Endocrine Abstracts

The Hvidoere International Study Group on Childhood Diabetes comprising of 26 paediatric diabetes centres from 23 countries (Europe, North America, Japan, and Australia) has conducted five major studies, in order to asses metabolic control and quality of life in children and young people with type 1 diabetes and determine factors influencing good metabolic control and those creating barriers.

The findings of these studies have led to an internationally recognised remission parameter and the development of validated well-being and quality of life questionnaires with multiple translations. Whilst major advances in diabetes management tools including CSII and glucose sensors metabolic control in children is suboptimal with less than one-third achieving a HbA1C of <59 mmol/mol (7.5%). Empowering the child and family by education, motivation, and support is the cornerstone of good control. The diabetes management regimen should be tailored to the individual psychosocial needs of the family and should be provided by a multidisciplinary team trained in paediatric diabetes care. Psychosocial factors are often not obvious, so it is important that healthcare professionals do not make assumptions but assess them scientifically. The health care team should have a cohesive approach and target optimal glycaemic control. Continued parent involvement is important with the promotion of independent, responsible self-management. Easily accessible ongoing care and phone support is required. Children from single parent families and ethnic minority groups have poorer metabolic control, poorer parent well-being, and ethnic minority groups have a significantly lower quality of life and thus require additional resources.

The best results were obtained by physicians who were target-driven and teams and families where there was unanimity of purpose. There is a need for ongoing collaborative international research to determine the most effective treatments, education, and psychosocial intervention programmes.