Home care in childhood diabetes : a controlled evaluation study

This thesis considers children with insulin-dependent diabetes mellitus and their\npsychological and medical functioning during 31 months of participation in a home-care\nprogram compared to traditional hospital-based care.\nIn general, diabetes mellitus -derived from the greek diabainein (to fall through) and\nmellos (as sweet as honey)- reflects a range of chronic metabolic disorders in which we\ndistinguish two main forms: first, juvenile-onset diabetes or insulin-dependent diabetes\nmellitus and second, the maturity-onset form or non-insulin-dependent diabetes mellitus.\nInsulin-dependent diabetes mellitus (IDDM:), also named type I diabetes, is diagnosed\nalmost exclusively before the age of thirty years. In case of IDDM, the pancreas produces\nno insulin at all and the child needs life-long insulin injections to control disease\nsymptoms. Non-insulin-dependent diabetes mellitus (NIDDM), or type II diabetes, is a\nless severe form, which develops usually after middle age. The pancreas of most NIDDM\npatients produces sometimes excess insulin and the lack of insulin-effect can be\ncompensated with a dietary regimen or oral medication. In some NIDDM patients,\nhowever, insulin production may decrease progressively over the years and, consequently,\nthese patients may also need insulin injections.\nIn this thesis the focus will be on children and adolescents with insulin-dependent diabetes\nmellitus