S416 Poster Session 2

P1608 P1610 Impact of Education, Psychosocial and Behavioral Aspects of The Effectiveness of a CD-ROM in Educating Teachers Who Have a Diabetes Mellitus in Childhood & Adolescence Student with Diabetes Y. RAMU, T. Ramanaiah, Y. Vidyullatha. Ramakrishna Diabets Research Centre, Nellore, India

ALLISON HUSBAND, Danible Pacaud, Kelly Cirebenc, Elaine McKiel. Pediatrics, University of Calgary, Calgary, AB, Canada

Aim: To evaluate tbe impact of Education, Socio-economic, behavioral and Psychosocial aspects in growth and development of Diabetic children and adolescents. Methods: 42 IDDM (‘Qpe-I) Patients of 4 to 18 years age group were selected for the study. Educational Status, Socio-economic, Psychosocial behaviour and emotional aspects were evaluated and councelling was done. Results: Maintaining good Metabolic Control, educating and councelling a diabetic child was quite difficult. 23(54.76%) were economically poor, 30(71.42%) had irregular eating habits and poor diet compliance. 34(80.94%) had poor glycemic control and only 10(23.8%) had knowl- edge regarding diet, exercise, drugs and self monitoring of blood and Urine sugar. 15(35.7%) had behavioral disorders. Children of bigger and socio-economically backward families lacked emotional care, had varied eating habits and insulin injection dosing. Poor metabolic control was observed during the transition period. Eating disorders and skipping insulin injection was observed in 30% of girls. Smoking, drinking and drug abuse was prevalent in 25% of boys. Dipression obsessive behaviour, rebelling, hyperactivity, sleep disorders, difficulty in learning and loss of concentration was observed in 20% of boys and girls of adolescent age. Conclusion: Education and councelling has a great impact on Psychoso- cial and behavioral growth in diabetic children and adolescents.

P1609 CEBNAD: An Instance of Group Support for Children and Adolescents with ‘Qpe 1 Diabetes F. NIEVES-RIVERA, M.N. Alicea, M. Lugo-P&ez, M.A. Rivera, L. Gonzilez-Pijem. University of Puerto Rico, School of Medicine, Puerto Rico

Research on diabetes and school issues demonstrates that teachers have a diabetes knowledge deficit. The purpose of this study was to determine if the CD-ROM teaching tool “Passport to Knowledge: A Guide to Diabetes Management in Children” (1998): 1) increases knowledge about ‘Qpe 1 diabetes in children 2) increases knowledge specific to the recognition and treatment of hypoglycemia 3) increases confidence in responding to the needs of children with Type 1 diabetes. Elementary school teachers who agreed to participate were randomized into control (n=19) or experimental (n=19) groups and completed a dia- betes knowledge questionnaire (maximum score 17, negative correction) and a confidence questionnaire (4 questions using a 5 point Likhert scale). The knowledge questionnaire was developed by the researchers and tested for validity and reliability (Cmnbach alpha 0.78, test-retest kappa above 0.7 for each question). The experimental group viewed the CD-ROM and then the questionnaires were repeated. Total scores were not significantly different at baseline and on post-test (experimental group: pre=llf3.2; post=12.6f3.4 and control group: pre=9.8&3.8; post=1 1.4f4.1). Baseline hypoglycemia subscale results were 4.2f1.8 and 4.4f2.0 (maximum score 6) for the experimental and control groups respectively. Hypoglycemia subscale scores did not change significantly on the post-test. The confidence level improved significantly in the experimental gmup after viewing the CD-ROM (p=O.Ol). Viewing of the CD-ROM did not increase general diabetes knowledge or hypoglycemia knowledge. However, subjects of the experimental group were more confident than the control group in their ability to care for their student with diabetes after viewing the CD-ROM.

P1611

Group support during childhood may be important to endow children with diabetes mellitus with coping skills and foster life-long well being. Because of the high incidence of type 1 diabetes mellitus n Puerto Rico -18 X Id-, a group of health professionals in the Island took the task of developing means to accomplish this goal. Since 1991 a diabetes residen- tial camp has been offered yearly for children and adolescents with type 1 diabetes mellitus in Puerto Rico free of charge. The entity is duly incorpo- rated as a local organization under the name of CEBNAD -Education and Well Being Committee for Children and Adolescent with Type 1 Diabetes Mellitus-. Our work includes the planing and developing of camps for children with type. 1 diabetes mellitus where they can enjoy outdoor as well as indoor activities, play sports, socialize and obtain personal accomplishments. Means to enhance their knowledge about their diabetes are emphasized. Experiences in real world where they can apply what is being learned is provided by visiting off camp site restaurants among the activities. Camps are staffed by young adults with type 1 diabetes mellitus who share life experiences and may serve as role models for some of the participants. Campers have the opportunity to learn proper dental care, feet care and response during actual real emergencies. Screening during camp for possible early detection of complications have also been provided. Pre- and post-tests are given to assess acquired knowledge. The results of these tests have consistently showed improvement of knowledge deficits detected at pretest. In addition, campers feel that camp is unique in providing emotional and peer support. In summary, an instance of support group for children with type 1 diabetes mellitus, as well as for their parents, is described. We conclude that early intervention through support groups tailored to patients’ age, type of illness and its duration can enhance the development of coping skills and promote life-long well being.

Peripheral Nerve Dysfunction in Children and Adolescents with ‘l)pe I Diabetes Mellitus NFXhUN SALAH ’ , Loubna Mansour ’ , Shereen Abdel-Ghaffar ’ , Ann Abdel-Kader’, Lamia Soubhy ‘. ‘Diabetes Endocrine Metabolism Pediatric Unit, Childrem' Hospital Cairn University, Cairo, Egypt: ‘Neurology Department, Cairo University, Cairo, Egypt

Diabetic neuropathy is one of the major complications of type I diabetes mellitus(DM).In this study, peripheral nerve functions were assessed in 40 diabetic patients aged 7.17 to 25.33 years having type I DM with duration more than 5 years referred to Diabetic Endocrine Metabolic Pediatric Unit (DEMPU),Cairo university.Twenty percent of patients had no symptoms of neuropathy while the rest had either symptoms of peripheral neuropathy alone (ZOolo), autonomic neuropathy (20%). or both(40%).Fifteen percent of patients had microalbuminuria,l2.5% had retinopathy while 50% had variable degrees of cardiovascular autonomic neuropathy.Examination of the conduction velocity,distal latency and amplitude of evoked potential of the sural and sensory component of ulnar nerve were used to detect the degree of sensory neuropathy, while those of the posterior tibial and motor component of the ulnar nerve were used for assessment of motor neuropathy while sympathetic skin response was used to detect peripheral autonomic neuropathy.Hundred percent of patients had neuropathy of different grades as detected by conduction velocity tests, 97.5% had motor affection, 90% had sensory affection while 92.5% had autonomic neuropathy. The degree of neuropathy was positively correlated with bad metabolic control,duration of diabetes,presence of other complications of diabetes.To conclude, all diabetics either symptomatizing or not should be screened for diabetic neuropathy especially pubertal patients and those with long duration of diabetes or other complications of diabetes.