Association of family structure with type 1 diabetes management and outcomes in adolescents: A population‐based cross‐sectional survey

2020 ◽  
Author(s):  
Christina Baechle ◽  
Anna Stahl‐Pehe ◽  
Katty Castillo ◽  
Silvia Selinski ◽  
Reinhard W Holl ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Family Structure ◽  
Diabetes Management ◽  
Population Based ◽  
Cross Sectional Survey ◽  
Cross Sectional

Accessibility and Openness to Diabetes Management Support via Mobile Phones: A Survey of People with Type 1 Diabetes Using Advanced Diabetes Technologies (Preprint)

2022 ◽  
Author(s):  
Yu Kuei Lin ◽  
Caroline Richardson ◽  
Iulia Dobrin ◽  
Rodica Pop-Busui ◽  
Gretchen Piatt ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Interactive Voice Response ◽  
Medical Center ◽  
Academic Medical Center ◽  
Text Messages ◽  
Management Support ◽  
Cross Sectional Survey ◽  
Cross Sectional

BACKGROUND Little is known about the feasibility of mobile health (mHealth) support among people with type 1 diabetes (T1D) using advanced diabetes technologies including continuous glucose monitors (CGMs) and hybrid closed-loop insulin pumps (HCLs). OBJECTIVE To evaluate patient access and openness to receiving mHealth diabetes support in people with T1D using CGMs/HCLs. METHODS We conducted a cross-sectional survey among T1D patients using CGMs or HCLs managed in an academic medical center. Participants reported information regarding their mobile device usage, cellular call/text message/internet connectivity, and openness to various channels of mHealth communication (smartphone applications or “apps”, text messages, and interactive voice response calls or IVR calls). Participants’ demographic characteristics and CGM data were collected from medical records. Analyses focused on differences in openness to mHealth and mHealth communication channels across groups defined by demographic variables and measures of glycemic control. RESULTS Among all participants (n=310; 64% female; mean age: 45 (SD:16)), 98% reported active cellphone use, and 80% were receptive to receiving mHealth support to improve glucose control. Among participants receptive to mHealth support, 98% were willing to share CGM glucose data for mHealth diabetes self-care assistance. Most (71%) were open to receiving messages via apps, 56% were open to text messages, and 12% were open to IVR calls. Older participants were more likely to prefer text messages (P=0.009) and IVR (P=0.03) than younger participants. CONCLUSIONS Most people with T1D who use advanced diabetes technologies have access to cell phones and are receptive to receiving mHealth support to improve diabetes control. CLINICALTRIAL Not applicable

scholarly journals Stigma and Its Association With Glycemic Control and Hypoglycemia in Adolescents and Young Adults With Type 1 Diabetes: Cross-Sectional Study (Preprint)

2017 ◽  
Author(s):  
Anne-Sophie Brazeau ◽  
Meranda Nakhla ◽  
Michael Wright ◽  
Mélanie Henderson ◽  
Constadina Panagiotopoulos ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Severe Hypoglycemia ◽  
Poor Glycemic Control ◽  
Self Report ◽  
Diabetes Diagnosis ◽  
Hypoglycemic Episode ◽  
Cross Sectional

BACKGROUND Qualitative studies in type 1 diabetes indicate that visibility of diabetes supplies, self-care, and hypoglycemia symptoms are associated with stigma and suboptimal management. This may be particularly salient in youth who face concurrent challenges such as establishing autonomy and making vocational choices. OBJECTIVE The aim of the study was to estimate stigma prevalence in youth (aged 14-24 years) with type 1 diabetes and its associations with glycemic control. METHODS Participants, recruited largely through social media, were asked to complete a Web-based survey and to send via mail capillary blood samples for glycated hemoglobin (HbA1c) measurement. The primary definition of stigma required endorsement of one or more of 3 stigma-specific items of the Barriers to Diabetes Adherence questionnaire. These addressed avoidance of diabetes management with friends present, difficulty telling others about diabetes diagnosis, and embarrassment in performing diabetes care with others present. Poor glycemic control was defined as HbA1c>9% (ie, >75 mmol/mol; measured value when available, else self-report) and/or ≥1 severe hypoglycemic episode in the previous year (reported requiring assistance from someone else during the episode). Stigma prevalence was computed (95% CI), and associations with glycemic control were evaluated (multivariate logistic regression models). RESULTS Among the 380 respondents, stigma prevalence was 65.5% (95% CI 60.7-70.3). Stigma was associated with a 2-fold higher odds of poor glycemic control overall (odds ratio [OR] 2.25, 95% CI 1.33-3.80; adjusted for age, sex, and type of treatment). There were specific associations with both HbA1c>9% (75 mmol/mol; OR 3.05, 95% CI 1.36-6.86) and severe hypoglycemia in the previous year (OR 1.86, 95% CI 1.05-3.31). CONCLUSIONS There is a high prevalence of stigma in youth with type 1 diabetes that is associated with both elevated HbA1c levels and severe hypoglycemia. Targeted strategies to address stigma are needed. CLINICALTRIAL ClinicalTrials.gov NCT02796248; http://clinicaltrials.gov/ct2/show/NCT02796248 (Archived by WebCite at http://www.webcitation.org/6yisxeV0B)

