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Zusammenfassung Fragestellung Assoziation zwischen Bildungsstand (BldS) der Eltern und diabetesbezogenen Outcomes bei Kindern mit Typ-1-Diabetes in Deutschland und Vergleich mit deren sozioökonomischem Status (SES). Material und Methode 1781 Kinder und Jugendliche mit Typ-1-Diabetes mellitus unter 18 Jahren aus 13 deutschen Diabeteszentren wurden von Juni 2013 bis Juni 2014 in die Studie eingeschlossen und Assoziationen des familiären BldS mit verschiedenen Diabetesoutcomes analysiert. Die Analyse wurde als Sekundäranalyse anhand des Datensatzes der DIAS-Studie durchgeführt. Diese hatte Assoziationen eines niedrigen SES (gemessen mit einem Index aus BldS, beruflicher Stellung und Haushaltseinkommen der Eltern) mit ungünstigen Diabetes- und Versorgungsoutcomes ermittelt. Die vorliegende Sekundäranalyse untersuchte Assoziationen derselben Outcomes mit dem BldS der Eltern, um zu prüfen, ob sich der BldS als vereinfachter Indikator für die Routinemessung des SES eignet.Die Daten wurden mittels der DPV-Software (Diabetes-Patienten-Verlaufsdokumentation) erfasst, die Analysen erfolgten je nach Verteilungscharakteristika der Outcomes mittels linearer, logistischer, negativ-binomialer oder Poisson-Modellen unter Adjustierung für Alter, Geschlecht, Diabetesdauer, jeweils mit und ohne zusätzliche Adjustierung für Migrationshintergrund. Ergebnisse Niedriger familiärer BldS war im Vergleich zu mittlerem/hohem BldS mit einer schlechteren glykämischen Einstellung (HbA1c) (8,1 % versus 7,8 %, p Zusammenfassung Der BldS der Eltern ist ein bedeutsamer Prädiktor für Gesundheits- und Versorgungsoutcomes bei Kindern mit Typ-1-Diabetes und sollte in der personalisierten Diabetestherapie von Kindern und Jugendlichen mehr Berücksichtigung erfahren. Als kurzer und leicht zu erhebender Indikator bildet er einen guten Näherungswert für die Routineerhebung der individuellen Stellung der Patientinnen und Patienten in der Sozialhierarchie in Diabetes-Standarddokumentationen.

Background Caring for a child with type 1 diabetes is a tremendous challenge for a family. The aim of the study was to explore the experiences of transition to sensor-augmented pump therapy (SAP) in families with 2 affected children and the internal and external conditions which potentially impede or facilitate the adjustment process. Methods 5 families (9 parents, 8 children and adolescents) who used the SAP technology for 6 months were interviewed to describe their experiences. The interviews were analysed using thematic content analysis. Results Qualitative analysis of the transcribed interviews revealed that the adaptation process to SAP consisted of several phases and differed among families. There were benefits as well as hassles of using SAP with regard to managing the diabetes, and psychosocial issues: school and peer relations, as well as family relations. While parents clearly regarded the improved metabolic control and hypoglycaemic safety as the most important benefits of SAP, the hassles reported as most important covered a wide range, from technical problems of the system to family conflicts. On the whole, families rated the experience of using SAP as a positive one, with most recommending SAP to other families as long as they were willing to come to terms with the technology and commit to the work and time involved. Conclusion Sensor-augmented pump therapy can be extremely beneficial and a resource for families who care for more than one child with diabetes. During the adaptation process there is a great need of education and frequent follow-up e. g., by telemedical support.

Background: The introduction of continuous glucose monitoring (CGM) implies new challenges for diabetes care. As CGM systems are often directly linked to a web-based software solution, structured telemedicine care using a video-consultation may be a new option for families who care for children with type 1 diabetes mellitus (T1DM). Methods: “ViDiKi” (Virtual Diabetes Outpatient Clinic for Children and Youth) is a multicenter controlled trial carried out in Northern Germany. ViDiKi will examine if monthly telemedical consultations, in addition to regular care, will improve glycemic control and psychosocial outcomes. The primary outcome is glycemic control as measured by a change in glycated hemoglobin (HbA1c). A total of 240 participants aged between one year and 16 years using a CGM with multiple daily injections (MDI) or insulin pump therapy were recruited and assigned to a starter group or a six-month waiting control group. The sample size is designed to detect a between-group difference of 0.5% in HbA1c change at six months. Secondary outcomes are variability of blood glucose, health-related quality of life, self-efficacy, and satisfaction with telemedicine. To gain deeper insight into the experience of using telemedicine, qualitative interviews will be conducted. In a health-economic analysis, the costs of telemedicine and a cost-of-care analysis will be calculated. Conclusions: The results from the ViDiKi study shall give important information on the feasibility and putative benefits of telemedicine in children with T1DM and their caregivers. German Clinical Trails Register (DRKS): DRKS00012645

Objective To evaluate the association between socioeconomic status (SES) and diabetes outcomes in German children and adolescents. Methods A total of 1829 subjects

Aims To improve the quality of care in children with Type 1 diabetes who have limited access to specialized diabetes care in rural areas, by providing a mobile diabetes education and care team, affiliated with a University hospital paediatric diabetes centre. Methods A cohort of 107 children and their families from eight rural hospitals was followed between July 2000 and July 2002. Parameters on quality of metabolic control (HbA1c, hospitalization rate and number of episodes of severe hypoglycaemia), diabetes knowledge and quality of life at baseline (t0), 6 weeks (t1) and 6 months (t2) after the interventions were measured. Results Mean HbA1c was 7.9 ± 1.4% at t0. The proportion of HbA1c values 8.0% decreased significantly (P

Aim: This study investigated insulin pump therapy in pediatric patients with type 1 diabetes and Turkish origin compared with those without migration background in Germany. Subjects and Methods: Using a nationwide documentation program, we estimated the prevalence of insulin pump therapy in patients