Randomised prospective study of short-term and long-term initial stay in hospital by children with diabetes mellitus

Lancet. 1991 Mar 16;337(8742):656-60. doi: 10.1016/0140-6736(91)92464-d.

Abstract

To assess how an isolated change in the pattern of care influences outcome of care and hospital use, a randomised prospective 2-year study was done in which 31 of 61 consecutive children with newly diagnosed insulin-dependent diabetes mellitus (IDDM) were admitted to hospital at disease onset for about a week and compared with the other 30 children who were admitted for about 4 weeks. Insulin treatment and education about diabetes were similar in the two groups. Duration of initial stay in hospital had no effect on metabolic control during the 2 years but time since diagnosis was significant with respect to effect on haemoglobin A1 (p = 0.001), haemoglobin A1c (p = 0.004), and insulin dose (p less than 0.001). At 2 years, 45% of the children in the short-term group and 29% in the long-term group were C-peptide positive (p = NS); C-peptide positivity correlated with age. A change in the pattern of care of children with IDDM, led to a pronounced decrease in hospital use by this patient group. Irrespective of the length of initial stay in hospital, equally good metabolic control was obtained in both groups for 2 years.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • C-Peptide / blood
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Drug Administration Schedule
  • Evaluation Studies as Topic
  • Female
  • Finland / epidemiology
  • Glycated Hemoglobin / analysis
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Insulin / administration & dosage
  • Insulin / therapeutic use
  • Length of Stay*
  • Male
  • Patient Education as Topic
  • Prospective Studies
  • Time Factors

Substances

  • C-Peptide
  • Glycated Hemoglobin A
  • Insulin