Home-based management can achieve intensification cost-effectively in type I diabetes.
Newly diagnosed insulindependent diabetic children are most often admitted to hospital for education and insulin management and subsequently followed in outpatient clinics or office settings.
However, most could be managed at home, given adequate family and health care team support and subsequent follow-up facilitated by home-based nursing intervention.
We conducted a randomized trial of clinical, psychosocial, and cost effects of home-based management in a 2-year follow-up study of newly diagnosed diabetic children.
Sixty three patients were randomly assigned to traditional hospitalization and outpatient follow-up (hospital-based group) or home management (home-based group).
Treatment differences between the two groups consisted of duration of initial hospital stay, site and timing of initial teaching, and nature and extent of subsequent nursing follow-up.
Metabolic control was assessed by means of quarterly glycosylated hemoglobin measurements for 24 months and then at 36 months.
Diabetes-related adverse events, knowledge of diabetes, adherence to the diabetes regimen, psychosocial impact, and social (total) costs incurred were assessed for 24 months.
Glycosylated hemoglobin concentrations were significantly lower in the home-based group at 12 to 24 months and at 36 months.
Both groups had comparable numbers of diabetes-related adverse events.
There were no significant group differences in psychosocial impact. (...)
Mots-clés Pascal : Diabète insulinodépendant, Education, Modalité traitement, Ambulatoire, Analyse coût efficacité, Essai clinique, Economie, Enfant, Homme, Etude longitudinale, Endocrinopathie, Immunopathologie, Maladie autoimmune
Mots-clés Pascal anglais : Insulin dependent diabetes, Education, Application method, Ambulatory, Cost efficiency analysis, Clinical trial, Economy, Child, Human, Follow up study, Endocrinopathy, Immunopathology, Autoimmune disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0074081
Code Inist : 002B30A04B. Création : 31/05/1999.