Home care in childhood diabetes : a controlled evaluation study

This thesis considers children with insulin-dependent diabetes mellitus and their psychological and medical functioning during 31 months of participation in a home-care program compared to traditional hospital-based care. In general, diabetes mellitus -derived from the greek diabainein (to fall through) and mellos (as sweet as honey)- reflects a range of chronic metabolic disorders in which we distinguish two main forms: first, juvenile-onset diabetes or insulin-dependent diabetes mellitus and second, the maturity-onset form or non-insulin-dependent diabetes mellitus. Insulin-dependent diabetes mellitus (IDDM:), also named type I diabetes, is diagnosed almost exclusively before the age of thirty years. In case of IDDM, the pancreas produces no insulin at all and the child needs life-long insulin injections to control disease symptoms. Non-insulin-dependent diabetes mellitus (NIDDM), or type II diabetes, is a less severe form, which develops usually after middle age. The pancreas of most NIDDM patients produces sometimes excess insulin and the lack of insulin-effect can be compensated with a dietary regimen or oral medication. In some NIDDM patients, however, insulin production may decrease progressively over the years and, consequently, these patients may also need insulin injections. In this thesis the focus will be on children and adolescents with insulin-dependent diabetes mellitus

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