Asunto(s)
Automonitorización de la Glucosa Sanguínea , Glucemia , Diabetes Mellitus Tipo 1 , Hemoglobina Glucada , Humanos , Hemoglobina Glucada/análisis , Hemoglobina Glucada/metabolismo , Estudios Retrospectivos , Automonitorización de la Glucosa Sanguínea/métodos , Glucemia/análisis , Glucemia/metabolismo , Adolescente , Masculino , Femenino , Niño , Diabetes Mellitus Tipo 1/sangre , Control Glucémico/estadística & datos numéricosRESUMEN
OBJECTIVES: The purpose of this study was to assess parental perceptions of the current state of care for children with diabetes in the Alabama public school system, identify existing disparities, and determine what resources would most improve diabetes management in this setting. There is a significant need for such information because of the paucity of published data on the current state of diabetes care in Alabama public schools. METHODS: We based our survey on the American Diabetes Association guidelines and collected responses on the Internet via SurveyMonkey and by paper surveys. We distributed surveys to parents of children with diabetes through the Children's Hospital endocrinology clinic, a diabetes camp, and through the Alabama Association of School Nurses e-mail listserv. RESULTS: A majority of children had type 1 diabetes mellitus. Students who could conveniently check their blood glucose levels (BGLs) at school were significantly more likely to participate in all school activities and their parents were significantly more likely to be satisfied with their child's diabetes care at school. Compared with minority students (defined as all races other than white), white students were more likely to be able to conveniently check their BGLs at school. CONCLUSIONS: The accommodation and care for children with diabetes is highly variable within much of the Alabama public school system. The ability to conveniently check BGLs at school is key for participation in all school activities and for parental satisfaction with diabetes care at school. Institution of a uniform, statewide diabetes training protocol for school personnel could improve care and parental satisfaction.
Asunto(s)
Diabetes Mellitus Tipo 1/terapia , Servicios de Salud Escolar/normas , Alabama/epidemiología , Niño , Diabetes Mellitus Tipo 1/epidemiología , Manejo de la Enfermedad , Femenino , Disparidades en Atención de Salud , Humanos , Modelos Logísticos , Masculino , Estadísticas no Paramétricas , Encuestas y CuestionariosRESUMEN
AIM: To further define the pathogenesis of infantile hypocalcemia, the prevailing vitamin D status, and treatment outcomes. METHODS AND RESULTS: Of the 23 infants admitted with infantile hypocalcemia, 21 had biochemical evidence of hypocalcemia and hyperphosphatemia and the other two had isolated hypocalcemia. The majority of these infants had relatively low serum intact parathyroid hormone responses against the backdrop of hypocalcemia. Thirteen (56.5%) of these infants had low 25-hydroxyvitamin D (25-OHD) levels, of whom 69% were Hispanic and 23% were African American. Infantile serum vitamin D status reflected that of the mother in all the 16 instances in which it was measured. Treatment with calcitriol hastened recovery from hypocalcemia in our series. CONCLUSIONS: Relative hypoparathyroidism is the etiology in the majority of cases of late onset and early infantile hypocalcemia. We identified vitamin D deficiency in a significant percentage of infants with hypocalcemia, especially Hispanics and African Americans. Maternal 25-OHD concentrations should be ascertained if the infant has low 25-OHD levels.