scholarly journals The Quality of Life and Satisfaction with Continuous Glucose Monitoring Therapy in Children under 7 Years of Age with T1D Using the rtCGM System Integrated with Insulin Pump—A Caregivers Point of View

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3683
Author(s):  
Ewa Rusak ◽  
Natalia Ogarek ◽  
Karolina Wolicka ◽  
Anna Mrówka ◽  
Sebastian Seget ◽  
...  

Quality of life (QoL) is an important parameter that affects the choice of therapy. Assessment of QoL and satisfaction with therapy using the rtCGM in children with T1D aged < 7 years was conducted. The study group consisted of 38 children with T1D aged < 7 years (34% aged 2–4, 66% aged 5–7 years), HbA1c: 6.53 ± 0.63%, duration of diabetes: 2.6 ± 1.6 years, treated with an rtCGM-augmented insulin pump for 1.92 ± 1.15 years. Two anonymous surveys were conducted: a. PedsQL3.0 diabetes standardized questionnaire—QoL assessment among age groups: 2–4/5–7 years. b. An original survey assessing the CGM use satisfaction. The mean scores in PedsQL3.0: communication 75%, worries 30%, treatment 70%, and problems associated with diabetes 65%. The QoL scale is: 0–19% very low, 20–39% low, 40–59% moderate, 60–79% high, 80–100% very high. The most frequently reported concerns were long-term diabetes complications and prick pain. Satisfaction with CGM use was high (68% in group aged 5–7 and 92% 2–4 years). Twenty-seven (71%) caregivers confirmed the positive effect of CGM on sleep. During the use of rtCGM a high quality of life was reported, and the quality of sleep in their caregivers was increased.

2020 ◽  
pp. ijgc-2020-002145
Author(s):  
Saira Sanjida ◽  
Andreas Obermair ◽  
Val Gebski ◽  
Nigel Armfield ◽  
Monika Janda

ObjectiveTo compare long-term quality of life in women treated for early-stage endometrial cancer with population norms, and to compare quality of life outcomes of patients who had total laparoscopic or total abdominal hysterectomy.MethodsOnce the last enrolled patient had completed 4.5 years of follow-up after surgery, participants in the Laparoscopic Approach to Cancer of the Endometrium (LACE) clinical trial were asked to complete a self-administered questionnaire. Two instruments—EuroQol 5 Dimension 3-level (EQ-5D-3L) and the Functional Assessment of Cancer Treatment-General Population (FACT-GP)—were used to determine quality of life. The mean computed EQ-5D-3L index scores for LACE participants at different age categories were compared with Australian normative scores; and the FACT-GP scores were compared between patients treated with surgical treatments.ResultsOf 760 women originally enrolled in the LACE trial, 259 (50.2%) of 516 women consented to provide long-term follow-up data at a median of 9 years (range 6—12) after surgery. On the EQ-5D-3L, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression than normative levels across all age groups (55–64 years, 30% vs 14.9%; 65–74 years, 30.1% vs 15.8%; ≥75 years, 25.9% vs 10.7%). For women ≥75 years of age, the prevalence of impairment in mobility (57.6% vs 43.3%) and usual activities (58.8% vs 37.9%) was also higher than for population norms. For the FACT-GP, the physical (effect size: −0.28, p<0.028) and functional (effect size: −0.30, p<0.015) well-being sub-scale favored the total laparoscopic hysterectomy compared with total abdominal hysterectomy recipients.ConclusionCompared with population-based norms, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression across all age groups, and deficits in mobility and usual activities for women aged ≥75 years. Physical and functional well-being were better among women who were treated with total laparoscopic hysterectomy than among those receiving total abdominal hysterectomy.


2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Priyantha Siriwardana ◽  
Bruno Lorenzi ◽  
Mohammad Qamruddin ◽  
Alexandros Charalabopoulos ◽  
Michael Harvey ◽  
...  

Abstract Background Symptomatic giant para-oesophageal hernia (PEH) can often be troublesome and may require surgical intervention. It commonly presents with dyspnoea, post-prandial pain, vomiting and dysphagia but rarely strangulation. In a good proportion of patients, iron deficiency anaemia may also be present. Patients are often elderly and may have co-morbidities and hence there may be a reluctance to refer and to offer surgery. This long-term study offers an insight to the outcomes following this complex surgery in a relatively elderly cohort of patients. Methods A retrospective analysis of prospectively collected data of patients who underwent surgery for symptomatic PEH from January 2001- June 2021 was performed. Clinical presentation, management, post-operative clinical outcomes, radiographic evaluation, pre and post-operative haemoglobin levels, respiratory function {Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 Second (FEV1)} as well as quality-of-life (QoL) with SF-36 questioners (including general health, physical, emotional and social components) were assessed. Results 202 patients (122-females) with median age 68 years (36-88) underwent PEH-surgery. The  commonest symptomEighty-one presented with dyspnoea(41%). Ninety-five(47%) were ASA III, 119(59%) had microcytic-anaemia. 142(70%) had a fundoplication during PEHR. Hospital-stay was significantly lower in laparoscopic group Mortality:1.8%(2/112). Median follow-up:10 years. Symptoms improved in 166(82%) with respiratory function and anaemia. 42(21%) had radiological recurrences but only nine (4.5%) clinical recurrence requiring surgery. Conclusions Laparoscopic repair of giant para-oesophageal hernia is safe with good outcomes in all age groups with improvement in symptoms, quality of life, respiratory function and associated anaemia.


