scholarly journals Parents’ preferences for follow-up care in a type 1 diabetes paediatric population: a survey-based study in Quebec, Canada

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e046757
Author(s):  
Maude Laberge ◽  
Monia Rekik ◽  
Kodjo Mawuegnigan Djiffa
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Guidelines ◽  
Primary Outcome ◽  
Probit Model ◽  
Standard Of Care ◽  
Paediatric Population ◽  
Follow Up Care ◽  
Intensity Of Care

ObjectivesExamine variations in parent’s preferences for their child’s type 1 diabetes (T1D) follow-up care and the determinants of the preferred intensity of care. Clinical guidelines recommend multidisciplinary management of T1D, with follow-up visits with an endocrinologist at least every 3 months in the paediatric population. However, there could be heterogeneity in parents’ needs, and preferences in terms of care management may deviate from clinical guidelines.SettingNot applicable.ParticipantsParents who have a child living with T1D and who reside in Quebec, Canada.InterventionIn collaboration with a patient-partner (a parent of a child with T1D), we developed a survey to collect data from parents of children living with T1D. Our primary outcome of interest was the preferred time in months between two appointments. We ran a probit model to analyse longer time (over 3 months between appointments), compared with the standard of care (3 months or less).ResultsResults suggest that about one-third (33%) of parents want to deviate from the guideline. Parents who want to increase the time between appointments are more experienced in the management of the disease and have higher costs than those who wish to follow the 3-month guideline. The number of years since the diagnosis is positively associated with a preference for a longer time between appointments, while the perceived useful of information provided during the consultation, and a parent having made a change in their professional life were negatively associated with a desire to space out appointments. The child’s gender is not a significant factor in parents’ preferences.ConclusionsAdapting visit protocols could make the health system more efficient to respond to T1D patients and their parent’s needs.

Saving families time and money: a new model using telemedicine of follow-up care for children with type 1 diabetes

2009 ◽  
Vol 33 (3) ◽  
pp. 309-310
Author(s):  
D. Pacaud ◽  
G. Currie ◽  
S. Crawford ◽  
T. Schweitzer ◽  
M. Chiasson
Keyword(s):  
Type 1 Diabetes ◽  
New Model ◽  
Follow Up Care

scholarly journals Online survey to assess parents’ experience and preferences for follow-up visits for children living with type 1 diabetes in Quebec, Canada: a study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031185
Author(s):  
Maude Laberge ◽  
Malek Badreddine ◽  
Monia Rekik
Keyword(s):  
Social Media ◽  
Type 1 Diabetes ◽  
Online Survey ◽  
Patient Survey ◽  
Ethics Committee ◽  
Need For Care ◽  
Follow Up Care ◽  
French And English

IntroductionIt is accepted that although patients may initiate a visit to a healthcare provider, follow-up visits are often based on recommendations from providers. This suggests that follow-up care, since not initiated by patients, may not reflect patients’ perception of a need for care. However, few studies have examined the burden of regular follow-up care and patients’ perceived value of such care. For parents of children with type 1 diabetes (T1D), follow-up visits are scheduled regardless of how well controlled the diabetes is. Our study examines how benefits and burden from the parents’ perspective could affect their preferences in regard to the frequency of regular follow-up care.MethodsWe aim to develop an online patient survey to be distributed to parents of children living with T1D in the province of Quebec, Canada. The survey will be available in French and English, and distributed through diabetes clinics, on social media groups and forums for parents of children with T1D. The survey will be developed in collaboration with parents of children with T1D to ensure that it appropriately reflects the services in regular follow-up care and that the language is understandable and clear.Ethics and disseminationAll participants will be informed of the requirements and objectives of the survey at the beginning of the questionnaire and that the data collected will remain anonymous and confidential. Ethics approval for the study was obtained from the research ethics committee of the CHU de Québec-Université Laval. Results of the study will be shared with relevant stakeholders with the aim of improving practices and better meeting patients’ and families’ needs.

