scholarly journals Glucose Control, Disease Burden, and Educational Gaps in People With Type 1 Diabetes: Exploratory Study of an Integrated Mobile Diabetes App (Preprint)

2017 ◽  
Author(s):  
Cornelis J Tack ◽  
Gerardus J Lancee ◽  
Barend Heeren ◽  
Lucien JLPG Engelen ◽  
Sandra Hendriks ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Control ◽  
Exploratory Study ◽  
Disease Burden ◽  
Hemoglobin A1c ◽  
Insulin Dose ◽  
Diabetes Control ◽  
Self Management ◽  
Scale Scores

BACKGROUND Self-monitoring and self-management, crucial for optimal glucose control in type 1 diabetes, requires many disease-related decisions per day and imposes a substantial disease burden on people with diabetes. Innovative technologies that integrate relevant measurements may offer solutions that support self-management, decrease disease burden, and benefit diabetes control. OBJECTIVE The objective of our study was to evaluate a prototype integrated mobile phone diabetes app in people with type 1 diabetes. METHODS In this exploratory study, we developed an app that contained cloud-stored log functions for glucose, carbohydrates (including a library), insulin, planned exercise, and mood, combined with a bolus calculator and communication functions. Adults with diabetes tested the app for 6 weeks. We assessed the feasibility of app use, user experiences, perceived disease burden (through questionnaires), insulin dose and basal to bolus ratio, mean glucose level, hemoglobin A1c, and number of hypoglycemic events. RESULTS A total of 19 participants completed the study, resulting in 5782 data entries. The most frequently used feature was logging blood glucose, insulin, and carbohydrates. Mean diabetes-related emotional problems (measured with the Problem Areas in Diabetes scale) scores decreased from 14.4 (SD 10.0) to 12.2 (SD 10.3; P=.04), and glucose control improved, with hemoglobin A1c decreasing from 7.9% (mean 62.3, SD 8 mmol/mol) to 7.6% (mean 59.8, SD 7 mmol/mol; P=.047). The incidence of hypoglycemic events did not change. Participants were generally positive about the app, rating it as “refreshing,” and as providing structure by reinforcing insulin-dosing principles. The app revealed substantial knowledge gaps. Logged data enabled additional detailed analyses. CONCLUSIONS An integrated mobile diabetes app has the potential to improve diabetes self-management and provide tailored educational support, which may decrease disease burden and benefit diabetes control.

scholarly journals Glucose Control, Disease Burden, and Educational Gaps in People With Type 1 Diabetes: Exploratory Study of an Integrated Mobile Diabetes App

JMIR Diabetes ◽  
2018 ◽  
Vol 3 (4) ◽  
pp. e17 ◽  
Author(s):  
Cornelis J Tack ◽  
Gerardus J Lancee ◽  
Barend Heeren ◽  
Lucien JLPG Engelen ◽  
Sandra Hendriks ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Control ◽  
Exploratory Study ◽  
Disease Burden ◽  
Control Disease ◽  
Educational Gaps

Partial remission in children and adolescents with type 1 diabetes: an analysis based on the insulin dose-adjusted hemoglobin A1c

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emine Ayça Cimbek ◽  
Aydın Bozkır ◽  
Deniz Usta ◽  
Nazım Ercüment Beyhun ◽  
Ayşenur Ökten ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Partial Remission ◽  
Hemoglobin A1c ◽  
Insulin Dose ◽  
Age At Onset ◽  
Insulin Requirement ◽  
C Peptide ◽  
Factors Associated ◽  
Daily Insulin

Abstract Objectives Most patients with type 1 diabetes (T1D) experience a transient phase of partial remission (PR). This study aimed to identify the demographic and clinical factors associated with PR. Methods This was a longitudinal retrospective cohort study of 133 children and adolescents with T1D. PR was defined by the gold standard insulin dose-adjusted hemoglobin A1c (HbA1c) (IDAA1c) of ≤9. Results Remission was observed in 77 (57.9%) patients. At diagnosis, remitters had significantly higher pH (7.3 ± 0.12 vs. 7.23 ± 0.15, p=0.003), higher C-peptide levels (0.45 ± 0.31 ng/mL vs. 0.3 ± 0.22, p=0.003), and they were significantly older (9.3 ± 3.6 years vs. 7.3 ± 4.2, p=0.008) compared with non-remitters. PR developed more frequently in patients without diabetic ketoacidosis (DKA) (p=0.026) and with disease onset after age 5 (p=0.001). Patients using multiple daily insulin regimen were more likely to experience PR than those treated with a twice daily regimen (63.9 vs. 32%, p=0.004). Only age at onset was an independent predictor of PR (OR: 1.12, 95% CI: 1-1.25; p=0.044). Remitters had lower HbA1c levels and daily insulin requirement from diagnosis until one year after diagnosis (p<0.001). PR recurred in 7 (9%) patients. The daily insulin requirement at three months was lower in remitters with PR recurrence compared to those without (0.23 ± 0.14 vs. 0.4 ± 0.17 U/kg/day, p=0.014). Conclusions Addressing factors associated with the occurrence of PR could provide a better comprehension of metabolic control in T1D. The lack of DKA and higher C-peptide levels may influence PR, but the main factor associated with PR presence was older age at onset. PR may recur in a small proportion of patients.

scholarly journals Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)

2020 ◽  
Author(s):  
Yuting Xie ◽  
Fang Liu ◽  
Fansu Huang ◽  
Chunna Lan ◽  
Jia Guo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Quality Assurance ◽  
Diabetes Education ◽  
Insulin Dose ◽  
Education Programme ◽  
Chinese Patients ◽  
Self Management ◽  
Structured Interviews ◽  
Structured Education

Abstract Background: Various guidelines recommend that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase in newly diagnosed T1D cases and is now the fourth largest country in the number of new T1D cases per year. However, there is yet no validated SEP targeted to T1D patients in China. The purpose of this study is to establish a structured T1D self-management education programme—‘Type 1 Diabetes Education in Lifestyle and Self Adjustment’ (TELSA) that is adapted to medical and cultural practices in China. Methods: TELSA programme was developed based on the ADDIE model, following three steps: i) Semi-structured interviews were administered to 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. ii) Extracted themes were modified according to Delphi consultation. iii) Preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum was finalized accordingly. Results: A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: ‘behaviour modification’ and ‘outcome improvement’; ii) contents: ‘living with T1D’, ‘self-monitoring of blood glucose’, ‘knowing insulin’, ‘insulin dose adjustment’, ‘carbohydrates and carbohydrate counting’, ‘hypoglycaemia’, ‘complications’, ‘managing psychological issues’, ‘physical activities’, and ‘question-and-answer’; iii) format: ‘multidisciplinary team combined with peer support’, ‘face-to-face education followed with distal learning’, and ‘2-day programme held on weekends’; and iv) quality assurance: ‘after-class quiz’, ‘patients’ feedback’, and ‘long-term evaluation on effectiveness’. Conclusions: A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.

scholarly journals Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)

2020 ◽  
Author(s):  
Yuting Xie ◽  
Fang Liu ◽  
Fansu Huang ◽  
Chunna Lan ◽  
Jia Guo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Quality Assurance ◽  
Diabetes Education ◽  
Insulin Dose ◽  
Education Programme ◽  
Chinese Patients ◽  
Self Management ◽  
Structured Interviews ◽  
Structured Education

Abstract Background: Various guidelines recommend that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase in newly diagnosed T1D cases, of which 65% are adults. However, there is yet no validated SEP targeted to T1D patients in China. The purpose of this study is to establish a structured T1D self-management education programme—‘Type 1 Diabetes Education in Lifestyle and Self Adjustment’ (TELSA) that is adapted to medical and cultural practices in China. Methods: TELSA programme was developed based on the ADDIE model, following three steps: i) Semi-structured interviews were administered to 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. ii) Extracted themes were modified according to Delphi consultation. iii) Preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum was finalized accordingly. Results: A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: ‘behaviour modification’ and ‘outcome improvement’; ii) contents: ‘living with T1D’, ‘self-monitoring of blood glucose’, ‘knowing insulin’, ‘insulin dose adjustment’, ‘carbohydrates and carbohydrate counting’, ‘hypoglycaemia’, ‘complications of diabetes’, ‘managing psychological issues’, ‘physical activity’, and ‘question-and-answer’; iii) format: ‘multidisciplinary team combined with peer support’, ‘face-to-face education followed by remote learning’, and ‘2-day programme held on weekends’; and iv) quality assurance: ‘after-class quiz’, ‘patients’ feedback’, and ‘long-term evaluation on effectiveness’. Conclusions: A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.

Parenting Children With Diabetes

2009 ◽  
Vol 35 (3) ◽  
pp. 476-483 ◽  
Author(s):  
Diana Sherifali ◽  
Donna Ciliska ◽  
Linda O'Mara
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Parenting Styles ◽  
Hemoglobin A1c ◽  
Glycosylated Hemoglobin ◽  
Diabetes Control ◽  
Target Range ◽  
Glycosylated Hemoglobin A1c

Purpose The purpose of this study was to examine the extent to which parenting styles is associated with diabetes control in children (aged 5—12 years) with type 1 diabetes, and on child and parent quality of life. Methods Data were collected from a total of 216 parent and child dyads, from 4 pediatric diabetes clinics in southern Ontario, using a cross-sectional survey methodology. Each parent and child independently completed the questionnaires. The study instruments included the Parenting Dimensions Inventory, Pediatric Quality of Life (diabetes specific), and chart reviews for glycosylated hemoglobin (A1C) levels. Results The results of the study demonstrated that parenting styles were not correlated with diabetes control and were weakly correlated with quality of life. Most parents reported behaviors of authoritative or democratic parenting. The mean glycosylated hemoglobin (A1C) for children in the study was slightly above optimal target range, at 8.4%. Parental education had a weak negative correlation with diabetes control. Conclusions Parenting styles are not associated with diabetes control and quality of life in children with type 1 diabetes. However, further research should assess the impact of the determinants of parenting on children with type 1 diabetes and quality of life.

Habits and Routines during Transitions among Emerging Adults with Type 1 Diabetes

2019 ◽  
Vol 42 (6) ◽  
pp. 446-453
Author(s):  
Kathleen M. Hanna ◽  
Jed R. Hansen
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Emerging Adults ◽  
Diabetes Management ◽  
Insulin Dose ◽  
A Priori ◽  
Self Management ◽  
Typical Day ◽  
Insight Into

To provide insight into poorly understood diabetes self-management among emerging adults with type 1 diabetes (TID) experiencing transitions, this study described their diabetes self-management-related habits, routines, and disruptions as well as explored relationships among habits and routines. A qualitative study, guided by critical incidence technique, was conducted. Participants were asked to describe situations when they did and did not check blood glucose, administer insulin, eat meals, and exercise as planned. They were also asked to describe activities in a typical day and in association with diabetes self-management. Content analysis with a priori definitions of habits and routines was performed. Participants described diabetes self-management-related transitional disruption as forgetting and disorder. They described habits associated with checking a blood glucose, giving an insulin dose, eating a meal, and initiating exercise. They described routines in association with meals, exercise, and overall diabetes management. These findings provide information on variables to target in intervention research.

scholarly journals Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)

2020 ◽  
Author(s):  
Yuting Xie ◽  
Fang Liu ◽  
Fansu Huang ◽  
Chunna Lan ◽  
Jia Guo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Quality Assurance ◽  
Diabetes Education ◽  
Insulin Dose ◽  
Education Programme ◽  
Chinese Patients ◽  
Self Management ◽  
Structured Interviews ◽  
Structured Education

