Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Nonpharmacological management and psychosocial support for children and adolescents with type 1 diabetes

  • Yoo, Jae-Ho (Department of Pediatrics, Dong-A University College of Medicine)
  • Received : 2011.01.11
  • Accepted : 2011.01.31
  • Published : 2011.02.15
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Abstract

Compared to that in the Caucasian population, type 1 diabetes mellitus (T1DM) incidence rates are very low in Koreans. Therefore, compared to the recent development of pharmacological therapy applicable to Korean children with T1DM, interest in nonpharmacological therapy and psychosocial support systems remains low, as is the development of Korean-style T1DM education programs for therapeutic application. Children who have been newly diagnosed with diabetes are placed in completely new environments for treatment. For appropriate control of diabetes, patients have to self-monitor blood glucose levels and inject insulin several times a day and must use extreme self-control when they eat foods to avoid increases in blood glucose levels. Blood glucose excursions resulting from impaired pancreatic ${\beta}$ cell functions cause mental stress due to vague fears of chronic complications of diabetes. In addition, children with diabetes cannot be excluded from the substantial amount of studies required of Korean adolescents, and the absolute shortage of time for ideal control of diabetes adds to their mental stress. Many of these patients are psychologically isolated in school where they spend most of their time, and they are not appropriately considered or supported with respect to blood glucose control in many cases. In this respect, this author will introduce some of the newest views on nonpharmacological therapy and psychosocial support systems that account for important parts of T1DM management and seek measures to apply them in conformity with the social characteristics of Korea.

