Increasing Trend of Outpatient Management of Children With Newly Diagnosed IDDM: Colorado IDDM Registry, 1978–1988

Abstract

The relatively new practice of outpatient care at diagnosis of IDDM increased between 1978 and 1988 in Colorado, in both specialized diabetes clinics and physicians' practices not affiliated with specialized clinics.

Hospital admission in children and adolescents with or without type 1 diabetes from Germany: An analysis of statutory health insurance data on 12 million subjects

“…This assumption was strengthened by the study of Icks et al indicating that in the DPV study population, 57% of all hospital admissions were due to diabetes education or metabolic control programs . In other countries, for example, the United States or UK, diabetes education programs are usually offered in the outpatient sector . Beside education programs or therapy adjustment, “T1D without complications” could also include hospital admissions due to social circumstances, for example, parental overload or refusal of treatment.…”

“…12 In other countries, for example, the United States or UK, diabetes education programs are usually offered in the outpatient FIGURE 2 Unadjusted odds ratio (OR, 95% CI) for hospitalization in children and adolescents with type 1 diabetes compared to the general pediatric population, stratified by gender and age-group sector. [18][19][20][21][22] Beside education programs or therapy adjustment, "T1D without complications" could also include hospital admissions due to social circumstances, for example, parental overload or refusal of treatment.…”

Care of Children and Adolescents With Type 1 Diabetes

“…Although outpatient initial care and education costs are substantially lower than those associated with inpatient care (9,19), hospitalization of patients, regardless of severity, is required in certain circumstances. Thus, if the center is not experienced in the outpatient management of newly diagnosed children with diabetes or is not adequately staffed to provide outpatient care because regional health care reimbursement is inadequate for initial outpatient care and education, hospitalization is necessary.…”

Management of newly diagnosed diabetes: home or hospital?

“…If the child is mildly to moderately symptomatic and clinically well, subcutaneous insulin and oral diet and fluids may be begun from diagnosis, 5 and stabilisation at diagnosis does not necessarily require hospital admission. [6][7][8][9][10][11] In this paper, we review the evidence about hospital versus home based treatment at diagnosis for children with type 1 diabetes. We briefly describe the Cardiff approach to home management and discuss the benefits and disadvantages of different approaches to initial management.…”