Abstract Background: Various guidelines recommend that all adults diagnosed with type 1 diabetes (T1D) should be offered an evidence based, structured education programme (SEP) to optimize self-management care. China has a 13,000 annual increase in newly diagnosed T1D cases, of which 65% are adults. However, there is yet no validated SEP targeted to T1D patients in China. The purpose of this study is to establish a structured T1D self-management education programme—‘Type 1 Diabetes Education in Lifestyle and Self Adjustment’ (TELSA) that is adapted to medical and cultural practices in China. Methods: TELSA programme was developed based on the ADDIE model, following three steps: i) Semi-structured interviews were administered to 10 healthcare professionals (HCPs) and 13 T1D patients. Different topic guides, focusing on 4 dimensions including goals, contents, format of delivery, and quality assurance, were designed for either HCPs or patients. The interviews were recorded and analysed with thematic analysis. ii) Extracted themes were modified according to Delphi consultation. iii) Preliminary courses were conducted as pilot study to evaluate the effects of TELSA and optimization of the curriculum was finalized accordingly. Results: A total of 18 themes in 4 dimensions of the programme design were identified in the final version: i) goals: ‘behaviour modification’ and ‘outcome improvement’; ii) contents: ‘living with T1D’, ‘self-monitoring of blood glucose’, ‘knowing insulin’, ‘insulin dose adjustment’, ‘carbohydrates and carbohydrate counting’, ‘hypoglycaemia’, ‘complications of diabetes’, ‘managing psychological issues’, ‘physical activity’, and ‘question-and-answer’; iii) format: ‘multidisciplinary team combined with peer support’, ‘face-to-face education followed by remote learning’, and ‘2-day programme held on weekends’; and iv) quality assurance: ‘after-class quiz’, ‘patients’ feedback’, and ‘long-term evaluation on effectiveness’. Conclusions: A type 1 diabetes structured education programme in China was set up and shown to be applicable under local medical, social, and cultural environment.

scholarly journals Customizing the Types of Technologies Used by Patients With Type 1 Diabetes Mellitus for Diabetes Treatment: Case Series on Patient Experience (Preprint)

2018 ◽  
Author(s):  
Anna Holubová ◽  
Martina Vlasáková ◽  
Jan Mužík ◽  
Jan Brož
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Diabetes Management ◽  
Case Series ◽  
Diabetes Control ◽  
Self Management ◽  
Telemedicine System ◽  
Specific Patient

BACKGROUND Despite the fact there are many wearable and mobile medical devices that enable patients to better self-manage their diabetes, not many patients are aware of all the options they have. In addition, there are those who are not fully satisfied with the devices they use, and those who often do not use them effectively. OBJECTIVE The study aimed to propose possible changes to the combination of devices used by 6 specific patients for diabetes self-management. We assessed the suitability of selected technical devices for diabetes control. METHODS Data of 6 patients (3 men and 3 women) with type 1 diabetes mellitus, who had been using the Diani telemedicine system for at least 3 months, were analyzed. The suitability of selected technical devices for diabetes control was ascertained using the data obtained via the Diani telemedicine system, as well as the patients’ subjective feelings and statements, their everyday life habits, and self-management of diabetes. Informed consent was signed and obtained from each of the patients included. RESULTS Each of the presented case studies describes how a given patient handled the system and its specific components based on his or her lifestyle, level of education, habits related to diabetes management, personality type, and other factors. At the conclusion of each case study, the best composition of devices for patients with similar personal descriptions was suggested. CONCLUSIONS We believe this study can provide relevant guidance on how to help particular patients choose the technology that is best suited for their needs, based on the specific patient information we are able to obtain from them. Furthermore, clinicians or educators should be aware of available technologies a given patient can choose from. In addition, there is a substantial need for proper patient education in order for them to effectively use devices for diabetes self-management.

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