Alessandro Scorsone, Italy
ASP Palermo - Partinico Civic Hospital Referral Centre for Diabetes and Insulin PumpsPresenter of 2 Presentations
PARENTAL DISTRESS OF INSULIN PUMP USERS IN PEDIATRIC AGE
Abstract
Background and Aims
Parents of a child suffering type 1 diabetes report distress.It may diminish in intensity, but that it does not disappear entirely. AIM: to test the hypothesis that technology may be a source of parental distress.
Methods
We studied 49 T1 DM subject since the onset (Age 9,3 ± 3,9 M± SD) using Parenting Stress Index 4th ed. Parental Distress (PD)—how parents feel competent, conflicted, supported, depressed in their role. Parent-Child Dysfunctional Interaction (P-CDI)—how they feel satisfied with their child and their interactions. Difficult Child (DC)—How they perceive their child to be. DIF (Difficulty Identifying Feeling). We used a multivariate approach.
Results
At the onset of diabetes there is a high correlation between DIF and PDS score (r=0.97) as seen also in our reference population not using insulin pumps. CHO counting adoption did not change this interaction. Soon after combination of SAP + Counting mantains the correlation between DIF and PDS score (r=0.90) but between PCDI and DC score become stronger (r = 0.94) with respect to DIF and PDS score (r = 0.83).
Conclusions
Parents try to portray himself as competent (abnormal emotional stress of parenting), or do not invest in their role experiencing stress associated with child care. After the onset of T1 DM parents cannot effectively cope with sources of stress (reduced sense of parental competence, conflict with the other parent, lack of social support, presence of depression). High DIF means no defense and sincerity (not necessary to give a favorable image). It's time for sudden intervention by the multidisciplinary team.
TRENDS OF COMPLICATIONS OF DIABETES IN TYPE 1 SUBJECTS WITH DIABETIC FOOT ON INSULIN PUMP THERAPY: A 5 YEARS REGISTRY ANALYSIS
Abstract
Background and Aims
The onset of a diabetic foot ulcer is a severe complication.Our aim was to study if diabetes complications are better managed in Type 1 diabetes subjects on insulin pump therapy presenting with a diabetic foot problem.
Methods
We extracted data on T1 DM, from our electronic registry during the last 5 yrs.AIM: to study if insulin pump users had different mangement of diabetic foot.
Results
Population: 193 insulin pump users admitted to our outpatient diabetic foot clinic (23.3% first access). Mean age was 37.7 ± 6,9 (M ± SD). 90% of users ( 73% not users) underwent a diabetic foot screening procedure before, 70% vs 63% screened for diabetic retinopathy (p < 0.05). Mean HbA1c was not different (7.9 ± 1,6 vs 8.0 ± 1.7 %) . LDL was < 100 mg/dl in 55% of both. Among T1 DM subjects (users vs not users) BMI was > 30 in 13,3% vs 18,2%, eGFR < 60 ml/min 66,7% vs 33 %, CV event in 3,3% vs 4,5%, Microalbuminuria 26,7% vs 31,3 %, diabetic retinopathy rate and blood pressure levels were not different. No maior amputation rate was registered in users 3% in non users, lesser degree amputation in 3,3% and 3.5%.
Conclusions
Insulin pump users may have a better management of diabetes related complications, apart from glucose control, due to a more intensive follow-up scheduled for them that does not overlook any action of diabetes care. This may improve the outcome of diabetic foot and diabetes-oriented databases may help us in controlling health care procedures.