ABSTRACT
The purpose of this pilot study was to test the hypothesis that children can learn to become more independent in their own diabetes self-management without compromising their metabolic control. Twenty-four children (ages 8 to 12 years) with insulin-dependent diabetes mellitus (IDDM) were matched by age and race, then randomly assigned either to a 6-week, self-management education program (experimental) or to receive usual care (control). A questionnaire was administered to the parents to determine the frequency with which 35 diabetes management behaviors were performed and the degree to which children assumed responsibility for these behaviors. Glycohemoglobin levels were monitored at baseline and at posttreatment, 12 weeks after baseline. At the posttreatment, children in the experimental group were found to be assuming significantly more responsibility for their diabetes self-care than were children in the control group. No decrease in the frequency with which self-care behaviors were performed was observed, and metabolic control was maintained. The results suggest that a diabetes self-management education program for children ages 8 to 12 years can be effective in facilitating children becoming more responsible for their own diabetes management.
Subject(s)
Diabetes Mellitus, Type 1/prevention & control , Internal-External Control , Patient Education as Topic/methods , Psychology, Child , Self Care/psychology , Child , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/psychology , Female , Humans , Male , Pilot ProjectsABSTRACT
Continuation of linear growth late into the third decade of life is rarely observed. This report describes a 27-year-old man with delayed growth and sexual maturation secondary to glycogen storage disease type I who grew 5.3 cm after orthotopic liver transplantation. Sequential improvement in selected measures of metabolic control (blood glucose, lactate, and bicarbonate concentrations) and growth-promoting peptides (testosterone and insulinlike growth factor I) were documented after transplantation and before the increase in height. Potential increases in final stature may be present in adult patients with underlying metabolic disease and delayed skeletal maturation.
Subject(s)
Glycogen Storage Disease Type I/surgery , Growth , Liver Transplantation , Adult , Anthropometry , Glycogen Storage Disease Type I/metabolism , Glycogen Storage Disease Type I/physiopathology , Humans , Male , Sexual MaturationABSTRACT
The medical profession is facing the challenges of the 1990s with a shift to outpatient care and preventive services. Medical schools will need to respond to these forces by reevaluating their curricula and setting new objectives. Nutrition is an essential element in the process of curriculum change. The nutrition educator will be expected to take a leading role in integrating nutrition into the medical school curriculum. This report presents steps and strategies to initiate the process.
Subject(s)
Education, Medical/trends , Nutritional Sciences/education , Curriculum , HumansSubject(s)
Parenteral Nutrition, Total , Burns/therapy , Child , Fat Emulsions, Intravenous/adverse effects , Female , Humans , Hyperglycemia/etiology , Infant, Newborn , Infant, Premature , Infusions, Parenteral , Intestinal Diseases/therapy , Male , Parenteral Nutrition, Total/adverse effects , Water-Electrolyte Imbalance/etiologySubject(s)
Diabetes Mellitus, Type 1/drug therapy , Insulin Infusion Systems , Adolescent , Adult , Child , Female , Humans , Pregnancy , Pregnancy in Diabetics/drug therapyABSTRACT
The clinical history before transplantation and subsequent clinical and biochemical course of 3 children and one adult with hereditary tyrosinemia treated by orthotopic hepatic transplantation is described. All four patients are now free of their previous dietary restrictions and appear to be cured of both their metabolic disease and their hepatic neoplasm.
