Učinak grupne edukacije u bolesnika sa šećernom bolešću tipa 1

master's thesis

• Title (english): The effect of group education in patients with type 1 diabetes
• Author: Lorena Dolački
• Mentor: Ivana Kraljević (mentor)
• Committee member: Tomislav Bulum (predsjednik povjerenstva)
• Committee member: Marija Bakula (član povjerenstva)
• Committee member: Ivana Kraljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Šećerna bolest tip 1 (ŠBT1) je autoimuna bolest karakterizirana destrukcijom β-stanica Langerhansovih otočića gušterače čija je uloga lučenje inzulina te održavanje glukoze u krvi unutar uskog raspona vrijednosti. Nedostatak inzulina dovodi do hiperglikemije te dugoročno do razvoja mikrovaskularnih i makrovaskularnih komplikacija bolesti. U svrhu prevencije komplikacija, važna je adekvatna glikemijska regulacija, a liječenje se temelji na fleksibilnoj intenziviranoj inzulinskoj terapiji koja omogućuje slobodan izbor prehrane. „Dose Adjustment For Normal Eating“ (DAFNE) strukturirani edukacijski program namijenjen je pacijentima sa ŠBT1, a cilj takvog programa je naučiti bolesnike kako uskladiti porciju ugljikohidrata s prandijalnim dozama inzulina u svrhu poboljšanja regulacije glikemije. Cilj ovog retrospektivnog istraživanja jest utvrditi učinak DAFNE grupne edukacije pomoću novih tehnologija, odnosno monitoriranjem glukoze u međustaničnoj tekućini pomoću FreeStyle Libre 1 senzora (FSL) i HbA1c, kao i utvrditi prevalenciju komplikacija te specifičnih problema u regulaciji među ispitanicima. Prikupljeni su i analizirani podaci o 126 ispitanika starijih od 18 godina koji boluju od ŠBT1 dijagnosticirane prije više od šest mjeseci. Ispitanici su od 2016. do 2020. pohađali DAFNE edukaciju na Zavodu za endokrinologiju Kliničkog bolničkog centra Zagreb. Praćenjem pacijenata nakon edukacijskog programa, utvrđeno je značajno poboljšanje glikemijske regulacije na temelju HbA1c, kao i FSL. Najčešća komplikacija šećerne bolesti u ovom istraživanju je dijabetička retinopatija, a najčešći specifičan problem u regulaciji glikemije bile su učestale hipoglikemije. Edukacija nije dovela do redukcije vremena provedenog u hipoglikemiji.

Abstract (english)

Type 1 diabetes (T1D) is an autoimmune disease characterized by the destruction of the β-cells in the pancreas known as the islets of Langerhans, which are responsible for producing insulin and maintaining blood glucose levels within a narrow range. Insulin deficiency leads to hyperglycemia and, in the long term, the development of microvascular and macrovascular complications of the disease. Adequate glycemic control is important for preventing complications, and treatment is based on flexible intensive insulin therapy, which enables free choice of diet. Dose Adjustment for Normal Eating (DAFNE) is structured education program designed for patients with T1D. This program aims to teach patients how to match their carbohydrate intake with prandial insulin doses to improve glycemic control. This retrospective study aims to determine the effect of DAFNE group education using new technologies, explicitly monitoring glucose in the interstitial fluid using FreeStyle Libre 1 (FSL), and HbA1c levels. Additionally, the study aims to determine the prevalence of complications and specific regulation problems among the participants. Data from 126 participants over 18, diagnosed with T1D for more than six months, were collected and analyzed. The participants attended the DAFNE education program at the Department of Endocrinology of the Clinical Hospital Center Zagreb from 2016 to 2020. Following the educational program, a significant improvement in glycemic control based on HbA1c and FSL was observed. The most common complication of diabetes in this study was diabetic retinopathy, and the most frequent specific regulation problem in glycemic control was recurrent hypoglycemia. The education did not lead to a reduction in time spent in hypoglycemia.

• Keywords: DAFNE edukacija; šećerna bolest tip 1; FreeStyle Libre
• Keywords (english): DAFNE education; type 1 diabetes; FreeStyle Libre
• Language: croatian
• URN:NBN: urn:nbn:hr:105:388095
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-24 09:13:31