Hassan Mona, ElHelaly Mahmoud, Badawi Nora, Nader Mariam, Shamma Radwa
Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Pediatrics, Military Medical Academy, Cairo, Egypt.
BMC Pediatr. 2025 Sep 1;25(1):670. doi: 10.1186/s12887-025-06018-4.
Structured diabetes education plays a crucial role in the management of Type 1 Diabetes (T1D), especially with advanced technologies such as continuous subcutaneous insulin infusion (CSII). This study evaluates the impact of tailored education on adherence and glycemic control among pediatric CSII users.
This interventional analytical study included 30 patients diagnosed with T1D with age ranged from 5 to 18 years, recruited from Diabetes & Endocrinology Clinic at tertiary university-based children's hospital. Patients were recruited for one year duration. Patients who were on multiple daily injection (MDI) for 2 to 10 years were shifted to CSII after receiving comprehensive diabetes education. Their education level was assessed individually using a questionnaire to assess patients' knowledge and application skills at the time of insulin pump insertion, 3 and 6 months later. Twenty-five patients were on mini-med 715, 10 patients used flash glucose monitoring, and 15 patients used self-monitoring blood sugar, while five patients were on mini-med 780G and continuous glucose monitoring (CGM) using guardian 4 (G4).
Study included 19 females (63.3%) and 11 males (36.7%) with age ranged from 7 to 11 with mean ± SD of 10.74 ± 1.86. Patients' education level was assessed before pump insertion, and 3 months later which shows significant improvement in patients' diabetes knowledge and technical skills with P-value 0.038. Also, time in range (TIR) improved significantly in well-educated patients at 3 and 6 months with P-values 0.048 and 0.025 respectively. There was highly significant improvement of HbA1c after 6 months (8.82 ± 1.5 vs. 7.18 ± 0.56) with P-value 0.000 after receiving diabetes education.
Tailored diabetes education significantly improves adherence and glycemic outcomes in pediatric patients using CSII. Integrating structured educational programs with diabetes technology is essential to achieve optimal metabolic control in youth.
结构化糖尿病教育在1型糖尿病（T1D）管理中起着关键作用，尤其是对于持续皮下胰岛素输注（CSII）等先进技术而言。本研究评估了量身定制的教育对儿科CSII使用者的依从性和血糖控制的影响。
这项干预性分析研究纳入了30例诊断为T1D的患者，年龄在5至18岁之间，从一所大学附属医院的糖尿病与内分泌诊所招募。患者招募为期一年。接受多次每日注射（MDI）治疗2至10年的患者在接受全面糖尿病教育后转为CSII治疗。在胰岛素泵植入时、3个月后和6个月后，使用问卷分别评估他们的教育水平，以评估患者的知识和应用技能。25例患者使用迷你Med 715，10例患者使用闪光葡萄糖监测，15例患者使用自我血糖监测，而5例患者使用迷你Med 780G并使用监护仪4（G4）进行持续葡萄糖监测（CGM）。
研究包括19名女性（63.3%）和11名男性（36.7%），年龄在7至11岁之间，平均年龄±标准差为10.74±1.86。在泵植入前和3个月后评估患者的教育水平，结果显示患者的糖尿病知识和技术技能有显著改善，P值为0.038。此外, 受过良好教育的患者在3个月和6个月时的血糖达标时间（TIR）也有显著改善，P值分别为0.048和0.025。接受糖尿病教育6个月后，糖化血红蛋白（HbA1c）有极显著改善（8.82±1.5 vs. 7.18±0.56），P值为0.000。
量身定制的糖尿病教育显著提高了使用CSII的儿科患者的依从性和血糖结局。将结构化教育计划与糖尿病技术相结合对于实现青少年的最佳代谢控制至关重要。
