Diabetes Education for Children Belonging to Low SES Groups

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Socio-economic gradients increases the prevalence of various health risk factors like
diabetes as low income is associated with poor diabetes control and related complications. Socio-
economic status (SES) is the determinants of health that are associated with disease prevalence
and access to care (Kanaya et al., 2012). According to Lysy et al., (2013) the link between
diabetes risk and income status is complex however there is increased risk among the low SES
groups especially children prone to type 1 diabetes. The children belonging to low SES are
unable to visit speciality care and as a result have poor utilization of diabetes care centres in
controlling the condition. Therefore, the following discussion involves the summarizing of
evidences that was gathered in the weeks 8, 9 and 10 regarding the diabetes education among the
children belonging to low SES groups.
The purpose for this PICOT question was that children with diabetes mellitus belonging
to low SES families have poor health outcomes as they have less access to diabetes care
specialists in controlling their condition. There is increased mortality, severe morbidity and life-
threatening complications among the children with worse health outcomes due to poor disease
control. Therefore, PICOT question was formulated to gain insight on how to structure
healthcare systems that meet the needs of the children with type 1 diabetes belonging to SES
families.
For aligning the PICOT outcomes with research objectives, literature review was
conducted on the topic. Relevant literature was sorted from the vast pool and conclusions
analyzed. The summarization of main findings was studied and the review was done in
understanding how education sessions about lifestyle modifications and daily diet are beneficial
in reducing A1C levels. Databases were used to carry out literature reviews as it provided
required literature relevant to PICOT question. Electronic databases PubMed and Web Search

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were used for the review. They have full-text journals published in English in last 10 years. The
keywords like diabetes in children, diabetes education, dietary modifications in children with
type 1 diabetes were used along with Boolean operators like AND and OR. Finally, three papers
were retrieved from the search that is published after 2011 were selected.
According to a paper published by Clapin et al., (2016) children with type 1 diabetes who
received home based education with adequate support are able to manage their condition
followed by practical skills training. The aim of the study was to compare hybrid home-based
education and inpatient model of care that examined diabetes knowledge, psychosocial and
metabolic outcomes, patient satisfaction and length of stay for the children newly diagnosed with
type 1 diabetes. The study design was randomized control trial and 50 patients (children aged 3
to 16 years) recruited 25 to each group were included in the study. The results showed that
families preferred home-based hybrid care as compared to hospital-based management with no
differences in diabetes knowledge or psychosocial outcomes. The use of simulations, proper
engagements and demonstrations to the children during the teaching sessions was helpful as
compared to speaking alone for enhancing understanding.
Another paper published by Nilsson, (2016) highlighted the fact hat type 1 diabetes is a
common diagnosis that is inherited along with environmental factors that is incompletely
understood. Children with type 1 diabetes belonging to low SES families can self-manage their
diabetic condition by using insulin replacement therapy and lifestyle modifications like diet and
physical exercise. Self-management diabetic activities not only help in making treatment safer,
but also help them to take care of themselves when they are in hospital. Moreover, self-
management of diabetes imparts a sense of control to the children newly diagnosed with type 1
diabetes. They learn to self-administer insulin therapy and parents play an important role in