Type 1 diabetes mellitus care and education in China: The 3C study of coverage, cost, and care in Beijing and Shantou

The lack of data on type 1 diabetes in China has hindered progress in care and policy making. In this study, the treatment and clinical outcome of type 1 diabetes in Beijing and Shantou were compared with current clinical guidelines.

The 3C trial is a cross-sectional study on clinical practice and outcome of patients with type 1 diabetes. This study registered 849 participants from hospital records, hospital wards and outpatient clinics. Data were collected through a direct interview with patients and medical professionals, a summary of diabetes self-care activities, medical records and venous blood samples. Please review your attention with the ISPAD / IDF indicator. Data description analysis and correlation test

The median age was 22 years (IQR = 13 to 34 years), 48.4% of the samples were diabetes less than 6 years old. The median HbA1c was 5% (69 mmol / mol) (IQR 2 - 10.5%), and there was a large regional difference (p = 0.002). Insulin therapy is mainly twice a day (45% of patients). Among adolescents, the highest incidence of diabetic ketoacidosis is 14.4 events / 100 patient years. Of the 57.3% of patients with LDL-C> 6 mmol / L, only 11.2% received treatment. Of 10.6% considered high blood pressure, 47.1% received treatment. Screening rates for retinopathy, kidney disease, peripheral neuropathy were 35.2%, 42.3% and 25.0%, respectively. The median number of self-monitoring days per week is 0 (IQR = 0 - 7.0). A big difference of regional nursing practice

Compared to clinical practice guidelines, this study documented overall medical deficiencies that attention varies widely from region to region. Changing treatment methods and care structures may improve outcomes

In the United States, 1 million people suffer from type 2 diabetes and 30 million to 40 million people suffer from impaired glucose tolerance, so annual medical expenses exceed 100 billion dollars (1). Treatment is primarily for microvascular and macrovascular complications (2). In type 1 diabetes, the relationship between glycemic control and microvascular complication is well documented (3). The relationship between severe glycemic control and microvascular disease in type 2 diabetes seems to have been determined in recently completed UK prospective diabetes studies (4, 5)

Based on the experience of diabetes education in Australia, this paper is exploring possible ways to improve diabetes care and develop effective educational models in China. The prevalence of diabetes in China is increasing rapidly. China is currently ranked second in the top 10 countries with the highest burden of diabetes. The great impact of diabetes on Chinese health system is extremely difficult and urgent response is necessary. Diabetes education is the cornerstone of diabetes treatment and structured self-management education is thought to be a key to achieving results. Many diabetes education programs were launched in China, but barriers to the implementation of these programs have been confirmed. These include the lack of general perception of diabetes, the lack of clinical standards for diabetes educators, and the lack of an evaluation program to evaluate their performance. We recommend four possible ways to solve the current problem of diabetes education in China.

Type 1 diabetes is also known as type 1 diabetes and is a form of diabetes in which the pancreas produces little or no insulin. This leads to an increase in the blood sugar level in the body before treatment. Typical symptoms are frequent urination, increased thirst, an increase in hunger and weight loss. Other symptoms include visual impairment, fatigue, poor healing and so on. Symptoms usually develop in a short period of time. The cause of type 1 diabetes is unknown. However, it is thought to include a combination of genetic factors and environmental factors. Risk factors include family status. Potential mechanisms include autoimmune destruction of insulin-producing beta cells in the pancreas. Diabetes is diagnosed by examining the level of sugar or glycosylated hemoglobin (HbA1C) in the blood. Type 1 diabetes can be distinguished from type 2 by examining the presence of autoantibodies.