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07 October 2008
A study led by experts from Cardiff University has recruited the first children with newly diagnosed type 1 diabetes as part of a national study funded by Diabetes UK.
The research project - Delivering Early Care In Diabetes Evaluation - The DECIDE Study - is being led by Dr Lesley Lowes from Cardiff School of Nursing and Midwifery Studies and Professor John Gregory from the Department of Child Health, School of Medicine.
With full coordination provided by the South East Wales Trials Unit (SEWTU) in the Department of Primary Care and Public Health, the team will investigate the advantages of home management and hospitalisation for children with type 1 diabetes and is the first centre to recruit children for the UK-wide study.
Dr Lowes said, "Children with type 1 diabetes have traditionally been hospitalised at diagnosis but are increasingly starting treatment at home. Currently there is no high quality evidence regarding psychological, social, physical or economic outcomes of home or hospital management."
"The aim of this research is to determine whether it is better to admit to hospital for initiation of insulin treatment and education of child and family, or whether results would be better if initial management was provided at home."
The study will be coordinated by Cardiff University and undertaken by eight centres across the UK; Cardiff and Vale NHS Trust, Southampton University Hospitals Trust, Hull and East Yorkshire NHS Trust, Royal Liverpool Children’s NHS Trust, Nottingham Universities NHS Trust, Newcastle Upon Tyne NHS Foundation Hospitals Trust, Cambridge University Hospitals NHS Foundation Trust and Belfast Health and Social Care Trust. Each centre will be responsible for recruiting 30 newly diagnosed children and their families to the study.
Dr Iain Frame, Research Manager at Diabetes UK, said: "Children with Type 1 diabetes require specialist care, and where this care takes place depends very much on the needs of the child and the family situation. Diabetes UK has funded this research because we hope that it will help healthcare professionals and families to make informed decisions about the best environment in which care should take place and we look forward to seeing the results. This is a good example of Diabetes UK funding research with the potential to make a real difference to the lives of people with diabetes."
There are strong and opposing views as to where best to manage newly diagnosed children. Although some units admit all children, others try to keep children out of hospital.
In the study, 240 children with type 1 diabetes (clinically well at diagnosis) aged 0-17 years from eight UK centres will be randomly selected to start treatment at home or in hospital from diagnosis but will receive the same support and education.
Best practice will be determined by assessing and comparing parents' and children's psychological adjustment, coping and adaptation, diabetes knowledge and satisfaction with service provision, children’s glycaemic control and well being, health service and patient borne costs, and by exploring parents’ and children’s experiences from their perspective.
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