ISSN:1357-8170    

DOI:10.1002/pdi.1960060402

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960060403

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960060404

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960060405

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractThe accuracy of home blood glucose monitoring was assessed in a group of children with insulin‐dependent diabetes mellitus. Seventy six children each provided a blood sugar profile on filter paper treated with 5% boric acid. Only 42 (55%) of the patients estimated more than half of their readings accurately. Patients using reflectance meters were no more accurate than those using visually read strips. Of the 34 patients in whom the initial results were inaccurate, 15 (44%) showed some degree of improvement after further teaching, but only seven of these patients (21 %) improved to greater than 50% accuracy. This study confirms that diabetic children as a group are not particularly accurate in blood sugar monitoring at home and suggests that a significant number do not improve even with intensive educatio

ISSN:1357-8170    

DOI:10.1002/pdi.1960060406

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractThis longitudinal study compares serum fructosamine (SF) and glycosylated haemoglobin (HbA1) in assessing glycaemic control in 172 insulin‐dependent diabetic outpatients over a 21 month period. Seven simultaneous measurements of SF and HbA1were performed in sequential order at intervals of 10 to 12 weeks, during which patients received standard diabetic care. In common with other studies, the between‐subject correlation of SF and HbA1was confirmed to be satisfactory (r = 0.68, p<0.001). However, the within‐subject correlation between these indices of glycaemic control was found to be of lower order (r = 0.21, p<0.05). This finding reflected the larger percentage variance due within‐subject variance of SF (47%) compared with HbA1(17%), and was consistent with the shorter biological half‐life of serum albumin compared with haemoglobin. At the end of the study, there was a significant reduction in the SF concentration (mean difference 0.55 mmol/l, SEM 0.04, p<0.001), but not in the HbA1. There was no significant between‐or within‐subject correlation of SF and immunologically determined serum albumin concentration (range 30‐ 54 g/l). We conclude that when monitoring metabolic control in individual insulin‐dependent diabetic patients, SF and HbA1provide different information on glycaemic status. Since this information may influence patient management, clinical trials should be undertaken to assess the merits conferred by use of either test. For the present we recommend that the measurement of SF and HbA1be employed additively and not interchangeably in the routine care of the diabetic patient; correction of SF for serum albumin concentration i

ISSN:1357-8170    

DOI:10.1002/pdi.1960060407

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractThe education and treatment programme of the diabetes day care unit in Malmo, Sweden, was evaluated with regard to metabolic control in 34 poorly controlled insulin‐treated diabetic patients. Three to 12 months before admission and on admission, mean HbA1cwas 9.09 ± 0.41% and 9.28 ± 0.35%, respectively, compared to 8.31 ± 0.38% and 8.41 ± 0.36%, respectively, p<0.05, in 29 out‐patient diabetic controls (reference value:4.00‐5.20%). Despite unchanged mean insulin doses in the patients, glycaemic control improved significantly during the education period, and mean blood glucose decreased significantly (p<0.001) from 12.8 ± 0.6 mmol/l on the day after admission to 9.2 ± 0.5 mmol/l on the last day before discharge. Six months after discharge from the unit, metabolic control was still improved and mean HbA1cvalues had been reduced to the level of the diabetic controls (8.11 ± 0.40 and 8.36 ± 0.39%, respectively).An education and treatment programme promoted metabolic control in poorly regulated diabetic patients. An intense education programme, insulin dose adjustments and self‐monitoring of blood glucose contributed

ISSN:1357-8170    

DOI:10.1002/pdi.1960060408

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960060409

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractThere is no standard approach to caring for children with diabetes mellitus. For physical and psychological well‐being the care provided must meet the needs of the individual. This essay concentrates on the stresses associated with diabetes mellitus, and the psychological care and support needed, rather than clinical management. The factors which affect attitudes to illness, and specifically to diabetes mellitus, are outlined. It is suggested that a major part of the care of children should be based in the home. The need for hospital outpatient visits can be markedly reduced if the standard of home based care is of a high level, and liaison with hospital specialists continuous. Children and their families often find hospital clinics time consuming, difficult, stressful and of limited use. The care giver must meet the needs of the child and family, so the approach must be flexible. As well as having sound clinical knowledge, the carers need experience in counselling and methods of support. The team should be multidisciplinary, with a key worker for each famil

ISSN:1357-8170    

DOI:10.1002/pdi.1960060410

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractThe general availability of potent sulphonylurea preparations and the ease with which they can be taken, may explain the increase in both the iatrogenic and factitious hypoglycaemia caused by them(Refs 1,2).Whereas insulin‐induced hypoglycaemia is relatively easy to diagnose in the laboratory, that caused by a sulphonylurea may not be, mainly because its biochemical features in many respects resemble those observed in insulinoma. In both conditions plasma insulin and C‐peptide concentrations are inappropriately high during hypoglycaemia and B‐hydroxybutyrate levels are low. The only sure way to distinguish between them in the absence of a positive history of ingestion, is by detection of sulphonylurea in the patient's blood. We describe here a typical case presentation and a preliminary assessment of the incidence of sulphonylurea‐induced factitious hypoglycaemia from a survey of 151 cases of “spontaneous” hy

ISSN:1357-8170    

DOI:10.1002/pdi.1960060411

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY