Glycemic outcomes related to depression in adults with type 1 diabetes

2021 ◽  
Vol 26 (6) ◽  
pp. 786-794
Author(s):  
Ifeoma Egbuonu ◽  
Paula M Trief ◽  
Cheryl Roe ◽  
Ruth S Weinstock
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Blood Glucose Control ◽  
Blood Glucose Monitoring ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Depressed Group ◽  
Patient Health ◽  
Glycemic Outcomes

Glycemic outcomes of adults with type 1 diabetes may be affected by depression. Our aim was to compare outcomes of “depressed” (Patient Health Questionnaire-9 ⩾ 10, N = 83) to “not-depressed” matched control (Patient Health Questionnaire-2 < 3, N = 166) adults with type 1 diabetes with objective measures. The depressed group had poorer blood glucose control and, for those with glucose meter downloads, fewer glucose tests/day. The groups did not differ on glucose variability or episodes of hypoglycemia. Depression in adults with type 1 diabetes is associated with poorer glycemic control and less blood glucose monitoring. Future research should examine whether treatment of depression results in better self-care and glycemic outcomes.

Glycemic outcomes related to depression in adults with type 1 diabetes

2019 ◽  
pp. 135910531987729 ◽  
Author(s):  
Ifeoma Egbuonu ◽  
Paula M Trief ◽  
Cheryl Roe ◽  
Ruth S Weinstock
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Blood Glucose Control ◽  
Blood Glucose Monitoring ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Depressed Group ◽  
Patient Health ◽  
Glycemic Outcomes

Glycemic outcomes of adults with type 1 diabetes may be affected by depression. Our aim was to compare outcomes of “depressed” (Patient Health Questionnaire-9 ⩾ 10, N = 83) to “not-depressed” matched control (Patient Health Questionnaire-2 < 3, N = 166) adults with type 1 diabetes with objective measures. The depressed group had poorer blood glucose control and, for those with glucose meter downloads, fewer glucose tests/day. The groups did not differ on glucose variability or episodes of hypoglycemia. Depression in adults with type 1 diabetes is associated with poorer glycemic control and less blood glucose monitoring. Future research should examine whether treatment of depression results in better self-care and glycemic outcomes.

scholarly journals A retrospective multisite examination of depression screening practices, scores, and correlates in pediatric diabetes care

2019 ◽  
Author(s):  
Shelagh A Mulvaney ◽  
Constance A Mara ◽  
Jessica C Kichler ◽  
Shideh Majidi ◽  
Kimberly A Driscoll ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Depressive Symptoms ◽  
Psychometric Properties ◽  
Mental Health Treatment ◽  
Clinical Care ◽  
Patient Characteristics ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Patient Health

Abstract Psychosocial guidelines recommend routine screening of depressive symptoms in adolescents and young adults (AYA) with diabetes. Best practices for screening in routine care and patient characteristics associated with depressive symptoms require further investigation. The purpose of this study was to examine psychometric properties of the Patient Health Questionnaire (PHQ-2 and PHQ-9); document rates of depressive symptoms and related clinical actions; and evaluate associations with patient characteristics. The Patient Health Questionnaire (PHQ-2 or PHQ-9) was administered at five pediatric academic medical centers with 2,138 youth with type 1 diabetes. Screening was part of routine clinical care; retrospective data from electronic health records were collected for the first screening date as well as 12 months prior. The PHQ demonstrated good psychometric properties. Evaluation of item-level PHQ-9 data identified 5.0% of AYA with at least moderate depressive symptoms who would not have been flagged for further screening using the PHQ-2 only. On the PHQ-9, 10.0% of AYA with type 1 diabetes endorsed elevated depressive symptoms and 7.0% endorsed thoughts of self-harm. Patients with moderate or greater depressive symptoms had a 43.9% documented referral rate for mental health treatment. Higher BMI, older age, public insurance, shorter diabetes duration, higher HbA1C, and a diabetic ketoacidosis (DKA) event in the past year were associated with depressive symptoms. The PHQ-9 identified AYA with elevated depressive symptoms that would not have been identified using the PHQ-2. Depressive symptoms were associated with negative diabetes indicators. To improve referral rates, standardized methods for provision and documentation of referrals are needed.

