RANDOMIZED PROSPECTIVE-STUDY OF SHORT-TERM AND LONG-TERM INITIAL STAY IN HOSPITAL BY CHILDREN WITH DIABETES-MELLITUS

被引:26
作者
SIMELL, T
KAPRIO, EA
MAENPAA, J
TUOMINEN, J
SIMELL, O
机构
[1] AURORA CITY HOSP,HELSINKI,FINLAND
[2] UNIV HELSINKI,CHILDRENS HOSP,SF-00100 HELSINKI 10,FINLAND
[3] UNIV TURKU,DEPT BIOSTAT,SF-20500 TURKU 50,FINLAND
[4] UNIV TURKU,CARDIORESP RES UNIT,SF-20500 TURKU 50,FINLAND
关键词
D O I
10.1016/0140-6736(91)92464-D
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To assess how an isolated change in the pattern of care influences outcome of care and hospital use, a randomised prospective 2-year study was done in which 31 of 61 consecutive children with newly diagnosed insulin-dependent diabetes mellitus (IDDM) were admitted to hospital at disease onset for about a week and compared with the other 30 children who were admitted for about 4 weeks. Insulin treatment and education about diabetes were similar in the two groups. Duration of initial stay in hospital had no effect on metabolic control during the 2 years but time since diagnosis was significant with respect to effect on haemoglobin A1 (p = 0.001), haemoglobin A1c (p = 0.004), and insulin dose (p < 0.001). At 2 years, 45% of the children in the short-term group and 29% in the long-term group were C-peptide positive (p = NS); C-peptide positivity correlated with age. A change in the pattern of care of children with IDDM, led to a pronounced decrease in hospital use by this patient group. Irrespective of the length of initial stay in hospital, equally good metabolic control was obtained in both groups for 2 years.
引用
收藏
页码:656 / 660
页数:5
相关论文
共 24 条
[1]   RESIDUAL BETA-CELL FUNCTION IN CHILDREN WITH IDDM - REPRODUCIBILITY OF TESTING AND FACTORS INFLUENCING INSULIN SECRETORY RESERVE [J].
CLARSON, C ;
DANEMAN, D ;
DRASH, AL ;
BECKER, DJ ;
EHRLICH, RM .
DIABETES CARE, 1987, 10 (01) :33-38
[2]   RANDOMIZED PROSPECTIVE-STUDY OF SELF-MANAGEMENT TRAINING WITH NEWLY DIAGNOSED DIABETIC CHILDREN [J].
DELAMATER, AM ;
BUBB, J ;
DAVIS, SG ;
SMITH, JA ;
SCHMIDT, L ;
WHITE, NH ;
SANTIAGO, JV .
DIABETES CARE, 1990, 13 (05) :492-498
[3]  
Diabetes Epidemiology Research International Group, 1988, DIABETES, V37, P1113
[4]  
DUNCAN JA, 1986, CONT PEDIAT, V3, P79
[5]   MEDICAL-CARE PATTERNS AT THE ONSET OF INSULIN-DEPENDENT DIABETES-MELLITUS - ASSOCIATION WITH SEVERITY AND SUBSEQUENT COMPLICATIONS [J].
HAMMAN, RF ;
COOK, M ;
KEEFER, S ;
YOUNG, WF ;
FINCH, JL ;
LEZOTTE, D ;
MCLAREN, B ;
ORLEANS, M ;
KLINGENSMITH, G ;
CHASE, HP .
DIABETES CARE, 1985, 8 :94-100
[6]   UNBALANCED REPEATED-MEASURES MODELS WITH STRUCTURED COVARIANCE MATRICES [J].
JENNRICH, RI ;
SCHLUCHTER, MD .
BIOMETRICS, 1986, 42 (04) :805-820
[7]   A COMPARISON OF CHILDHOOD AND ADULT TYPE-I DIABETES-MELLITUS [J].
KARJALAINEN, J ;
SALMELA, P ;
ILONEN, J ;
SURCEL, HM ;
KNIP, M .
NEW ENGLAND JOURNAL OF MEDICINE, 1989, 320 (14) :881-886
[8]  
KROLEWSKI AS, 1987, NEW ENGL J MED, V317, P1390
[9]  
Laron Z, 1979, Diabetes Care, V2, P342, DOI 10.2337/diacare.2.4.342
[10]  
MACLURE A, 1984, LANCET, V2, P682