Factors Affecting Type One Diabetes Self-Management According to Youth and Parents (Preprint)

2020 ◽  
Author(s):  
Janet Panoch ◽  
Lisa Yazel ◽  
Courtney Moore ◽  
Sarah Wiehe ◽  
Tamara Hannon
Keyword(s):  
Type 1 Diabetes ◽  
Decision Support ◽  
Decision Support Tool ◽  
Self Management ◽  
Adult Care ◽  
Patient Centered ◽  
Diabetes Clinic ◽  
Human Centered Design ◽  
Support Tool

BACKGROUND Adolescents with type 1 diabetes differ from their parents and physicians about what they need from healthcare. Therefore, it is important to implement patient-centered diabetes care for adolescents. OBJECTIVE This study used human-centered design to reveal diabetes self-management challenges faced by youth with type 1 diabetes and their parents. This was a pre-study design phase of a larger study to develop a patient-centered automated decision support tool for diabetes clinic. METHODS Data were collected from youth and parents in two settings 1) a diabetes summer camp to capture challenges faced by youth and parents, 2) youth and parents participating in human-centered design sessions to further explore challenges. RESULTS Fifty-six people completed the camp worksheet, identifying 15 unique themes. The sessions further verified three problematic themes each for youth and parents. Youth generated 23 questions and parents identified 33 questions for potential use for the decision support tool development. CONCLUSIONS Including patient and parent self-management needs is vital. Providers should understand the psychosocial factors associated with barriers to self-management. The incorporation of patient and parent questions, ideas, and subsequent patient-provider communication in the support tool may improve trust in the provider and youth self-efficacy as they navigate the transition to independent adult care. CLINICALTRIAL Trial Registration: ClinicalTrials.gov NCT03084900

Outsourcing glucose management to AI

2020 ◽  
Vol 12 (564) ◽  
pp. eabe8120
Author(s):  
James Ankrum
Keyword(s):  
Type 1 Diabetes ◽  
Decision Support ◽  
Insulin Therapy ◽  
Intensive Insulin Therapy ◽  
Decision Support Tool ◽  
Support Tool ◽  
Glucose Management

An automated decision support tool could expand access to intensive insulin therapy for patients with type 1 diabetes.

scholarly journals Patient Input for Design of a Decision Support Smartphone Application for Type 1 Diabetes

2019 ◽  
Vol 14 (6) ◽  
pp. 1081-1087
Author(s):  
Leah M. Wilson ◽  
Nichole Tyler ◽  
Peter G. Jacobs ◽  
Virginia Gabo ◽  
Brian Senf ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Decision Support ◽  
Decision Support Tool ◽  
Smartphone Application ◽  
Valuable Insight ◽  
Support Tool ◽  
Health Community ◽  
Continuous Glucose Monitors ◽  
Survey Responses

Background: Decision support smartphone applications integrated with continuous glucose monitors may improve glycemic control in type 1 diabetes (T1D). We conducted a survey to understand trends and needs of potential users to inform the design of decision support technology. Methods: A 70-question survey was distributed October 2017 through May 2018 to adults aged 18-80 with T1D from a specialty clinic and T1D Exchange online health community ( myglu.org ). The survey responses were used to evaluate potential features of a diabetes decision support tool by Likert scale and open responses. Results: There were 1542 responses (mean age 46.1 years [SD 15.2], mean duration of diabetes 26.5 years [SD 15.8]). The majority (84.2%) have never used an app to manage diabetes; however, a large majority (77.8%) expressed interest in using a decision support app. The ability to predict and avoid hypoglycemia was the most important feature identified by a majority of the respondents, with 91% of respondents indicating the highest level of interest in these features. The task that respondents find most difficult was management of glucose during exercise (only 47% of participants were confident in glucose management during exercise). The respondents also highly desired features that help manage glucose during exercise (85% of respondents were interested). The responses identified integration and interoperability with peripheral devices/apps and customization of alerts as important. Responses from participants were generally consistent across stratified categories. Conclusions: These results provide valuable insight into patient needs in decision support applications for management of T1D.

scholarly journals Experiences and perspectives of the parents of emerging adults living with type 1 diabetes

2020 ◽  
Vol 8 (1) ◽  
pp. e001125
Author(s):  
Cheryl Pritlove ◽  
Benjamin Markowitz ◽  
Geetha Mukerji ◽  
Andrew Advani ◽  
Janet A Parsons
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adulthood ◽  
Emerging Adults ◽  
Diabetes Management ◽  
Self Management ◽  
Comparative Approach ◽  
Transition To Adult Care ◽  
Adult Care ◽  
Difficult Time

