title: Observational study of diabetes management in type 1 diabetic school-age children during holiday versus school days.
abstract: BACKGROUND
  Type 1 diabetes (T1D) management requires year-round adherence to treatment regimen. Holidays may present a challenge towards achieving good metabolic control.
  
  
  OBJECTIVE
  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 school days (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.
authors.forename: Zohar
authors.initials: Z
authors.lastname: Landau
authors.forename: Yael
authors.initials: Y
authors.lastname: Lebenthal
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.forename: Orit
authors.initials: O
authors.lastname: Pinhas-Hamiel
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D012648:Self Care
chemical_list: D007328:Insulin