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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

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

Zohar Landau
  • Corresponding author
  • Maccabi National Juvenile Diabetes Center, Raanana, Israel
  • Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
  • Pediatric Endocrine and Diabetes Unit, E. Wolfson Medical Center, Holon 58100, Israel
  • Email:
/ Yael Lebenthal
  • Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
  • The 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
/ Mona Boaz
  • Epidemiology and Research Unit, E. Wolfson Medical Center, Holon 58100, Israel
/ Orit Pinhas-Hamiel
  • Maccabi National Juvenile Diabetes Center, Raanana, Israel
  • Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
  • Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Ramat-Gan 52621, Israel
Published Online: 2013-05-30 | DOI: https://doi.org/10.1515/jpem-2013-0045

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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About the article

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


Received: 2013-02-02

Accepted: 2013-05-06

Published Online: 2013-05-30

Published in Print: 2013-11-01


Citation Information: Journal of Pediatric Endocrinology and Metabolism, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2013-0045. Export Citation

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