title: Randomised prospective study of short-term and long-term initial stay in hospital by children with diabetes mellitus.
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.
authors.affiliation: Children's Hospital, University of Helsinki, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Simell
authors.forename: E A
authors.initials: EA
authors.lastname: Kaprio
authors.forename: J
authors.initials: J
authors.lastname: Mäenpää
authors.forename: J
authors.initials: J
authors.lastname: Tuominen
authors.forename: O
authors.initials: O
authors.lastname: Simell
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002096:C-Peptide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D004334:Drug Administration Schedule; D005069:Evaluation Studies as Topic; D005260:Female; D005387:Finland / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007902:Length of Stay; D008297:Male; D010353:Patient Education as Topic; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin