Özet:

Objective: In type 1 diabetes (T1DM), a good metabolic control is important to reduce and/or postpone complications. Achieving better metabolic control in children and adolescent with T1DM is difficult due to loss of motivation, psychological problems, getting bored and tired. The aim of this study was improvement of the metabolic control in patients with diabetes who come from middle and low income families. Patient and Methods: Within the project; all diabetic children were passed to flexible and intensive insulin treatment. Nutrition education was repeated by a dietitian and education books about diabetes were distributed to all children. Poorly controlled diabetics were allowed more times in their visits. If it was necessary for the glycemic regulation, patients were hospitalized. Mean HbA1c was compared at the beginning and at one year follow up examination.Results: Ninety-one children (46 boys) with mean diabetes duration of 6.0±3.2 years participated in this study. At the end of the year mean HbA1c was reduced from 8.2% to 7.8% and number of poorly controlled patients (HbA1c ı %9) decreased from 25 to 15 (p<0.001). The girls have shown higher success and their mean HbA1c level was reduced from 8.3% to 7.7%, and number of poorly controlled patients had fallen from 12 to 4 (p=0.002). However, there were no significant improvements in the mean HbA1c levels of the boys at the end of the year. Conclusions: To allow enough time to the diabetic children with intensive insulin and nutritional therapies can improve their metabolic controls. Achievement of good control in the diabetic boys shows a greater challenge. Different strategies must be developed to reach better metabolic control in boys with T1DM

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