SAGE Open Nursing (Nov 2018)

An Effective Diabetic Ketoacidosis Prevention Intervention in Children With Type 1 Diabetes

  • Rebecca J. Vitale MD, MPH,
  • Casey E. Card MBBChBAO,
  • Judith H. Lichtman PhD, MPH,
  • Kate Weyman APRN,
  • Camille Michaud MD,
  • Kristin Sikes APRN,
  • William V. Tamborlane MD,
  • Stuart A. Weinzimer MD

DOI
https://doi.org/10.1177/2377960818804742
Journal volume & issue
Vol. 4

Abstract

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The objective of this study was to evaluate the effectiveness of a brief, office-based educational intervention to increase parent or patient recognition of the early warning signs and symptoms of diabetic ketoacidosis (DKA). Forty-two patients aged > 13 years and 34 parents of children aged ≤ 13 years were given a pretest questionnaire about their knowledge of signs and symptoms of DKA and sick day management practices. They received a brief refresher course on sick day management specific to their treatment modality (pump vs. injection) and were given a take-home flow sheet of guidelines for diabetes sick day management. Subjects were retested with the same knowledge questionnaire after 6 to 12 months. Patients or parents scored higher on the posttest than the pretest and called the emergency line for assistance more frequently ( p = .032) following the intervention. Emergency department visits were significantly reduced in adolescents ( p = .024). A short educational intervention and printed management tool is effective in improving sick day and DKA knowledge and appears to be effective in reducing emergency department visits by increasing utilization of a diabetes emergency line for early outpatient intervention.