2021 ◽  
Vol 12 ◽  
Author(s):  
Andrea Crafa ◽  
Aldo E. Calogero ◽  
Rossella Cannarella ◽  
Laura M. Mongioi’ ◽  
Rosita A. Condorelli ◽  
...  

Endocrine diseases have a considerable impact on public health from an epidemiological point of view and because they may cause long-term disability, alteration of the quality-of-life of the affected patients, and are the fifth leading cause of death. In this extensive review of the literature, we have evaluated the prevalence of the different disorders of endocrine interest in the world and Italy, highlighting their epidemiological, clinical, and economic impact.


2021 ◽  
Vol 18 ◽  
Author(s):  
Emmanouil Benioudakis ◽  
Eleni Karlafti ◽  
Argyroula Kalaitzaki ◽  
Georgia Kaiafa ◽  
Christos Savopoulos ◽  
...  

Background: Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease, which is characterized by an increased prevalence worldwide, which, in fact, tends to take extensive dimensions. The recent rapid development of science and technology has significantly contributed to the improvement of the management of type 1 diabetes mellitus, both in achieving the required euglycaemic regulation and reducing the psychological burden associated with the disease, consequently improving the quality of life of the patients with type 1 diabetes mellitus. Methods: A literature review from 2010, related to the contribution of the modern insulin analogues, continuous glucose monitoring and the insulin pump, was performed using Scopus, ScienceDirect and PubMed databases. Results: Studies included in the review support a direct and indirect association of technological innovations with the quality of life. The use of type 1 diabetes mellitus technology was negatively associated with the frequency of the hypoglycaemias and the value of the glycosylated hemoglobin, while at the same time, the development and use of the related technology were highly associated with an improvement in the quality of life. Conclusion: Patients’ quality of life is an indicator of the management of type 1 diabetes mellitus, and it is just as important as glycaemic regulation. Through this review, it was concluded that a better quality of life of T1DM patients was associated with the improvement of glycosylated hemoglobin and hypoglycemic episodes.


2014 ◽  
Vol 16 (suppl 2) ◽  
pp. ii48-ii48
Author(s):  
M. Timmer ◽  
M. Seibl-Leven ◽  
K. Wittenstein ◽  
R. Goldbrunner

2018 ◽  
Vol 38 (8) ◽  
pp. 942-953 ◽  
Author(s):  
Wen Wan ◽  
M. Reza Skandari ◽  
Alexa Minc ◽  
Aviva G. Nathan ◽  
Parmida Zarei ◽  
...  

Background. The economic impact of both continuous glucose monitoring (CGM) and insulin pumps (continuous subcutaneous insulin infusion [CSII]) in type 1 diabetes (T1D) have been evaluated separately. However, the cost-effectiveness of adding CSII to existing CGM users has not yet been assessed. Objective. The aim of this study was to evaluate the societal cost-effectiveness of CSII versus continuing multiple daily injections (MDI) in adults with T1D already using CGM. Methods. In the second phase of the DIAMOND trial, 75 adults using CGM were randomized to either CGM+CSII or CGM+MDI (control) and surveyed at baseline and 28 weeks. We performed within-trial and lifetime cost-effectiveness analyses (CEAs) and estimated lifetime costs and quality-adjusted life-years (QALYs) via a modified Sheffield T1D model. Results. Within the trial, the CGM+CSII group had a significant reduction in quality of life from baseline (−0.02 ± 0.05 difference in difference [DiD]) compared with controls. Total per-person 28-week costs were $8,272 (CGM+CSII) versus $5,623 (CGM+MDI); the difference in costs was primarily attributable to pump use ($2,644). Pump users reduced insulin intake (−12.8 units DiD) but increased the use of daily number of test strips (+1.2 DiD). Pump users also increased time with glucose in range of 70 to 180 mg/dL but had a higher HbA1c (+0.13 DiD) and more nonsevere hypoglycemic events. In the lifetime CEA, CGM+CSII would increase total costs by $112,045 DiD, decrease QALYs by 0.71, and decrease life expectancy by 0.48 years. Conclusions. Based on this single trial, initiating an insulin pump in adults with T1D already using CGM was associated with higher costs and reduced quality of life. Additional evidence regarding the clinical effects of adopting combinations of new technologies from trials and real-world populations is needed to confirm these findings.


