scholarly journals Impact of ELKa, the Electronic Device for Prandial Insulin Dose Calculation, on Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus: A Randomized Controlled Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Agnieszka Kowalska ◽  
Katarzyna Piechowiak ◽  
Anna Ramotowska ◽  
Agnieszka Szypowska

Background. The ELKa system is composed of computer software, with a database of nutrients, and a dedicated USB kitchen scale. It was designed to automatize the everyday calculations of food exchanges and prandial insulin doses. Aim. To investigate the influence of the ELKa on metabolic control in children with type 1 diabetes mellitus (T1DM). Methods. A randomized, parallel, open-label clinical trial involved 106 patients aged <18 years with T1DM, HbA1C≤10%, undergoing intensive insulin therapy, allocated to the intervention group, who used the ELKa (n=53), or the control group (n=53), who used conventional calculation methods. Results. After the 26-week follow-up, the intention-to-treat analysis showed no differences to all endpoints. In per protocol analysis, 22/53 (41.5%) patients reporting ELKa usage for >50% of meals achieved lower HbA1C levels (P=0.002), lower basal insulin amounts (P=0.049), and lower intrasubject standard deviation of blood glucose levels (P=0.023) in comparison with the control. Moreover, in the intervention group, significant reduction of HbA1C level, by 0.55% point (P=0.002), was noted. No intergroup differences were found in the hypoglycemic episodes, BMI-SDS, bolus insulin dosage, and total daily insulin dosage. Conclusions. The ELKa system improves metabolic control in children with T1DM under regular usage. The trial is registered at ClinicalTrials.gov, number NCT02194517.

2021 ◽  
Vol 31 (2) ◽  
pp. 76-84
Author(s):  
Zahra Yosefi ◽  
◽  
Mohammad Afshar ◽  
Neda Mirbagher Ajorpaz ◽  
Zohre Sadat ◽  
...  

Introduction: Type 1 Diabetes Mellitus (T1DM) is one of the most frequent chronic diseases among children and adolescents. Educational strategies underscore patient’s roles in the management of diseases and enhance self-efficacy behaviors. Objective: The purpose of this study was to investigate the effects of an educational intervention based on James Brown’s model on self-efficacy in adolescents with T1DM. Materials and Methods: In this randomized clinical trial, 70 participants were selected and assigned to the control and intervention groups by random block. The two groups received routine care for T1DM. The intervention group was also provided with educational sessions, 60 minutes twice a week for 4 weeks, based on the educational model. The participants completed the diabetes management self-efficacy instrument at the beginning, at the end, and a month after the end of the study. Data analysis was performed using the Chi-square, Independent samples t-test, Covariance (ANCOVA), and repeated measures ANOVA. Results: The mean±SD age of the intervention and control groups was 14.81±2.05 and 15.18±2.11 years, respectively. Before the intervention, the two groups were not different statistically in terms of demographic variables (age, sex, duration of diabetes, insulin intake, etc.) and self-efficacy. The results showed that immediately after the intervention and also in the follow-up stage, the mean scores of self-efficacies and its subscales (nutrition, blood glucose monitoring, physical activity, and medical treatment) in the intervention group were significantly higher than the control group (P<0.05). The mean scores of self-efficacies at the beginning, at the end, and a month after the end of the study were 27.97±5.08, 41.46±4.41, and 44.55±4.38, respectively. In the control group, however, these differences were not significant. Conclusion: The education based on James Brown’s model can improve self-efficacy among adolescents with T1DM. It is recommended that nurses use this method to increase self-efficacy in adolescents with T1DM.


BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027913
Author(s):  
Desiree Ruiz-Aranda ◽  
Davinia M Resurrección ◽  
Mencia R Gutierrez-Colosia ◽  
Maria Asuncion Martinez-Brocca

IntroductionType 1 diabetes mellitus (T1DM) is one of the most frequent chronic endocrine diseases in the paediatric population. As a result, this disease has a strong impact on psychological well-being. In line with this, emotional factors play an important role in adaptation. The aim of the present study protocol is to design an emotional abilities programme to improve metabolic control assessed by haemoglobin A1c (HbA1c) samples. Specifically, this intervention will be focused on adaptive coping strategies to deal with unpleasant emotions associated with T1DM. The primary aim of this project is to assess whether the employment of this new psychological intervention improves the emotional abilities of adolescents with T1DM.Methods and analysisTwo focus groups will be carried out for the design and evaluation of the programme following the APEASE criteria (affordability, practicability, effectiveness, acceptability, side effects/safety and equity). Behavioural change will be based on the Behaviour Change Wheel. Sixty-two participants from 12 to 18 years of age will be recruited at a public hospital and randomised to either an intervention or a control group. The intervention group will receive an emotional abilities training programme. The control group will receive usual educational intervention. The primary outcomes are metabolic control and emotional abilities. The secondary outcomes include emotional distress control, positive and negative affect, healthy habits, and quality of life. Data will be collected at baseline, immediately postintervention, and at follow-up visits at 6 and 12 months. A feasibility analysis will be conducted.Ethics and disseminationThe study has been approved by the Ethics Committee of Universidad Loyola Andalucía. Results will be submitted for publication in peer-reviewed journals and disseminated across the scientific community.Trial registration numberNCT03734367.


