ABSTRACT
BACKGROUND: Multidisciplinary interventions may be useful for children and adolescents with diabetes mellitus (DM), especially in areas where new blood glucose monitoring and control technologies are difficult to access. METHODS: PAANDA, a care program for adolescents and children with diabetes, was implemented in patients aged 0 to 18 years and 11 months. The effect of the intervention was determined by self-blood glucose monitoring (SBGM) and glycosylated hemoglobin (HbA1C ) levels at start and after 6 months. RESULTS: A total of 121 patients with DM were evaluated, mean age of 14.27 years (SD: 4.60 years). Blood glucose measurements in range (70-120 mg/dL pre-prandial or 70-180 mg/dL post-prandial) increased by 20.67% before breakfast, 8.14% after breakfast (both P-value <.001), 5.02% before lunch (P-value = .02), 8.66% after lunch (P-value <.001), 11.50% before dinner (P-value <.001), 11.87% after dinner (P-value <.001), and 8.00% at dawn (P-value = .001). This change was accompanied by fewer values in the hyperglycemic category (-19.49% before breakfast, -7.73% after breakfast, both P-value <.001) and hypoglycemia (-1.18%). HbA1C levels decreased significantly 1.8% (P-value = .018). Multivariate logistic regression analysis showed an increase in glycemic control associated with each month after the intervention time in the PAANDA program (P-value <.001 for all the time points evaluated) and a significant decrease in glycemic variability. CONCLUSIONS: The multidisciplinary PAANDA intervention had a beneficial effect on glycemic control, with an improved time in range in a population of children and adolescents with DM.
