ESPE Abstracts (2019) 92 P2-77

Education in type 1 Diabetes Mellitus (T1D): what do Educators Really Know? A Tunisian Multicenter Study among Young Doctors, Nurses and Nutritionnists

Leïla Essaddam1,2, Wafa Kallali1,2, Safa Melliti2, Fatma Khalsi1,2, Faten Fdhila1,2, Amel Ben Chehida3,2, Zied Khlaifia4,2, Khedija Boussetta1,2, Monia Khemiri1,2, Neji Tebib3,2, Ahmed Maherzi4,2, Zohra Fitouri1,2, Saayda Ben Becher1,2


1Children Hospital Bechir Hamza of Tunis, Tunis, Tunisia. 2Université de Tunis El Manar, Tunis, Tunisia. 3La Rabta Hospital, Tunis, Tunisia. 4Mongi Slim Hospital. La Marsa, La Marsa, Tunisia


Background: Type1 diabetes mellitus is increasing worldwide in childhood. Education is an essential part of the package care at diagnosis. It adresses children with newly diagnosed type 1 diabetes and their families and is made by young doctors and paramedical staff (nurses and nutritionnists).

Objective: to assess the knowledge of the medical and paramedical staff concerning the global management of type 1 diabetes in children Methods:Cross sectionnal survey from November 2017 to January 2018 from 6 pediatric centers (located in the main 3 tertiary care centers of the capital, Tunis) and one primary care center.We evaluated by a questionnaire first their knowledge about diabetes: physiopathology,symptoms,urine examination,A1C, injection sites, symptoms,causes and management of hyperglycemia and hypoglycemia and second their food knowledge: dietary effect on blood glucose, food group knowledge, adequate food consumption.

Results: 105 persons were recruited (38 nurses, 34 young doctors (6th and 7th year of medicine),18 paediatricians in trainee and 15 nutritionnists.35% had a good knowledge about physiopathology of T1D;definition of A1C were known by 23,8% but the A1C goal values were ignored by more than 40%, 63% knew injection sites even though 90% knew the need to injections rotation,20% knew the hyperglycemia threshold and 54% practice a urinary test strip in case of hyperglycemia greater than 2.5g/L, 34% knew how to act correctly in case of hypoglycemia. Concerning the food knowledge:63% said not to know food groups even though 76% knew the two kind of sugars (simple and complex);89% said that fibers are necessary for diabetic children but 37% didn't know why and 34% didn't know where to find them. Only 22% knew the glycaemic index definition. Permitted food were correctly reported by 10,4% and restricted food were correct for 13%. Almost 90%said that sport is a key in the T1D management even though the mechanism was ignored by more than 58%. As far as the groups were concerned, we found the worst results among nurses and young doctors and best ones among nutritionnists and paediatricians in trainee.

Conclusion: Education is known to be a key in the management of T1D in children. Educators are not always evaluated to assess the informations they spread. This study highlights the gap between what they should know and what they really know in a multicentric tunisian study.Our results emphasizes the need to develop training programs for health professionals to improve their basic knowledge of T1D.