title: Intensive diabetes education program and multidisciplinary team approach in management of newly diagnosed type 1 diabetes mellitus: a greater patient benefit, experience at Siriraj Hospital.
abstract: It is accepted worldwide that an effective multidisciplinary management team is essential for providing comprehensive self-management training to type I diabetics and their families. Therefore, the authors developed an intensive multidisciplinary education team that included pediatric endocrinologists, a dietitian, a psychologist, nurses, scientists and volunteers in the Department of Pediatrics, Siriraj Hospital in August 1996. This study aimed to analyze twenty-four newly diagnosed diabetics who underwent this specified program and multidisciplinary team approach in comparison to twenty-eight diabetic patients who were diagnosed before the program and team were established in order to see whether the length of hospitalization had been reduced and to compare the readmission rates of recurrent DKA with previous patients. The results demonstrated that by using the intensive program and multidisciplinary team the average length of admission was reduced from 36.04 days to 17.63 days (p value = 0.03). The readmission rate in the first year after diagnosis was also reduced from 17.8 per cent to 4 per cent. Concerning diabetes control, the average HbA1c level showed significantly better control. Therefore, this study demonstrated a successful team and program for newly diagnosed Thai childhood and adolescent diabetics and also emphasized that a multidisciplinary team approach with an effectively intensive education program is important in helping diabetics and families cope with their emerging problems and receive the long-term benefits of effective self-care.
authors.affiliation: Division of Endocrinology and Metabolism, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Supawadee
authors.initials: S
authors.lastname: Likitmaskul
authors.forename: Jirapa
authors.initials: J
authors.lastname: Wekawanich
authors.forename: Renu
authors.initials: R
authors.lastname: Wongarn
authors.forename: Katharee
authors.initials: K
authors.lastname: Chaichanwatanakul
authors.forename: Pornpimol
authors.initials: P
authors.lastname: Kiattisakthavee
authors.forename: Saroj
authors.initials: S
authors.lastname: Nimkarn
authors.forename: Sangtong
authors.initials: S
authors.lastname: Prayongklin
authors.forename: Linda
authors.initials: L
authors.lastname: Weerakulwattana
authors.forename: Duangkamon
authors.initials: D
authors.lastname: Markmaitree
authors.forename: Yupin
authors.initials: Y
authors.lastname: Ritjarean
authors.forename: Wanla
authors.initials: W
authors.lastname: Pookpun
authors.forename: Luephorn
authors.initials: L
authors.lastname: Punnakanta
authors.forename: Kitti
authors.initials: K
authors.lastname: Angsusingha
authors.forename: Chanika
authors.initials: C
authors.lastname: Tuchinda
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000628:therapy*; D003927:Diet, Diabetic; D015444:Exercise; D005260:Female; D006302:Health Services Research; D006785:Hospitals, University; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D012720:Severity of Illness Index; D013785:Thailand
chemical_list: D007328:Insulin