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Evidence summaries

Routine Hospital Admission Versus out-Patient or Home Care in Children at Diagnosis of Type 1 Diabetes Mellitus

Out-patient/home management of type 1 diabetes in children at diagnosis may not lead to any disadvantages in terms of metabolic control, acute complications and hospitalisations, psychosocial variables, or total costs. Level of evidence: "C"

A Cochrane review (abstract , review [Abstract]) included 7 studies with a total of 298 children in the out-patient/home group. The one high quality trial identified suggested that home-based management of children with newly diagnosed type 1 diabetes may lead to slightly improved long term metabolic control (at two and three years follow-up). No differences between comparison groups were found in any of the psychosocial and behavioural variables assessed or in rates of acute diabetic complications within two years. Parental costs were found to be decreased, while health system costs were increased, leaving total social costs virtually unchanged.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by inconsistency (heterogeneity in studied interventions and outcomes).

    References

    • Clar C, Waugh N, Thomas S. Routine hospital admission versus out-patient or home care in children at diagnosis of type 1 diabetes mellitus. Cochrane Database Syst Rev 2007 Apr 18;(2):CD004099. [PubMed]

Primary/Secondary Keywords