Author(s):  
N.S. Glaser ◽  
S.B. Iden ◽  
D. Green-Burgeson ◽  
C. Bennett ◽  
K. Hood-Johnson ◽  
...  

1990 ◽  
Vol 9 (3) ◽  
pp. 251-255 ◽  
Author(s):  
J.I. Conget ◽  
E. Esmatjes ◽  
J. Ferrer ◽  
J. Vendrell ◽  
E. Moscoso ◽  
...  

Open Medicine ◽  
2009 ◽  
Vol 4 (4) ◽  
pp. 415-422
Author(s):  
Kamile Gul ◽  
Ihsan Ustun ◽  
Yusuf Aydin ◽  
Dilek Berker ◽  
Halil Erol ◽  
...  

AbstractThe aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.


2013 ◽  
Author(s):  
Joana Caetano ◽  
Sara Ferreira ◽  
Ester Pereira ◽  
Marta Ferreira ◽  
Helena Lourenco ◽  
...  

2021 ◽  
Vol 11 (7) ◽  
pp. 1154-1160
Author(s):  
Yan Sun ◽  
Haoshu Niu ◽  
Zhixia Wang ◽  
Ying Wang ◽  
Xuechun Li ◽  
...  

The aim of this study was to investigate the difference between multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII) in blood glucose control during the treatment of type 1 diabetes mellitus (T1DM) in children. under the nano-hydrogel delivery carrier. In order to improve the efficiency and therapeutic effect of the experiment, this paper adopts injectable nanomaterial-polymer composite hydrogel as drug delivery system to cooperate with insulin injection to improve the effective utilization of drugs. Eighty children diagnosed with T1DM by the department of Endocrinology, Genetics, and Metabolism of INNER MONGOLIA BAOGANG Hospital from October 2018 to December 2019 were selected as research subjects for this study. The children were randomly divided into MDI group (treated with MDI) and CSII group (treated with CSII), with 40 children in each group. The basic data of the children were compared, and changes in hemoglobin A1c (HbA1c) at admission and 1, 2, and 3 months after treatment were detected. During the detection, the blood glucose level, therapeutic time of blood glucose normalization, and daily insulin dosage were recorded. The HbA1c and fasting blood glucose (FBG) were followed up three months after discharge, and incidences of hypoglycemia in the two groups were observed. The results showed that the mean value of HbA1c in the MDI group was higher than that in the CSII group (P < 0.05). Each patient was assessed for the number of times their blood sugar was allowed to dip below normal levels; patients with less hypoglycemia had a higher rate of blood sugar control. The control rates of blood glucose in the MDI and CSII groups were 19.21% and 23.50%, respectively. The CSII group showed significantly higher blood glucose rates than the MDI group (P < 0.05). The therapeutic time of blood glucose normalization in the MDI group was significantly longer than that in the CSII group (P < 0.05). There was no significant difference in the average daily insulin dosage between the MDI and CSII groups (P > 0.05), which indicated that CSII therapy had significant advantages in reducing blood glucose in children with T1DM.


2021 ◽  
pp. 1-5
Author(s):  
Mehmet Türe ◽  
Alper Akın ◽  
Edip Unal ◽  
Ahmet Kan ◽  
Suat Savaş

Abstract Background: Adult patients diagnosed with type 1 diabetes mellitus are at risk for ventricular arrhythmias and sudden cardiac death. Aim: The objective of our study is to evaluate the electrocardiographic data of children diagnosed with type 1 diabetes mellitus and to determine the possibility of arrhythmia in order to prevent sudden death. Methods: Electrocardiographic data of 60 patients diagnosed with type 1 diabetes mellitus and 86 controls, who were compatible with the patient group in terms of age and gender, were compared. Results: The duration of diabetes in our patients with type 1 diabetes mellitus was 5.23 ± 1.76 years, and the haemoglobin A1c levels were 9.63% ± 1.75%. The heart rate, QRS, QT maximum, QT dispersion, QTc minimum, QTc maximum, QTc dispersion, Tp-e maximum, Tp-e maximum/QTc maximum and the JTc were significantly higher compared to the control group. There was no significant correlation between the duration of type 1 diabetes mellitus and HbA1c levels and the electrocardiographic data. Conclusion: We attributed the lack of a significant correlation between the duration of type 1 diabetes mellitus and the haemoglobin A1c levels and the electrocardiographic data to the fact that the duration of diabetes was short, since our patients were children. We believe that patients with type 1 diabetes mellitus should be followed up closely in terms of sudden death, as they have electrocardiographic changes that may cause arrhythmias compared to the control group. However, more studies with longer follow-up periods are necessary to support our data.


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