Department of Paediatrics and Child Health, Flinders Medical Centre, Adelaide, South Australia, Australia.
Department of Paediatrics and Child Health, Flinders University, Adelaide, South Australia, Australia.
J Paediatr Child Health. 2022 Mar;58(3):463-467. doi: 10.1111/jpc.15742. Epub 2021 Oct 8.
Australian and New Zealand (NZ) paediatric endocrinologists' and NZ general paediatricians' insulin initiation strategies for children with type 1 diabetes (T1D) was recently described. The aim of this study was to document the insulin initiation practices of Australian general paediatricians in newly diagnosed children with T1D.
An online survey was sent to Australian general paediatricians identified through the Australian Paediatric Society diabetes database.
Twenty four general paediatricians participated on behalf of their Australian regional and metropolitan diabetes units managing 2059 patients. The diabetes units averaged 86 patients and all practices were multidisciplinary models of care. Intensive insulin therapy regimens were initiated at diagnosis for children age 2-10 years by 93% respondents compared with 73% Australian endocrinologists, 17% NZ endocrinologists and 36% NZ general paediatricians. Carbohydrate counting as part of flexible bolus dosing was usual practice for 83% of respondents, which was substantially more than Australian endocrinologists (63%), NZ endocrinologists (64%) and NZ general paediatricians (33%).
Almost all Australian general paediatricians who completed the survey initiate intensive insulin therapy regimes with carbohydrate counting in newly diagnosed children with T1D, consistent with the 2018 evidence-based recommendations of the International Society of Pediatric and Adolescent Diabetes. A substantial proportion of children with T1D within Australia are managed by general paediatricians who tend to align with international peak body guidelines.
最近描述了澳大利亚和新西兰（NZ）儿科内分泌学家和 NZ 普通儿科医生为 1 型糖尿病（T1D）儿童启动胰岛素的策略。本研究旨在记录澳大利亚普通儿科医生在新诊断的 T1D 儿童中启动胰岛素的做法。
通过澳大利亚儿科学会糖尿病数据库向澳大利亚普通儿科医生发送了在线调查。
24 名普通儿科医生代表他们所在的澳大利亚区域和大都市糖尿病单位参与了调查，这些单位共管理了 2059 名患者。每个糖尿病单位平均有 86 名患者，所有的实践都是多学科的护理模式。93%的受访者在 2-10 岁的儿童诊断时即开始采用强化胰岛素治疗方案，而澳大利亚内分泌学家、17%的新西兰内分泌学家和 36%的新西兰普通儿科医生的这一比例分别为 73%、73%和 36%。83%的受访者通常采用碳水化合物计数作为灵活推注剂量的一部分，这一比例明显高于澳大利亚内分泌学家（63%）、新西兰内分泌学家（64%）和新西兰普通儿科医生（33%）。
参与调查的几乎所有澳大利亚普通儿科医生都在新诊断的 T1D 儿童中启动强化胰岛素治疗方案并进行碳水化合物计数，这与 2018 年国际儿科和青少年糖尿病协会的循证建议一致。澳大利亚有相当一部分 T1D 儿童由普通儿科医生管理，他们倾向于与国际权威机构的指南保持一致。
