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Dsme Presentation-2
Dsme Presentation-2
Cally Byrne
DSME Rotation
Preceptors: Mary Julius & Neal Kurmas
Background
Diabetes Control and Complications Trial (DCCT)
Metabolic Control
Long-term Complications
Risk of Hypoglycemia
Hypoglycemia Treatment Options
Glucose tablets, juice, dried fruit, soda and candy
Factors: convenience, cost, taste and portability
Purpose
To determine the most effective treatment option for
managing naturally occurring hypoglycemia in children with
type 1 diabetes.
Objectives
Primary
Secondary
Participants
Included
Diabetes Clinic at the Alberta Childrens Hospital
3 18 y.o.
Minimum 3-month duration of type 1 diabetes
Excluded
Newly diagnosed
<4 hypoglycemic events per month
Adrenal insufficiency
Uncompensated hypothyroidism
Clinical autonomic neuropathy
Celiac disease
Lack of family support
Unable to to follow the study protocols
mg/dl)
Prepackaged treatments used 5 times each
Glucose: BD Glucose Tablets
Sucrose: Skittles
Fructose: Fruit to Go
study
Statistical Analyses
MANOVA
First analysis
DV: # of successes
IV: treatment method
Repeated stratifying for age group
Second analysis
DV: pretreatment blood glucose levels
IV: treatment method
Third analysis
Analyzed posttreatment blood glucose levels across the three
treatments
Results
N=33
Treatment Failure
Glucose: 12%
Fructose: 33%
Sucrose: 12%
Results
Conclusions
Skittles = BD Glucose Tablets > Fruit to Go
Sucrose = Glucose > Fructose
Factors that influence the effectiveness
Soluble fiber
Chewing
Glycemic Index
Metabolic pathways
resolution of hypoglycemia?
References
Husband AC, Crawford S, McCoy LA, et al. The
QUESTIONS?