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Using a primary nurse manager to implement DCCT recommendations in a large pediatric program.

J A Ahern1, N Ramchandani1, J Cooper1

  • 1The Department of Pediatrics, the Children's Clinical Research Center, Yale University School of Medicine and Yale New Haven Hospital, New Haven, Connecticut

The Diabetes Educator
|March 27, 2002
PubMed
Summary
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Implementing the Diabetes Control and Complications Trial (DCCT) protocol in pediatric patients significantly lowered HbA1c levels. A dedicated diabetes nurse specialist facilitated intensive management and improved long-term glycemic control.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Management
  • Clinical Nursing

Background:

  • The Diabetes Control and Complications Trial (DCCT) established intensive management protocols for type 1 diabetes.
  • Implementing DCCT recommendations in large pediatric populations presents unique challenges.

Purpose of the Study:

  • To assess the feasibility of implementing DCCT recommendations in a large pediatric cohort.
  • To evaluate the impact of a dedicated diabetes clinical nurse specialist program coordinator on intensive diabetes management.

Main Methods:

  • Retrospective chart review of pediatric patients (N=124) with type 1 diabetes.
  • Comparison of HbA1c levels before and 1 year after DCCT protocol implementation.
  • Analysis of insulin regimens and injection frequency.

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Main Results:

  • Significant reduction in HbA1c levels 1 year post-implementation.
  • Continued HbA1c improvement observed at the 3-year follow-up.
  • Increased insulin dosage and injection frequency correlated with improved glycemic control.

Conclusions:

  • The DCCT protocol is implementable in large pediatric populations.
  • A dedicated diabetes nurse specialist is crucial for overcoming barriers to normoglycemia.
  • Ongoing patient support and adjustments facilitate successful intensive diabetes management.