and 12 months after the end of the education programme. Results Results of the knowledge test after the education have shown higher knowledge at baseline. At the end of the education programme an average of total daily insulin dose was significantly lower. There was a 3.17% reduction in HbA1c values over 9 months, and 1.8% over 12 months in the comparison to the baseline values (p<0.001). Conclusions Structured education programme of functional insulin therapy was associated with improved glycaemic control in type 1 diabetes patients and their parents. It motivated patients and parents to improve glycaemic control. One year after the follow up, glycaemic control was worsening, due to lack of patients' motivation, therefore, there is a need for yearly re-education.
目的 本研究旨在评估一项基于杜塞尔多夫模型前瞻性开展的为期5天的互动式教育项目对1型糖尿病患者糖化血红蛋白(A1C)及胰岛素每日总剂量的影响。方法 共分析了67例1型糖尿病患者;平均年龄11±0.68岁,女性43例,男性24例。该项目由一组经过培训的糖尿病专科医生和护士团队主导。所有受试者及其父母在教育开始时、教育结束时以及12个月后(30道题)完成了一项关于糖尿病的知识测试。对受试者在基线时以及教育项目结束后的3、6、9和12个月时的每日胰岛素总量和糖化血红蛋白进行评估。结果 教育后的知识测试结果显示基线时知识水平更高。在教育项目结束时,每日胰岛素总剂量平均显著降低。与基线值相比,9个月内糖化血红蛋白值降低了3.17%,12个月内降低了1.8%(p<0.001)。结论 功能性胰岛素治疗的结构化教育项目与1型糖尿病患者及其父母血糖控制的改善相关。它激励患者和父母改善血糖控制。随访一年后,由于患者缺乏动力,血糖控制情况恶化,因此,需要每年进行再教育。