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References

  1. Patterson CC, Dahlquist GG, Gyurus E, Green A, Soltesz G, EURODIAB Study Group. Incidence trends for childhood type 1 diabetes in europe during 1989-2003 and predicted new cases 2005-20: a multicentre prospective registration study. Lancet 2009;373:2027-33. https://doi.org/10.1016/S0140-6736(09)60568-7
  2. DIAMOND Project Group. Incidence and trends of childhood type 1 diabetes worldwide 1990-1999. Diabet Med 2006;23:857-66. https://doi.org/10.1111/j.1464-5491.2006.01925.x
  3. Shin CH. Epidemiologic characteristics of type 1 diabetes in children aged 14 years or under in Korea, 1985-2000. Korean J Pediatr 2008;51:569-75. https://doi.org/10.3345/kjp.2008.51.6.569
  4. Rhie YJ, Chae HW, Kim HS, Kim DH. The effect of lantus on glycemic control in children and adolescents with type 1 diabetes mellitus. Korean J Pediatr 2007;50:565-9. https://doi.org/10.3345/kjp.2007.50.6.565
  5. Lee YJ, Ko JM, Yoo HW. Effect of insulin glargine in adolescents with uncontrolled type 1 diabetes mellitus. J Korean Soc Pediatr Endocrinol 2008;13:36-40.
  6. Franz MJ, Bantle JP, Beebe CA, Brunzell JD, Chiasson JL, Garg A, et al. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2003;26 Suppl 1:S51-61. https://doi.org/10.2337/diacare.26.2007.S51
  7. Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, et al. Care of children and adolescents with type 1 diabetes: a statement of the american diabetes association. Diabetes Care 2005;28:186-212. https://doi.org/10.2337/diacare.28.1.186
  8. Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ, et al. Nutrition recommendations and interventions for diabetes--2006: a position statement of the american diabetes association. Diabetes Care 2006;29:2140-57. https://doi.org/10.2337/dc06-9914
  9. kingdom. Report of the panel on dietary reference values of the committee on medical aspects of food policy. Rep Health Soc Subj (Lond) 1991;41:1-210.
  10. Helgeson VS, Viccaro L, Becker D, Escobar O, Siminerio L. Diet of adolescents with and without diabetes: trading candy for potato chips? Diabetes Care 2006;29:982-7. https://doi.org/10.2337/dc05-2197
  11. Smart C, Aslander-van Vliet E, Waldron S. Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2009;10 Suppl 12:100-17. https://doi.org/10.1111/j.1399-5448.2009.00572.x
  12. Overby NC, Flaaten V, Veierod MB, Bergstad I, Margeirsdottir HD, Dahl-Jorgensen K, et al. Children and adolescents with type 1 diabetes eat a more atherosclerosis-prone diet than healthy control subjects. Diabetologia 2007;50:307-16. https://doi.org/10.1007/s00125-006-0540-9
  13. Bresson JL. Protein and energy requirements in healthy and ill paediatric patients. Baillieres Clin Gastroenterol 1998;12:631-45. https://doi.org/10.1016/S0950-3528(98)90001-X
  14. Wysocki T. Behavioral assessment and intervention in pediatric diabetes. Behav Modif 2006;30:72-92. https://doi.org/10.1177/0145445505284275
  15. Riddell MC, Iscoe KE. Physical activity, sport, and pediatric diabetes. Pediatr Diabetes 2006;7:60-70. https://doi.org/10.1111/j.1399-543X.2006.00146.x
  16. Ertl AC, Davis SN. Evidence for a vicious cycle of exercise and hypoglycemia in type 1 diabetes mellitus. Diabetes Metab Res Rev 2004;20:124-30. https://doi.org/10.1002/dmrr.450
  17. McMahon SK, Ferreira LD, Ratnam N, Davey RJ, Youngs LM, Davis EA, et al. Glucose requirements to maintain euglycemia after moderateintensity afternoon exercise in adolescents with type 1 diabetes are increased in a biphasic manner. J Clin Endocrinol Metab 2007;92:963-8. https://doi.org/10.1210/jc.2006-2263
  18. Nordfeldt S, Ludvigsson J. Fear and other disturbances of severe hypoglycaemia in children and adolescents with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2005;18:83-91.
  19. Herbst A, Bachran R, Kapellen T, Holl RW. Effects of regular physical activity on control of glycemia in pediatric patients with type 1 diabetes mellitus. Arch Pediatr Adolesc Med 2006;160:573-7. https://doi.org/10.1001/archpedi.160.6.573
  20. Bernardini AL, Vanelli M, Chiari G, Iovane B, Gelmetti C, Vitale R, et al. Adherence to physical activity in young people with type 1 diabetes. Acta Biomed 2004;75:153-7.
  21. Roberts L, Jones TW, Fournier PA. Exercise training and glycemic control in adolescents with poorly controlled type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2002;15:621-7.
  22. Sarnblad S, Ekelund U, Aman J. Physical activity and energy intake in adolescent girls with type 1 diabetes. Diabet Med 2005;22:893-9. https://doi.org/10.1111/j.1464-5491.2005.01544.x
  23. Woo J, Yeo NH, Shin KO, Lee HJ, Yoo J, Kang S. Antioxidant enzyme activities and DNA damage in children with type 1 diabetes mellitus after 12 weeks of exercise. Acta Paediatr 2010;99:1263-8. https://doi.org/10.1111/j.1651-2227.2010.01736.x
  24. Trigona B, Aggoun Y, Maggio A, Martin XE, Marchand LM, Beghetti M, et al. Preclinical noninvasive markers of atherosclerosis in children and adolescents with type 1 diabetes are influenced by physical activity. J Pediatr 2010;157:533-9. https://doi.org/10.1016/j.jpeds.2010.04.023
  25. Mason NJ, Jenkins AJ, Best JD, Rowley KG. Exercise frequency and arterial compliance in non-diabetic and type 1 diabetic individuals. Eur J Cardiovasc Prev Rehabil 2006;13:598-603. https://doi.org/10.1097/01.hjr.0000216546.07432.b2
  26. Heyman E, Toutain C, Delamarche P, Berthon P, Briard D, Youssef H, et al. Exercise training and cardiovascular risk factors in type 1 diabetic adolescent girls. Pediatr Exerc Sci 2007;19:408-19. https://doi.org/10.1123/pes.19.4.408
  27. Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, et al. National standards for diabetes self-management education. Diabetes Care 2010;33 Suppl 1:S89-96. https://doi.org/10.2337/dc10-S089
  28. American association of diabetes educators. AADE position statement. Individualization of diabetes self-management education. Diabetes Educ 2007;33:45-9. https://doi.org/10.1177/0145721706298308
  29. American association of diabetes educators. Management of children with diabetes in the school setting. Diabetes Educ 2000;26:32-5. https://doi.org/10.1177/014572170002600105
  30. Murphy HR, Wadham C, Rayman G, Skinner TC. Approaches to integrating paediatric diabetes care and structured education: experiences from the families, adolescents, and children's teamwork study (FACTS). Diabet Med 2007;24:1261-8. https://doi.org/10.1111/j.1464-5491.2007.02229.x
  31. Smart CE, Ross K, Edge JA, King BR, McElduff P, Collins CE. Can children with type 1 diabetes and their caregivers estimate the carbohydrate content of meals and snacks? Diabet Med 2010;27:348-53. https://doi.org/10.1111/j.1464-5491.2010.02945.x
  32. Lloyd CE, Dyer PH, Lancashire RJ, Harris T, Daniels JE, Barnett AH. Association between stress and glycemic control in adults with type 1 (insulin-dependent) diabetes. Diabetes Care 1999;22:1278-83. https://doi.org/10.2337/diacare.22.8.1278
  33. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001;24:1069-78. https://doi.org/10.2337/diacare.24.6.1069
  34. de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med 2001;63:619-30. https://doi.org/10.1097/00006842-200107000-00015
  35. Kwon EY, Jung HJ, Kim HJ, Choi IJ, Lee JH, Yoo JH. Effects of family environment and parenting behavior on glycemic control and depressive symptoms in children with type 1 diabetes. J Korean Soc Pediatr Endocrinol 2009;14:100-9.
  36. Murphy HR, Rayman G, Skinner TC. Psycho-educational interventions for children and young people with type 1 diabetes. Diabet Med 2006;23:935-43. https://doi.org/10.1111/j.1464-5491.2006.01816.x
  37. Wysocki T, Harris MA, Greco P, Bubb J, Danda CE, Harvey LM, et al. Randomized, controlled trial of behavior therapy for families of adolescents with insulin-dependent diabetes mellitus. J Pediatr Psychol 2000;25:23-33. https://doi.org/10.1093/jpepsy/25.1.23
  38. Wysocki T, Greco P, Harris MA, Bubb J, White NH. Behavior therapy for families of adolescents with diabetes: maintenance of treatment effects. Diabetes Care 2001;24:441-6. https://doi.org/10.2337/diacare.24.3.441
  39. Laffel LM, Vangsness L, Connell A, Goebel-Fabbri A, Butler D, Anderson BJ. Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes. J Pediatr 2003;142:409-16. https://doi.org/10.1067/mpd.2003.138
  40. American Diabetes Association. Diabetes care in the school and day care setting. Diabetes Care 2010;33 Suppl 1:S70-4. https://doi.org/10.2337/dc10-S070
  41. Mancuso M, Caruso-Nicoletti M. Summer camps and quality of life in children and adolescents with type 1 diabetes. Acta Biomed 2003;74 Suppl 1:35-7.

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