基层医疗机构的医生能否及时识别儿童 1 型糖尿病？

Can primary care physicians recognize type 1 diabetes in children on time?

机构信息

Department of Pediatric and Adolescent Endocrinology, Collegium Medicum Jagiellonian University, Krakow, Poland.

Division of Pediatric and Adolescent Endocrinology, University Children's Hospital in Krakow, Poland.

出版信息

Pediatr Endocrinol Diabetes Metab. 2021;27(4):245-248. doi: 10.5114/pedm.2021.107723.

DOI:10.5114/pedm.2021.107723

PMID:34817149

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10226347/

Abstract

INTRODUCTION

Although the diagnostic criteria for diabetes in children and adolescents should be widely known to all healthcare professionals, many cases of type 1 diabetes (DM1) are still not recognized in time. The aim of this study was to compare the experiences with the diagnosis of DM1 of young doctors during training and specialists working as primary health care physicians in Poland.

MATERIAL AND METHODS

50 specialists in paediatrics or family medicine (average professional experience of 14.6 years) and 50 doctors, and those without specialization (up to 4 years after graduating from medical studies, average professional experience of 1.4 years) participated in the survey. The questionnaires were conducted from November 2019 to November 2020.

RESULTS

Most of the study participants correctly answered the questions about the diagnostic criteria of diabetes and its management at the moment of diagnosis, except for the question regarding diagnostic criteria for diabetes in oral glucose tolerance test. The correct answers varied from 96% to 72% among medical specialists and physicians during the training, respectively. What is interesting is the relatively small number of diagnosed cases of DM1 during the entire professional career of specialists (0-12 cases), compared to the doctors without specialization (0-5 cases). Medical specialists declared more frequently the use of a glucometer in their daily practice (mean 6 vs. 1, p < 0.05), but after taking into account the years of experience, the difference was insignificant.

CONCLUSIONS

It is important to educate primary care physicians, despite their professional experience. Practical education of physicians is also necessary.

摘要

简介

尽管儿童和青少年糖尿病的诊断标准应该为所有医疗保健专业人员所熟知，但仍有许多 1 型糖尿病（DM1）病例未能及时得到识别。本研究旨在比较波兰年轻医生在培训期间和作为初级保健医生工作的专家在诊断 DM1 方面的经验。

材料与方法

50 名儿科或家庭医学专家（平均专业经验 14.6 年）和 50 名医生（毕业后至参加研究时的平均专业经验为 1.4 年）参与了调查。问卷调查于 2019 年 11 月至 2020 年 11 月进行。

结果

大多数研究参与者正确回答了诊断时糖尿病的诊断标准及其管理的问题，但关于口服葡萄糖耐量试验诊断糖尿病标准的问题除外。医学专家和培训医生的正确答案分别为 96%至 72%。有趣的是，与没有专业背景的医生（0-5 例）相比，专家在整个职业生涯中诊断出的 DM1 病例相对较少（0-12 例）。医学专家在日常实践中更频繁地使用血糖仪（平均值为 6 比 1，p<0.05），但考虑到工作年限后，差异并不显著。