Glycemic control and the psychosocial benefits gained by patients with type 1 diabetes mellitus attending the diabetes camp.

Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Patient Education and Counseling (Impact Factor: 2.37). 08/2008; 73(1):60-6. DOI:10.1016/j.pec.2008.05.023
Source: PubMed

ABSTRACT The aim of this study was to evaluate the effectiveness of diabetes camp on glycemic control, knowledge, and psychosocial benefits among patients with type 1 diabetes (T1D). Glycemic control among patients with infrequent and frequent self-monitoring of blood glucose (SMBG) was also compared.
During a 5-day camp, 60 patients were taught diabetes self-management education (DSME). After camp, patients were divided into two groups based on frequency of SMBG (<3 versus 3-4 times/day) and were followed up until 6-month post-camp. Patients' HbA1c levels and knowledge were assessed at baseline, 3- and 6-month post-camp. Patients' impressions towards camp were assessed.
In both SMBG groups, HbA1c levels decreased significantly at 3-month post-camp but did not sustain at 6-month monitoring. The patients with frequent SMBG had a lower mean HbA1c level. A significant improvement in knowledge was noted and sustained up to 6-month post-camp. The patients found diabetes camp of benefit and felt they could better cope with diabetes.
Although the effect of the diabetes camp on glycemic control was short-lived, an improvement in knowledge and a better attitude towards having diabetes were seen among participants.
The psychosocial benefits and knowledge gained by patients attending diabetes camp underline the importance of including a camp in a diabetes management plan. To improve patients' long-term glycemic control, a continuous education is required.

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    ABSTRACT:   To examine the effects of insulin dose adjustments on rates of hypoglycaemia for school-aged children with Type 1 diabetes attending camp.   Camp records for 256 children aged 7-15 years (55% on continuous subcutaneous insulin infusion) attending a week-long residential summer camp were analysed.   In anticipation of increased physical activity, basal insulin was decreased for all children on continuous subcutaneous insulin infusion and injection therapy by 10% upon arrival at camp. During the first day, children on continuous subcutaneous insulin infusion received 11.1±6.3% less basal insulin than home doses, whereas children on injections decreased intermediate/long-acting insulin by 8.2±12.8%. Despite these decreases, 60% had at least one blood sugar level <70 mg/dl (3.9 mmol/l) during the first day. Children on continuous subcutaneous insulin infusion were more likely to have hypoglycaemia during the first day than those on injections. The number of episodes of hypoglycaemia increased with increasing camper age. Overall, children did not have further significant reductions in their total daily insulin dose by the last day of camp. However, on the last day, children had fewer episodes of hypoglycaemia than during the first day (0.7±0.9 vs. 1.1±1.2, P<0.001) and 51% had no low blood sugar levels that day.   An empiric 10% reduction in basal insulin appears reasonable, as nearly equal numbers of children required dose increases as dose decreases as camp progressed. However, hypoglycaemia was still common in all age groups. Prospective studies characterizing individual variables are needed in order to facilitate tailored insulin dose adjustments that minimize glycaemic variability while optimizing control in the diabetes camp setting.
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