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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Editorial Board Member: Darendeliler, Feyza / Gustafsson, Jan / Luo, Feihong / Mericq, Veronica / Lanes M. D., Roberto / Battelino, Tadej / Buyukgebiz, Atilla / Cassorla, Fernando / Chrousos, George P. / Cutfield, Wayne / Fideleff, Hugo L. / Hershkovitz, Eli / LaFranchi, Stephen H. / Mohn, Angelika / Root, Allen W. / Rosenfeld, Ron G. / Wabitsch, Martin / Werther, George / Zadik, Zvi

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Observational study of diabetes management in type 1 diabetic school-age children during holiday versus school days

1–3, , / Yael Lebenthal2, 4 / Mona Boaz5 / Orit Pinhas-Hamiel1, 2, 6

1Maccabi National Juvenile Diabetes Center, Raanana, Israel

2Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel

3Pediatric Endocrine and Diabetes Unit, E. Wolfson Medical Center, Holon 58100, Israel

4The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel (SCMCI), Petah Tikva 49202, Israel

5Epidemiology and Research Unit, E. Wolfson Medical Center, Holon 58100, Israel

6Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Ramat-Gan 52621, Israel

Corresponding author: Zohar Landau, MD, Pediatric Endocrinology Service, E. Wolfson Medical Center, Holon 58100, Israel, Phone: +972 544822792, Fax: +972 35028803, E-mail:

Citation Information: Journal of Pediatric Endocrinology and Metabolism. Volume 26, Issue 11-12, Pages 1083–1086, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: 10.1515/jpem-2013-0045, May 2013

Publication History

Received:
2013-02-02
Accepted:
2013-05-06
Published Online:
2013-05-30

Abstract

Background: Type 1 diabetes (T1D) management requires year-round adherence to treatment regimen. Holidays may present a challenge towards achieving good metabolic control.

Objectives: Our aim was to investigate the effect of holidays on diabetes management of schoolchildren with T1D.

Methods: Observational, case-crossover study of 45 schoolchildren, age range 7–19 years, mean 13.2±3.4 years, followed in a pediatric diabetes clinic. Subjects were stratified by age [<12 years (n=21), >12 years (n=24)] and treatment modality [insulin pump (n=29) or multiple daily injections (n=16)]. Data were downloaded from glucometers and insulin pumps during five non-weekend holidays and five subsequent school days.

Results: The mean number of blood glucose (BG) readings was significantly lower (4.4±1.9 vs. 4.8±1.9, p<0.01) and mean BG marginally higher (11.4±2.7 vs. 10.7±3.1 mmol/L, p=0.1) during holidays than during school days in the entire cohort. Children were significantly more adherent to diabetes management than adolescents as expressed by lower mean glycated hemoglobin level (7.7±0.8% vs. 8.6±1.4%, p<0.05), more BG readings per day (p<0.001) and lower mean BG on holidays (p<0.05) and on schooldays (p<0.01). In pump users, no difference in the mean number of boluses per day and mean insulin units per kilogram per day was observed between holidays and school days.

Conclusions: The management of school-aged children with T1D during holidays was worse than during school days; these finding were more pronounced in adolescents. The diabetes team should be aware of suboptimal therapy during holidays and should consider intervention programs in attempts to educate patients accordingly.

Keywords: diabetes management; holidays; type 1 Diabetes

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