Personal illness models of diabetes: parents of preadolescents and adolescents.

The purpose of this research was to explore personal illness models of parents of preadolescents and adolescents regarding diabetes mellitus. Personal illness models were defined as the parents' cognitive representations of the disease. Fifty-five parents of children ages 10 to 17 years with a diagnosis of insulin-dependent diabetes mellitus were interviewed using a semistructured questionnaire. Data were content analyzed for common themes. Parents attributed the cause of diabetes to genetics coupled with a viral infection. Most believed the diabetes would last a lifetime but they were hopeful for a cure. Parents requested ongoing education for their children, support groups, counseling, one consistent healthcare provider, and intensive insulin therapy. Parents reported that the major problems caused by diabetes were increased structure of daily routines and that their children with diabetes felt different from healthy peers. Parents' fears about diabetes included long-term complications, early death, and severe insulin reactions.

Personal illness models of diabetes: preadolescents and adolescents.

The purpose of this research study was to explore personal illness models of preadolescents and adolescents regarding diabetes mellitus. Personal illness models were defined as the adolescents' cognitive representations of their disease. Sixty children ages 10 to 17 years with a diagnosis of insulin-dependent diabetes mellitus were interviewed using a semistructured questionnaire. Data were content analyzed for common themes. Although most participants expressed an understanding that their disease would last a lifetime, they were hopeful for a cure. Participants wanted healthcare professionals to provide strategies for controlling blood glucose to prevent future complications. Family and friends who followed the same diet as the adolescent with diabetes were viewed as supportive. The majority of adolescents were responsible for much of their own disease management. Their greatest fears concerned insulin reactions and long-term complications such as amputation of limbs.

Adherence behaviors in research protocols: comparison of two interventions.

The effectiveness of an enhanced preparation intervention was compared with the standard preparation intervention for accuracy in overnight urine specimen collections. The sample consisted of 179 individuals with type I insulin-dependent diabetes mellitus (IDDM). Subjects were assigned randomly to an enhanced or standard preparation group. The enhanced preparation included written instructions, a reminder to post instructions in the bathroom, a toilet seat cover with a reminder to save urine, and a nurse-initiated telephone call to review the instructions. The standard preparation included written instructions and a telephone number to call with any questions. For subjects without previous collection experience, significantly fewer inaccurate collections were reported in the enhanced preparation group than in the standard group (chi 2 = 4.61, P < .05). There were no differences in collection accuracy between enhanced and standard groups for subjects with collection experience (chi 2 = .4598, P > .05).

Profile of renal permselectivity by simultaneous enzyme-linked immunosorbent assay of albumin, transferrin, IgG, and alpha 1-microglobulin with a new microplate reader.

A competitive enzyme-linked immunosorbent assay (ELISA) is described for determining a renal permselectivity profile involving the urinary proteins albumin, transferrin, IgG, and alpha 1-microglobulin (alpha 1-m). The ELISA reader uses a computer-controlled array of multiplexed light-emitting diode (LED)-photodiode pairs for rapid measurements of absorbance on microplates. A 3,3'-dimethylnaphthidine reagent adapts the 3,5,3',5'-tetramethylbenzidine chromophore to monochromatic LED emission at 550 nm. We applied this ELISA to the determination of renal permselectivity in healthy children and young adults and in children with insulin-dependent diabetes mellitus. The geometric means (and SD) of protein excretion rates in a group of 85 normal subjects were as follows: albumin, 3.5 micrograms/min (1.83); transferrin, 173 ng/min (2.76); IgG, 1.11 micrograms/min (2.22), and alpha 1-m, 0.98 microgram/min (2.36).

Assessment of the effect of a comprehensive diabetes management program on hospital admission rates of children with diabetes mellitus.

Admission records at Children's Hospital Medical Center in Cincinnati were reviewed to determine the impact of a comprehensive diabetes management program on selected indicators of health status in children with diabetes mellitus. Two periods were compared: January 1973 through June 1978 (period A), prior to institution of the program, and July 1978 through December 1987 (period B). Although the number of children admitted with a diagnosis of type I diabetes not associated with DKA or other diagnoses increased by 10% during these 10 years, the number of children with diabetic ketoacidosis (DKA) not associated with other diagnoses fell from 58% in period A to 24% in period B. Similarly, average length of stay for the reported DKA admissions decreased from a mean of 5.84 days in period A to a mean of 4.62 days in period B. This reduction of 1.2 days saved an estimated $342,000 in hospitalization costs. These findings suggest that a comprehensive diabetes management program consisting of medical treatment, education, and psychological support services, has a positive influence on patient outcome and can be cost effective.