scholarly journals Evaluation of lipid profile among children and adolescents with type 1 diabetes mellitus in Bangladesh

Mediscope ◽  
2018 ◽  
Vol 5 (1) ◽  
pp. 15-21
Author(s):  
M Parveen ◽  
MA Muttalib ◽  
ST Huq ◽  
N Nazneen ◽  
MA Kabir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Detailed Medical History

The study, a cross-sectional survey, was carried out at the Department of Biochemistry in Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital from July 2015 to June 2016. A total of 576 clinically diagnosed children and adolescents with type 1 diabetes mellitus (T1DM) aged 10-18 years attending in ‘Changing Diabetes in Children’ clinic, BIRDEM-2, Dhaka were selected according to appropriate inclusion and exclusion criteria. The study subjects underwent detailed medical history and examination. Fasting blood samples were drawn from the participants for biochemical assays such as fasting blood sugar (FBS), glycated haemoglobin (HbA1c), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides. Anthropometric data and blood pressures both systolic and diastolic were measured. Student unpaired t-test and Chi-square test were used to determine the association between different groups. Out of 576 T1DM patients, 45.0% (259) were male and 55.0% (317) were female. Of the 576 T1DM patients, 35.1% were without dyslipidemia (DLP) and 64.9% were with DLP. Study revealed that the patients with DLP were more likely to have higher values of HbA1c (10.1±2.2% vs 9.4±1.9%, p < 0.001) and FBS (13.0±4.4 mmol/L vs 10.2±2.9 mmol/L, p < 0.001). A substantial proportion of children and adolescents with T1DM had DLP. We found an association between poor glycemic control and abnormal lipid profiles in those patients. Mediscope Vol. 5, No. 1: Jan 2018, Page 15-21

Implications of the School Day on Health Behaviors for Children With Type 1 Diabetes: A Survey of Parent Perspectives During the COVID-19 Pandemic

2021 ◽  
Vol 47 (6) ◽  
pp. 447-456
Author(s):  
Christine A. March ◽  
Linda M. Siminerio ◽  
Radhika H. Muzumdar ◽  
Ingrid M. Libman
Keyword(s):  
Type 1 Diabetes ◽  
Health Behaviors ◽  
Online Survey ◽  
Diabetes Management ◽  
Return To School ◽  
Sleep Habits ◽  
School Closures ◽  
Cross Sectional ◽  
School Day

Purpose The purpose of this study is to survey parents of youth with type 1 diabetes during the COVID-19 pandemic with school closures to better understand the implications of the school day on health care behaviors. Methods A cross-sectional, online survey was distributed to parents of youth with type 1 diabetes ≤19 years of age in a large, academic diabetes center. Questions encompassed perceived changes in management behaviors and plans for return to school. Subgroup analysis compared parent responses by child’s age, reported stressors, and socioeconomic markers. Results Parents reported a worsening in their child’s diabetes health behaviors during school closures compared to what they perceived during a regular school day before the pandemic. More than half of parents reported feeling that their child was unable to maintain a normal routine, with particular implications for snacking between meals, daily physical activity, and sleep habits. Families with adolescents or those experiencing multiple pandemic-related stressors reported greater challenges. In open-ended responses, families highlighted difficulty in balancing school, work, and diabetes care and expressed concerns about the mental health repercussions of school closures for their children. Nearly half of parents reported being at least moderately worried about return to school, whereas only a minority reported seeking guidance from their diabetes provider. Conclusions Parent-reported disruptions of school-day routines frequently had adverse consequences for diabetes management in this population. These findings highlight the importance of a school-day routine for children with type 1 diabetes; during closures, families may benefit from mitigating strategies to maintain effective habits.

