糖保包－兒童糖尿病胰島素注射與緊急處置整合輔助

糖尿病是全球性健康問題，全世界20歲以下的兒童和青少年患有第1型糖尿病者超過120萬人。糖尿病患者因血糖失控而導致的急性合併症如糖尿病酮酸中毒、高血糖高滲透壓狀態及低血糖等，若無法及時辨認症狀並予以處置，會導致生命有立即威脅，亦是造成年輕糖尿病族群死亡原因，但卻是可以避免的死因。觀察兒童和青少年糖尿病患者在胰島素使用和疾病認知中，發生高、低血糖急症可能的導因包含：第一、學齡期孩童因為認知受限，無法辨識高、低血糖之緊急症狀；第二、青春期的糖尿病個案，因為心理社會發展之自我認同因素，甚至會希望隱藏胰島素注射行為或設備，當未按時施打胰島素而發生緊急狀態時，本身或周圍的旁人若無法即時辨識出高、低血糖的症狀，將導致無法及時處置而危及生命。為協助解決上述兒童及青少年糖尿病患遭遇之問題，引發「糖保包」之創作動機。「糖保包」（圖一）是一項糖尿病兒童暨青少年外出的整合性產品，提供胰島素注射工具與引導急性併發症辨識與即刻處置之整合功能，核心設計包含有四：第一為胰島素注射工具儲存整合功能（包含酒精棉片、新針頭與使用過之染污針頭儲存空間）；第二為高、低血糖症狀認知引導；第三為低血糖緊急處置用物置放空間；第四為胰島素注射劑量提醒與緊急聯絡電話。本作品「糖保包」外觀設計成一本A5小冊子，方便攜帶與使用胰島素注射裝置，免於因注射工具外露而感到不自在或需隱藏，亦能提供急性狀況的症狀認知引導，與緊急處理措施相關用物與資訊，提升糖尿病兒童暨青少年自我照護能力。

關鍵字

兒童青少年糖尿病；緊急處置；整合用品

並列摘要

Today, more than 1.2 million children and adolescents under the age of 20 have type 1 diabetes worldwide. Acute complications such as diabetic ketoacidosis, diabetic hyperglycemic hyperosmolar syndrome, and hypoglycemia occur when there is a sudden drop or spike in blood sugar for diabetic patients. If the symptoms cannot be identified and treated in time, it will lead to life-threatening situation. It is also one of the causes of death in the younger diabetic population, yet a preventable one. According to the observation of the use of insulin and the disease awareness among children and adolescents with diabetes, the causes of the occurrences of acute conditions such as hypoglycemia or hyperglycemia may include: 1. Due to their limited cognitive abilities, school-age children cannot identify the emergent symptoms of hyperglycemia and hypoglycemia in time. 2. For adolescents with diabetes, they may even want to hide the insulin injection procedure and device out of the intention of seeking self-acceptance which is one of the crucial factors in the process of their psychosocial development. When the emergent conditions occur, the patients or the bystanders cannot immediately identify the symptoms of hyperglycemia and hypoglycemia, therefore, the proper treatments cannot be given in time. Without prompt interventions, the conditions will then deteriorate to eventually endanger the patients' lives. The impetus for this innovation of "Sugar Secure Pack" came from the motivation of helping resolve the above-mentioned problems encountered by children and adolescents with diabetes. "Sugar Secure Pack" (Figure 1) is an integrated product for diabetic children and teenagers for outdoor use. It provides insulin injection tools, a guide to the identification of acute diabetes-related complications, and an explanation of how to administer urgent treatments. There are four core designs, the first is the storing of insulin injection tools (including storage space for alcohol pads, new disposable needles, and contaminated needles after use), the second is the guidance on the identification of symptoms of hyperglycemia and hypoglycemia through graphic demonstrations, the third is the storage space for emergency treatment supplies of hypoglycemia, and the last is the display of the reference for insulin injection dosage and the emergency contact information. The appearance of "Sugar Secure Pack" is designed as an A5 booklet. Children and teenagers can carry it with them and not worry about their diabetes-related supplies drawing potentially emparrassing attention. It guides symptom identifications in acute conditions, contains emergency trentment supplies of hypoglycema and provides information for emergency treatment measures. With the combination of the above-mentioned designs, the goal of this product innovation is to help improve the self-care ability of children and teenagers with diabetes.

並列關鍵字

diabetes in children and adolescents ； emergency treatment ； integrated supplies

參考文獻

王怡瑾、劉秀美、呂明蕙、涂丹菁、陳怡婷(2016)．提昇第一型糖尿病病童護理指導完整率之方案．馬偕護理雜誌，10 (1)，20-32。https://doi.org/10.29415/JMKN.201601_10(1).0002

陳月枝(2021)．緒論．於陳月枝總校閱，實用兒科護理學(九版，19-20頁)．華杏。https://doi: 10.6224/JN.44.5.5

黃俊達、李淳權(2020)．測量血糖的新趨勢：即時性連續血糖監測(Real-time CGM)．內科學誌，31 (1)，30-39。https://doi.org/10.6314/JIMT.202002_31(1).06

楊偉勛(2020)．正常葡萄糖代謝與低血糖反應．台灣醫學，24 (3)，272-274。http://doi:10.6320/FJM.202005_24(3).0004

羅福松(2020)．第一型糖尿病發生低血糖頻率、原因，危險因素及處置．台灣醫學，24 (3)，280-288。https://doi.org/10.6320/FJM.202005_24(3).0006

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