2021 ◽  
pp. 66-75
Author(s):  
E. G. Ivanova ◽  
E. V. Makarova

Introduction. Currently, one of the directions in medicine is the study of the issue of the quality of life of patients. This indicator is a complex characteristic in terms of the physical and psychological component of health. The state of health is influenced by many factors and one of them is the peculiarities of the climatogeographic region where a person lives. The conditions of the Far North are characterized by extreme climatic and industrial conditions. In such areas, a rotational method is used, which assumes distance from the permanent place of residence. Thus, the influence of the climatic conditions of the Far North on the quality of life of respondents working on a rotational basis determines the relevance of this study, which was carried out in the Khanty-Mansi Autonomous Okrug — UGRA (KhMAO — Ugra).The aim of the research was to study the quality of life of respondents working on a rotational basis in the Far North.Materials and methods. Only men took part in this study — 207 people working in the conditions of the Far North (KhMAO — Ugra) on a rotational basis. All respondents were divided into four age groups: group 1 — 24–28 years old (n=36); group 2 — 29–34 years old (n=63); group 3 — 35–38 years old (n=78); group 4 — 39–45 years old (n=30). The duration of follow-up ranged from 1 to 3 months. A simple survey of all respondents was used to obtain information. In order to study the quality of life (QL) of those working in the Far North on a rotational basis, the MOS SF-36 questionnaire was used. Statistical analysis was performed using the STATGRAPHICS 12 Plus for Windows software in accordance with the general principles of QOL research in medicine.Results. With a long stay in the Far North, a restructuring of the adaptive mechanisms is noted, which goesthrough several stages: initially, minor physiological changes are noted that do not lead to serious changes in the body systems. The second stage is characterized by stable working capacity, but already there is a decrease in health indicators on all scales of the SF-36 questionnaire. The third stage or period of uncompensated fatigue is characterized by a significant decrease in psychological and physical indicators. Conclusion. Unfavorable from the point of view of the medico-biological aspect in the work on a rotational basis in the Far North is the coincidence of the period of work with the phase of the greatest adaptation falling on the first month of stay in the North.


2009 ◽  
Vol 3 (6) ◽  
pp. 1402-1410 ◽  
Author(s):  
Richard R. Rubin ◽  
Mark Peyrot

Background: Little is known about how the most advanced technology affects treatment satisfaction and health-related quality of life (HRQOL) in adults with diabetes. This study was designed to assess treatment satisfaction and HRQOL among users of an integrated real-time (RT) continuous glucose monitoring (CGM)/continuous subcutaneous insulin infusion (CSII) system compared with those using self-monitoring of blood glucose (SMBG) with CSII. Methods: Participants were 311 adult respondents to an Internet survey, 162 using RT-CGM/CSII, 149 using SMBG + CSII (median age 43 years; type 1 diabetes 94%; diabetes duration >15 years 61%; median insulin use 15 years). Respondents completed instruments assessing glucose monitoring system and insulin delivery system convenience, interference, burden, glucose control efficacy, cost satisfaction, overall satisfaction, and treatment preference, as well as quality of life (diabetes-related worries, social burden, and psychological well-being). Real-time CGM/CSII users also assessed specific elements of the RT-CGM/CSII system. Group differences were assessed using analysis of covariance controlling for respondent characteristics. Results: The RT-CGM/CSII group gave significantly better ratings than the SMBG + CSII group for their glucose monitoring system's glucose control efficacy, overall satisfaction, desire to switch, and willingness to recommend, and significantly worse ratings for interference with daily activities. The RT-CGM/CSII group gave significantly better ratings than the SMBG + CSII group for their insulin delivery system's convenience and glucose control efficacy, overall satisfaction, desire to switch, and willingness to recommend. Real-time CGM/CSII users gave positive ratings of all system features. Conclusions: Users of the integrated RT-CGM/CSII system reported more benefits of treatment, higher treatment satisfaction and quality of life, and greater preference for this system than SMBG + CSII users.


Author(s):  
Nina Simmons-Mackie

Abstract Purpose: This article addresses several intervention approaches that aim to improve life for individuals with severe aphasia. Because severe aphasia significantly compromises language, often for the long term, recommended approaches focus on additional domains that affect quality of life. Treatments are discussed that involve increasing participation in personally relevant life situations, enhancing environmental support for communication and participation, and improving communicative confidence. Methods: Interventions that have been suggested in the aphasia literature as particularly appropriate for people with severe aphasia include training in total communication, training of communication partners, and activity specific training. Conclusion: Several intervention approaches can be implemented to enhance life with severe aphasia.


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