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Insúlínháð sykursýki barna og unglinga á Íslandi : mat á gæðum meðferðar

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Authors
Rannveig L. Þórisdóttir
Ragnar Bjarnason
Elísabet Konráðsdóttir
Árni V. Þórsson
Issue Date
2008-10-01

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Other Titles
Childhood type 1 diabetes in Iceland; evaluation of quality of treatment
Citation
Læknablaðið 2008, 94(10):659-62
Abstract
INTRODUCTION: The importance of adequate metabolic control in Type 1 DM has been repeatedly demonstrated in recent years. The care of diabetic children and adolescents in Iceland is centralized to one unit. The aim of the study was to analyze the quality of treatment and acute complications of Icelandic children with Type 1 diabetes. METHODOLOGY: The total number of diabetic children in paediatric care was 98. A cross-sectional survey was done for the period March 15th to July 14th, 2004. The results for the patient last visit to the diabetes clinic were recorded. HbA1c levels (DCA 2000) and number of severe hypoglycaemic episodes, were evaluated. RESULTS: The number of visits to the clinic during the 4 month interval were 83 (43 boys, 40 girls), mean age 13.3+/-3.78 years. Mean value of HbA1c in the cross-sectional survey was 8.16+/-1.31%. No difference in HbA1c was found between girls and boys. HbA1c increased with age in girls (p<0.01). Ten children experienced a total of 12 severe hypoglycaemic events during the period (43.4/100 patient years). CONCLUSION: Overall the metabolic control in children and adolescents with IDDM in Iceland is satisfactory compared to internationally published results. It is important to focus attention on children with inadequate metabolic control, especially adolescent girls, and children experiencing serious hypoglycaemic episodes.
Inngangur: Á síðustu árum hefur endurtekið verið sýnt fram á mikilvægi góðrar blóðsykurstjórnunar hjá sykursjúkum. Umönnun langflestra íslenskra barna og unglinga með sykursýki fer fram við göngudeild á Barnaspítala Hringsins. Lýst er árangri meðferðar hjá íslenskum ungmennum með insúlínháða sykursýki. Efniviður og aðferðir: Heildarfjöldi barna og unglinga með sykursýki við göngudeildina var 98. Tekin var þverskurðarathugun á tímabilinu 15. 3. 2004 - 14. 7. 2004 og niðurstöður mælinga við síðustu heimsókn barnanna sem til deildarinnar komu voru skráðar. HbA1c (DCA 2000) og fall blóðsykurs var athugað. Niðurstöður: Fjöldi heimsókna í þverskurðarúrtaki voru 83 (drengir 43, stúlkur 40), meðalaldur 13,3 ± 3,78 ár. Meðalgildi HbA1c var 8,18 ± 1,31%. Enginn marktækur munur fannst á meðalgildi HbA1c milli stúlkna og drengja. Marktæk hækkun var á HbA1c eftir aldri hjá stúlkum (p<0,01). Tíu börn (12%) fengu 12 sinnum alvarlegt blóðsykurfall á rannsóknartímabilinu (43,4/100 sjúklingaár). Ályktanir: Niðurstöður rannsóknarinnar sýna að meðhöndlun barna og unglinga með sykursýki á Íslandi gengur allvel miðað við niðurstöður sem birtar hafa verið frá mörgum öðrum löndum. Þó er mikilvægt að fylgja betur eftir þeim sem hafa ekki nægilega góða blóðsykurstjórnun, sérstaklega hjá unglingsstúlkum og börnum og unglingum sem falla alvarlega í blóðsykri.
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