Southampton research finds children with type 1 diabetes, treated in hospital or at home immediately following their diagnosis, had the same outcomes two years later.
Dr Nicola Trevelyan, consultant paediatrician at University Hospital Southampton NHS Foundation Trust and Dr Justin Davies, consultant paediatric endocrinologist, have been part of a new study that suggests children with type 1 diabetes could be safely treated at home in the two years after their diagnosis.
The Delivering Early Care in Diabetes Evaluation (DECIDE) trial, led by a paediatric centre in Cardiff, aimed to see if newly diagnosed children who were treated at home would have better clinical and psychological outcomes than those who stayed in hospital.
The results, published in the journal BMJ Open, suggest that there was little difference in the two groups, with hospital and home-treated children showing similar control of their blood sugar levels.
Lifelong condition
Type 1 diabetes is a serious, lifelong condition and causes the level of glucose (sugar) in the blood to become too high. It happens when a person’s body can't produce enough of a hormone called insulin, which controls blood glucose levels.
It affects around eight percent of people with diabetes in the UK and, unlike the more common type 2 diabetes, it is not linked to obesity or an unhealthy lifestyle and is usually diagnosed in childhood.
Patients and their carers must learn to regularly check their blood glucose level and inject insulin to lower it, as if it remains high for a long period this can damage their heart, eyes, feet and kidneys.
Currently, standard practice is to admit patients to hospital immediately after they have been diagnosed for up to three days, where they are monitored and taught how to inject insulin.
Safe home care
The study involved 203 newly diagnosed children under 17 years of age and their carers from eight paediatric diabetes centres across the UK, including Southampton.
They were split into two groups – while one group stayed in hospital immediately following their diagnosis, the other was discharged the same day and had no overnight stays in hospital.
Families in both groups were given the same care, with an appointment at a diabetes clinic, ongoing support from health professionals over the phone and at visits, and access to out-of-hours help and advice.
The health and psychological wellbeing of both the children and their carers was checked one month, a year and two years after the diagnosis by blood sugar control tests and questionnaires.
Promising results
Two years after their diagnosis, children treated at home and their carers managed blood sugar levels just as effectively as those who stayed in hospital. They also reported a similar knowledge of the condition, affect on their quality of life and ability to cope.
“This study has shown that children with type 1 diabetes can be safely and effectively treated at home, without the need for long stays in hospital,” said Dr Trevelyan, who led the Southampton-arm of the study.
“If it became standard practice, home-based treatment could also free up hospital beds and NHS resources, without affecting the quality of care these children receive.”
Posted on Wednesday 19 February 2020