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Medical Progress Report [3 month]


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Medical Progress Report [3 month]

Diabetes - this is not just a disease but a very special way of life. Even the most effective insulin will not benefit unless there is no correct nutrition. The purpose of this project is to improve the lives of children with diabetes.
25 children with diabetes take part in the project "Diabetes garden". All of them have mellitus type I and their age vary from 8 to 14 years, including 11 girls and 14 boys. All of them are on intensified insulin therapy, including 16 people - at engineered human insulin. 19 people use analogues, 2 people are on pump therapy.
The timing of the disease: 3 people have been sick during the year, 11 people have experience of the disease up to 3 years, 8 people - up to 7 years and over 7 years - 3 people.
All the children have self-diaries, in addition every child has a sheet of observations with the following parameters: glycated hemoglobin, fasting glucose, postprandial hypoglycemia, nocturnal blood glucose, microalbuminuria, the presence of hypoglycemia, ketoacidosis, complications, chronic intercurrent diseases.
We studied the general condition of the child, his mood, social interaction and activity. These observations were noted on the sheet in front of on-roan project and subsequently every 3 months.
Before the project the average glycated hemoglobin of the whole group of children - 8.2%, including those who are sick less than a year - 7.2%, up to 3 years – 8,1%, to 7 years - 8.4% over 7 years - 9.3%.
Hypoglycaemia was reported by 8 patients (32%), ketoacidosis – by 6 people (24%),8 patients (32%) had compensated diabetes (optimal glycemic control), 13 persons (52%) had subcompensated (suboptimal) and 4 children(16%) experienced the risk of decompensation, requiring intervention. Concomitant diseases in children: the gastro-intestinal tract - 15 people. (60%), diffuse goiter - 3 people. (12%), ENT diseases - 4 people. (16%), epilepsy - 1 person. (4%), cardiomyopathy - 1 person. (4%).
Complications of diabetes were diagnosed in 11 people. (44%), including nephropathy - 5 people. (20%), neuropathy - 9. (36%), angiopathy - 2 people. (8%), hayropatiya - 1 person. (4%).
After 3 months of the project, "Diabetes garden", in which children with parents learn self-correction of health, get the basic information about diabetes and its treatment, learn how to grow vegetables at home and in the garden the children's condition has improved greatly, they became more interactive and sociable. Signs of depression have disappeared in some children, they became more active.
Laboratory indicesof compensationof diabetes have improved too. Average glycated hemoglobin decreased from 8.2 to 7.7%, including children with the duration of the disease up to one year - from 7.2 to 6.9%, up to 3 years - from 8.1 to 7, 7%, and 7 years - from 8.4 to 7.8% and more than 7 years - from 9.3 to 8.1%.
Fasting glucose came to normal in 9 people. (63%), decreased in 12 people. (48%).
Postprandial glycemia decreased in10 people (40%), night glycemia normalized in 8 people (32%). Severe hypoglycemia wasn’t observed, hypoglycemia after exercise was experienced by 5 people. (20%).
Microalbuminuria –( two people with nefropatology have it) decreased, but still is higher than normal.
During 3 month study 5 people had acute respiratory disease - (20%), ketoacidosis due to an acute pathology had 3 people (12 %).
Two children changed engineered insulin into analogues because of compensation of diabetes mellitus and then it was compensated.
Observing children on insulin therapy for 3 months and basing on objective and laboratory data, we can see some improvements in compensation of diabetes in children. Number of children with good compensation of diabetes (optimal glycemic control)increased from 8 people up to 14 people. (56%).
Number of children with incomplete compensation decreased from 13 to 11 people. (44%), all children (4 pers.) with the risk of decompensation - compensated.
3 months of observation show that even in this short period of training and the involvement of children in the cultivation of food they need (vegetables)helped to improve the lives of children with diabetes. Not only health of children improved, but the project has made it possible to reduce hyperglycemia, hypoglycemia, and reduce the number of at-close glycated hemoglobin to the recommended standards.

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