الفهرس 
Introduction and Aim of the StudyOnly 14 pages are availabe for public view
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Abstract
Obesity and diabetes mellitus represent significant public health issues with potentially great personal and social cost. According to WHO, more than 250 million people are obese worldwide this equivalent to7%of the children
Many studies conducted in Egypt revealed that obesity is becoming public health problem affecting different age groups National Nutrition Institute. In Egypt obesity is increasing among children in different age groups
Aim of study
To assess the effect of obesity on diabetes among diabetic school age children through the following objectives:
1. Assess knowledge of the child regarding obesity and diabetes.
2. Assess of the physical measurement for obese diabetic children.
3. Assess diabetic school children’s health problems and needs.
Research questions
4. Is there any relation between demographic characteristics and child knowledge regarding obese diabetic children?
5. Is there a relation between obesity and diabetic health problems and needs?
Research Design:
This study was a descriptive study aimed to assess the effect of obesity on diabetes among diabetic school age children.
Setting:
This study was conducted in two sites, the first one was the out patients clinic for diabetic children in University Children Hospital affiliated to Ain Shams University hospitals and the second place was the out patients clinic for diabetic children in National Institute of Nutrition.
They are located in Cairo Governorate which are highly density of attendance also they serve the low socioeconomic target populations and introduce the medical services for all school children age all over the Arab Republic of Egypt.
Sampling
Sample type:
Purposeful sample was used to conduct this study.
Subjects of the study:
The sample composed of one hundred of the diabetic school age randomly children regularly during 3 days/ week. The size of the study samples is 100 diabetic children selected randomly from outpatient clinic, where the number of diabetic children in last two years were about 1005 children in both previous mentioned sits at year 2015/ 2016 and 10% of total children taken in the study, according to the following inclusion criteria set for sample selection as follows:
Inclusion Criteria:
The diabetic school children were selected according to the following criteria:
1. School aged children from 6-12 years having diabetes.
2. Free from any disease more.
Study Tools:
Three different tools were used for data collection
It was written in simple Arabic language by researcher after reviewing a related literature to assess the effect of obesity on diabetes among diabetic school age children.
First tool: interviewing Questionnaire.
This tool divided in three parts:
Part I: This section includes 18 opened and closed questions from 1- 18 questions. It includes questions to assess the socio-demographic characteristics of the study sample diabetic school children such as (age, gender, children ranking, educational level, type of school) and their parents such as (fathers’ and mothers’ age, educational level, job, family type, family income level, and home status as, residence, family size, number of home rooms, and crowding index (Appendix I).
Part II: This section includes questions to assess diabetic children’s family history, medical history and their present complains. It consisted of 25 opened and closed questions from 1- 25 questions and composed of three parts as follow: (Appendix II).
Part III: This section includes questions to assess physical, social and psychological health problems of the study diabetic school children. It consisted of 33 closed questions from 1- 33 questions and composed of four parts (Appendix III).
Part IV: This section includes questions to assess the health needs of the study diabetic school children according to their life style. It consisted of 54 closed questions from 1- 54 questions and composed of four parts as nutritional health needs, rest and sleeping pattern, practicing exercises, and hygienic measures (Appendix IV).
Part V: This section includes questions to assess the knowledge of the study diabetic school children about diabetes and obesity. It consisted of 15 close ended questions and 9open ended questions from 1- 24 questions and composed of two parts.
Second Tool: physical assessment sheet:
Physical assessment sheet included questions to assess the study sample of diabetic school children according to their anthropometric measurements and vital signs. These questions constructed by Wong et al. (2013): such as vital signs abnormalities, body mass index including weight & height and using weighting scale, meter, thermometer, stethoscope, sphygmomanometer Q1- Q8 (Appendix VI).
Third Tool: Medical analysis records
This tool included assessment of the study sample of diabetic school children according to their laboratory investigations and X rays Q1- Q11 such as fasting blood sugar, post prandial, random blood sugar, hemoglobin A1C (HbA1c), sugar in urine, CBC, hemoglobin (HB), sedimentation rate (ESR), complete urine analysis, abdominal sonar, and chest X ray.
Result of study as the following:
• The study result revealed that, the highest percentage of the study diabetic children 39.0% were in the age group
6 - <8 years, their mean age was 10.3± 1.2. Also 87.0% of study children were male. 29.0%of them were overweight and 11% of them suffered from obesity.
• Majority of study diabetic children (89.0%) suffered from diabetic complications and 49% of them had high level of social health problems and 37.0% of them had psychological health problems.
• Also revealed that, 49.0% of the study sample of diabetic school children had poor level of health needs while, only 11.0% of them had good level of total health needs.
• The results showed that, only 12.0% from the all study sample of diabetic children, had good level of total knowledge while, 33.0% of them had poor level.
• There were highly statistical significant relations between demographic characteristics of diabetic children and their total knowledge regarding to diabetes and obesity.
• The result revealed that, there were statistical significant relations between obesity and their health problems as ear, circulatory system, digestive system, skin, musculoskeletal system, and general condition P value < 0.05.
• Also there were a statistical significant relation between obesity of them and their social health problems and highly significant for Psychological health problems P value < 0.001.
• Based on the findings of the present study the following recommendations were formulated:
• The study recommended further intervention studies on healthy lifestyles and a healthy diet for school children with diabetes that have an effective impact on their health.
• Health education sessions for diabetic children and their family about diabetes and obesity to raise diabetes awareness about complication of obesity and the bad behaviors which lead to it .
• Regular investigation for school age children to control diabetes.
• Routine blood suger analysis for diabetic children at school.