Independent Association of a Metabolic Syndrome Severity Score with All-Cause Mortality in Type 1 Diabetes—A 10-Year Follow-Up

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 618-P
Author(s):  
GIUSEPPE PENNO ◽  
MONIA GAROFOLO ◽  
ROSA GIANNARELLI ◽  
FABRIZIO CAMPI ◽  
DANIELA LUCCHESI ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Type 1 Diabetes ◽  
Severity Score ◽  
All Cause Mortality ◽  
Independent Association

Estimated Glucose Disposal Rate as a Predictor of All-Cause Mortality in Type 1 Diabetes—A 10-Year Follow-Up Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1694-P
Author(s):  
MONIA GAROFOLO ◽  
ALESSANDRA BERTOLOTTO ◽  
FABRIZIO CAMPI ◽  
DANIELA LUCCHESI ◽  
LAURA GIUSTI ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Disposal ◽  
Follow Up Study ◽  
All Cause Mortality ◽  
Estimated Glucose Disposal Rate ◽  
Glucose Disposal Rate

322-OR: Risk Factors for Peripheral and Cardiovascular Autonomic Neuropathy in Type 1 Diabetes: Thirty Years of Follow-Up in DCCT/EDIC

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 322-OR
Author(s):  
BARBARA BRAFFETT ◽  
ROSE GUBITOSI-KLUG ◽  
JAMES W. ALBERS ◽  
EVA L. FELDMAN ◽  
CATHERINE MARTIN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Autonomic Neuropathy ◽  
Cardiovascular Autonomic Neuropathy

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

2020 ◽  
Author(s):  
Ananta Addala ◽  
Marie Auzanneau ◽  
Kellee Miller ◽  
Werner Maier ◽  
Nicole Foster ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Hemoglobin A1c ◽  
Diabetes Technology ◽  
Design And Methods ◽  
Relationship Of ◽  
The Relationship ◽  
Pediatric Type 1 Diabetes

<b>Objective:</b> As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. <p> </p> <p><b>Research Design and Methods: </b>Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. </p> <p> </p> <p><b>Results: </b>HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant.</p> <p> </p> <p><b>Conclusions: </b>Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry. </p>

scholarly journals One repeated transplantation of allogeneic umbilical cord mesenchymal stromal cells in type 1 diabetes: an open parallel controlled clinical study

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Jing Lu ◽  
Shan-mei Shen ◽  
Qing Ling ◽  
Bin Wang ◽  
Li-rong Li ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Stromal Cells ◽  
Treated Group ◽  
Control Group ◽  
Adult Onset ◽  
Β Cell ◽  
Juvenile Onset ◽  
C Peptide

Abstract Background The preservation or restoration of β cell function in type 1 diabetes (T1D) remains as an attractive and challengeable therapeutic target. Mesenchymal stromal cells (MSCs) are multipotent cells with high capacity of immunoregulation, which emerged as a promising cell-based therapy for many immune disorders. The objective of this study was to examine the efficacy and safety of one repeated transplantation of allogeneic MSCs in individuals with T1D. Methods This was a nonrandomized, open-label, parallel-armed prospective study. MSCs were isolated from umbilical cord (UC) of healthy donors. Fifty-three participants including 33 adult-onset (≥ 18 years) and 20 juvenile-onset T1D were enrolled. Twenty-seven subjects (MSC-treated group) received an initial systemic infusion of allogeneic UC-MSCs, followed by a repeat course at 3 months, whereas the control group (n = 26) only received standard care based on intensive insulin therapy. Data at 1-year follow-up was reported in this study. The primary endpoint was clinical remission defined as a 10% increase from baseline in the level of fasting and/or postprandial C-peptide. The secondary endpoints included side effects, serum levels of HbA1c, changes in fasting and postprandial C-peptide, and daily insulin doses. Results After 1-year follow-up, 40.7% subjects in MSC-treated group achieved the primary endpoint, significantly higher than that in the control arm. Three subjects in MSC-treated group, in contrast to none in control group, achieved insulin independence and maintained insulin free for 3 to 12 months. Among the adult-onset T1D, the percent change of postprandial C-peptide was significantly increased in MSC-treated group than in the control group. However, changes in fasting or postprandial C-peptide were not significantly different between groups among the juvenile-onset T1D. Multivariable logistic regression assay indicated that lower fasting C-peptide and higher dose of UC-MSC correlated with achievement of clinical remission after transplantation. No severe side effects were observed. Conclusion One repeated intravenous dose of allogeneic UC-MSCs is safe in people with recent-onset T1D and may result in better islet β cell preservation during the first year after diagnosis compared to standard treatment alone. Trial registration ChiCTR2100045434. Registered on April 15, 2021—retrospectively registered, http://www.chictr.org.cn/

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