scholarly journals Beliefs Around Hypoglycemia and Their Impacts on Hypoglycemia Outcomes in Individuals with Type 1 Diabetes and High Risks for Hypoglycemia Despite Using Advanced Diabetes Technologies

2022 ◽  
Author(s):  
Yu Kuei Lin ◽  
Caroline R. Richardson ◽  
Iulia Dobrin ◽  
Melissa J. DeJonckheere ◽  
Kara Mizokami-Stout ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Hypoglycemic Episode ◽  
Cross Sectional ◽  
The Impact ◽  
Level 2

<i>Objective:</i> This study aims to: (1) identify the frequency of severe and level 2 hypoglycemia presenting in people with type 1 diabetes using continuous glucose monitoring systems (CGMs), including those with concomitant closed-loop insulin pumps, in a clinical practice setting; (2) evaluate the impact of beliefs around hypoglycemia in the development of severe and level 2 hypoglycemia in this population. <p><i>Research Design and Methods:</i> A cross-sectional survey study in adults with type 1 diabetes using CGMs >6 months was conducted at a large tertiary academic center. Participant demographics, 6-month severe hypoglycemia history, hypoglycemia beliefs (with the Attitude to Awareness of Hypoglycemia questionnaire) and 4-week CGM glucose data were collected. Statistical analysis was performed to assess the presentation of severe and level 2 hypoglycemia and identify associated risk factors. </p> <p><i>Results: </i>A total of 289 participants were recruited (including 257 participants with CGM data within the last 3 months). Of these, 25.6% experienced at least one severe hypoglycemic episode in the last 6 months, and 13.6% presented with ≥1% of time in level 2 hypoglycemia on CGMs. Reporting beliefs about prioritizing hyperglycemia avoidance was associated with severe hypoglycemia development (<i>P</i><0.001), while having beliefs of minimal concerns for hypoglycemia was associated with spending ≥1% of time in level 2 hypoglycemia (<i>P</i>=0.038).</p> <p><i>Conclusions:</i> Despite the use of advanced diabetes technologies, severe and level 2 hypoglycemia continues to occur in people with type 1 diabetes and high hypoglycemia risks. Human factors, including beliefs around hypoglycemia, may remain to impact the effectiveness of glucose self-management.</p>

Diabetes Device Downloading: Benefits and Barriers Among Youth With Type 1 Diabetes

2021 ◽  
pp. 193229682110595
Author(s):  
Benjamin A. Palmer ◽  
Karissa Soltys ◽  
M. Bridget Zimmerman ◽  
Andrew W. Norris ◽  
Eva Tsalikian ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Retrospective Review ◽  
Insulin Dose ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Fear Of Hypoglycemia ◽  
Glycemic Targets

Background: The majority of youth with type 1 diabetes (T1D) fail to meet glycemic targets despite increasing continuous glucose monitoring (CGM) use. We therefore aimed to determine the proportion of caregivers who review recent glycemic trends (“retrospective review”) and make ensuant insulin adjustments based on this data (“retroactive insulin adjustments”). We additionally considered that fear of hypoglycemia and frequency of severe hypoglycemia would be associated with performing retrospective review. Methods: We conducted a cross-sectional survey of caregivers of youth with T1D, collecting demographics, diabetes technology usage, patterns of glucose data review/insulin dose self-adjustment, and Hypoglycemia Fear Survey (HFS). Results: Nineteen percent of eligible caregivers (191/1003) responded. Performing retrospective review was associated with younger child age (12.2 versus 15.4, P = .0001) and CGM use (92% versus 73%, P = .004), but was not associated with a significant improvement in child’s HbA1c (7.89 versus 8.04, P = .65). Retrospective reviewers had significantly higher HFS-behavior scores (31.9 versus 27.7, P = .0002), which remained significantly higher when adjusted for child’s age and CGM use ( P = .005). Linear regression identified a significant negative association between HbA1c (%) and number of retroactive insulin adjustments (0.24 percent lower mean HbA1c per additional adjustment made, P = .02). Conclusions: Retrospective glucose data review is associated with improved HbA1c when coupled with data-driven retroactive insulin adjustments. Barriers to data downloading existed even in this cohort of predominantly CGM-using T1D families.

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