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A multidisciplinary, comprehensive, ambulatory treatment scheme for diabetes mellitus in children
Insights
A multidisciplinary team improved juvenile diabetes (type 1 diabetes) management in children. This approach led to better disease control, fewer complications, and enhanced psychological well-being for patients and families.
Area of Science:
- Pediatric Endocrinology
- Child Psychology
- Public Health
Background:
- Juvenile diabetes (type 1 diabetes) requires comprehensive management.
- Previous treatment approaches had limitations in sustained control and complication rates.
Purpose of the Study:
- To evaluate the impact of a multidisciplinary team approach on the management of juvenile diabetes.
- To assess improvements in disease control, complications, and psychosocial outcomes.
Main Methods:
- Ambulatory treatment of 262 children with juvenile diabetes and their parents over 10 years.
- Involvement of a multidisciplinary team: pediatric endocrinologist, nurse, dietitian, psychologist, and social worker.
- Comparison with pre-intervention data.
Main Results:
- Significantly higher and more regular glycemic control.
- Marked reduction in complications, including no episodes of coma or severe ketoacidosis, and minimal hospitalizations.
- Improved child, parent, and teacher attitudes, increased understanding of diabetes, and enhanced motivation.
- Reduced family conflicts, higher self-concept, and better scholastic and social adjustment.
Conclusions:
- Psychological stability is crucial for effective diabetes management.
- A multidisciplinary approach is highly effective for treating chronic pediatric diabetes, improving both clinical and psychosocial outcomes.
Abstract:
A study has been carried out on 262 children with juvenile diabetes and their parents, treated up to 10 yr on an ambulatory basis by a multidisciplinary team composed of pediatric endocrinologist, nurse, dietitian, psychologist, and social worker. Comparison of the findings with those of a study performed before inception of the Counselling Center for Juvenile Diabetics revealed the following positive influences: the degree of control attained was both higher and sustained with greater regularity; there were fewer complications with no episodes of coma, brittle diabetes, or severe ketoacidosis and almost no need for hospitalization; the attitude of the affected child, his parents, and his teachers was found to be considerably improved; there was better understanding of the nature of the disease and its requirements; the child's motivation to maintain the diabetic regimen was greater and conflicts within the family circle were markedly reduced; the child's self-concept was much higher; and both scholastic achievements and social adjustment were greater. We concluded that psychological stability is a basic factor in the control of diabetes, and the value of the multidisciplinary approach in the treatment of this chronic disease is indicated.