IntroductionWhereas it is widely recognized that emerging adulthood can be a difficult time in the life of an individual living with type 1 diabetes, relatively little is known about the experiences of their parents or guardians. These individuals once shouldered much of the burden for their child’s diabetes ‘self’-management, yet their contribution is often overlooked by the adult healthcare system. Here, we set out to gain an understanding of the perspectives of parents of emerging adults living with type 1 diabetes.Research design and methodsSemi-structured interviews were performed with a purposeful sample of parents of emerging adults with type 1 diabetes recruited from two urban young adult diabetes clinics and through a national diabetes charity. Thematic coding was derived using a constant comparative approach.ResultsAnalysis of interviews with 16 parents of emerging adults with type 1 diabetes identified three themes: parental experiences of the transition to adult care; negotiating parent–child roles, responsibilities and relationships; and new and evolving fears. Parents spoke in detail about the time surrounding their child’s diagnosis of type 1 diabetes to emphasize the complexity of diabetes care and the need to establish a ‘new normal’ for the family. In turn, adolescence and emerging adulthood required a renegotiation of roles and responsibilities, with many parents continuing to play a role in high-level diabetes management. Several parents of emerging adults with type 1 diabetes (particularly those of young men) vocalized worries about their child’s readiness to assume responsibility for their self-care, and some expressed frustration with the apparent dichotomy in the role expectations of parents between the pediatric and adult care settings.ConclusionsAdult healthcare providers should recognize both the ongoing involvement of parents in the ‘self’-management of emerging adults with type 1 diabetes and the unique aspects of the caregiver burden that they experience.

Provider experience of a decision support tool to promote patient-centered contraceptive care

Contraception ◽  
2017 ◽  
Vol 96 (4) ◽  
pp. 289-290
Author(s):  
R Reed ◽  
K Kimport ◽  
J Fitzpatrick ◽  
E Fox ◽  
CE Dehlendorf
Keyword(s):  
Decision Support ◽  
Decision Support Tool ◽  
Patient Centered ◽  
Support Tool ◽  
Provider Experience

scholarly journals Impact of COVID-19 lockdown on flash and real-time glucose sensor users with type 1 diabetes in England

2020 ◽  
Author(s):  
Joshi Prabhu Navis ◽  
Lalantha Leelarathna ◽  
Womba Mubita ◽  
Andrea Urwin ◽  
Martin K. Rutter ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Sensor ◽  
Management Strategies ◽  
Self Management ◽  
International Consensus ◽  
Diabetes Clinic ◽  
Period 2 ◽  
Freestyle Libre ◽  
The Uk

Abstract Aims People with type 1 diabetes (T1D) face the daily task of implementing self-management strategies to achieve their glycaemic goals. The UK COVID-19 lockdown has had an impact on day-to-day behaviour, which may affect diabetes self-management and outcomes. We assessed whether sensor-based outcomes pre- and during lockdown periods were different in a cohort of glucose sensor users with T1D. Methods Data were collected from Freestyle Libre (FSL) or Dexcom G6 sensor users who remotely shared their data with the diabetes clinic web platform. Sensor metrics according to international consensus were analysed and compared between pre-lockdown period and 2 and 3 weeks into lockdown (periods 1 and 2). Results Two hundred and sixty-nine T1D patients (baseline HbA1c 57 ± 14 mmol/mol) were identified as FSL (n = 190) or Dexcom G6 (n = 79) users. In patients with sensor use > 70% (N = 223), compared to pre-lockdown period percentage TIR 3.9–10 mM (TIR) significantly increased during period 1 (59.6 ± 18.2 vs. 57.5 ± 17.2%, p = 0.002) and period 2 (59.3 ± 18.3 vs. 57.5 ± 17.2%, p = 0.035). The proportion of patients achieving TIR ≥ 70% increased from 23.3% pre-lockdown to 27.8% in period 1 and 30.5% in period 2. A higher proportion also achieved the recommended time below and above range, and coefficient of variation in periods 1 and 2. Dexcom G6 users had significantly lower % time below range (< 3.9 mM) compared to FSL users during both lockdown periods (period 1: Dexcom G6 vs. FSL: 1.8% vs. 4%; period 2: 1.4% vs. 4%, p < 0.005 for both periods). Conclusion Sensor-based glycaemic outcomes in people with T1D in the current cohort improved during COVID-19 lockdown, which may be associated with positive changes in self-management strategies. Further work is required to evaluate long-term sustainability and support.

scholarly journals Worker-Recovered Companies in Brazil: self-management process assessment by applying multi-criteria decision support tools

2017 ◽  
Vol 14 (2) ◽  
pp. 249
Author(s):  
Fernanda Santos Araujo ◽  
Vicente Nepomuceno Oliveira ◽  
Denise Alvarez ◽  
Helder Costa
Keyword(s):  
Decision Support ◽  
Management Practices ◽  
Decision Support Tool ◽  
Self Management ◽  
Management Process ◽  
Decision Support Tools ◽  
Process Assessment ◽  
Support Tool ◽  
Support Tools ◽  
Means Of Production

Company recovery is a practice developed by workers who, in the imminence of becoming unemployed, negotiate or fight for access to the means of production of bankrupting companies, and start to manage them collectively, guided by the principles of self-management.  Nevertheless, how to assess self-management in worker-recovered companies (WRCs)? The criteria selected by a bibliographic review on the concept of self-management were used in dealing with the data collected by the Brazilian WRCs national mapping. A multi-criteria decision support tool was used to build a model for analyzing and classifying the companies in three categories related to their form of management. The multi-criteria approach allowed to create an assessment of self-management practices in the WRCs studied.

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