Comparative Effects of Two Different Multiple Injection Regimens on Blood Glucose Control and Patient Acceptance in Type 1 Diabetes

1990 ◽  
Vol 7 (8) ◽  
pp. 695-699 ◽  
Author(s):  
B.H.R. Wolffenbuttel ◽  
B.M. Ouwerkerk ◽  
B.F.E. Veldhuyzen ◽  
P.H.L.M. Geelhoed-Duijvestijn ◽  
G. Jakobsen ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Control ◽  
Blood Glucose Control ◽  
Patient Acceptance ◽  
Multiple Injection

scholarly journals Hybrid Closed-Loop System Achieves Optimal Perioperative Glycemia in a Boy With Type 1 Diabetes: A Case Report

2021 ◽  
Vol 9 ◽  
Author(s):  
Jesus Dominguez-Riscart ◽  
Nuria Buero-Fernandez ◽  
Ana Garcia-Zarzuela ◽  
Fernando A. Marmolejo-Franco ◽  
Ana C. Perez-Guerrero ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Insulin Infusion ◽  
Closed Loop ◽  
Total Duration ◽  
Blood Glucose Monitoring ◽  
Medical Team ◽  
The Family ◽  
The Impact

The goal in type 1 diabetes (T1D) therapy is to maintain optimal glycemic control under any circumstance. Diabetes technology is in continuous development to achieve this goal. The most advanced Food and Drug Administration- and European Medicines Agency-approved devices are hybrid closed-loop (HCL) systems, which deliver insulin subcutaneously in response to glucose levels according to an automated algorithm. T1D is frequently encountered in the perioperative period. The latest international guidelines for the management of children with diabetes undergoing surgery include specific adjustments to the patient's insulin therapy, hourly blood glucose monitoring, and intravenous (IV) insulin infusion. However, these guidelines were published while the HCL systems were still marginal. We present a case of a 9-year-old boy with long-standing T1D, under HCL system therapy for the last 9 months, and needing surgery for an appendectomy. We agreed with the family, the surgical team, and the anesthesiologists to continue HCL insulin infusion, without further adjustments, hourly blood glucose checks or IV insulin, while monitoring closely. The HCL system was able to keep glycemia within range for the total duration of the overnight fast, the surgery, and the initial recovery, without any external intervention or correction bolus. This is, to the best of our knowledge, the first reported pediatric case to undergo major surgery using a HCL system, and the results were absolutely satisfactory for the patient, his family, and the medical team. We believe that technology is ripe enough to advocate for a “take your pump to surgery” message, minimizing the impact and our interventions. The medical team may discuss this possibility with the family and patients.

136-OR: Nocturnal Hypoglycemia Prevention Strategies Used by People with Type 1 Diabetes According to Their Insulin Delivery and Blood Glucose Monitoring Technology

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 136-OR
Author(s):  
MERYEM K. TALBO ◽  
VIRGINIE MESSIER ◽  
KATHERINE DESJARDINS ◽  
RÉMI RABASA-LHORET ◽  
ANNE-SOPHIE BRAZEAU ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Monitoring ◽  
Insulin Delivery ◽  
Blood Glucose Monitoring ◽  
Prevention Strategies ◽  
Monitoring Technology ◽  
Nocturnal Hypoglycemia

T1D Hypoglycemia Prediction Algorithms: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Stella Tsichlaki ◽  
Lefteris Koumakis ◽  
Manolis Tsiknakis
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Digital Libraries ◽  
Predictive Models ◽  
Real Life ◽  
Blood Glucose Monitoring ◽  
Detection Techniques ◽  
Glucose Levels ◽  
Wide Range

BACKGROUND Diabetes is a chronic condition that necessitates regular monitoring and self-management of the patient's blood glucose levels. People with type 1 diabetes (T1D) can live a productive life if they receive proper diabetes care. Nonetheless, a loose glycemic control might increase the risk of developing hypoglycemia. This incident can occur due to a variety of causes, such as taking additional doses of insulin, skipping meals, or over-exercising. Mainly, the symptoms of hypoglycemia range from mild dysphoria to more severe conditions, if not detected in a timely manner. OBJECTIVE In this review, we report on innovative detection techniques and tactics for identifying and preventing hypoglycemic episodes, focusing on type 1 diabetes. METHODS A systematic literature search following the PRISMA guidelines was performed focusing on the “PUBMED”, “Google Scholar”, “IEEE Xplore” and “ACM” digital libraries to find articles about technologies related to hypoglycemia detection in type 1 diabetes patients. RESULTS The presented approaches have been utilized or devised to enhance blood glucose monitoring and boost its efficacy to forecast future glucose levels, which could aid the prediction of future episodes of hypoglycemia. We detected nineteen predictive models for hypoglycemia, specifically on type 1 diabetes, utilizing a wide range of algorithmic methodologies, spanning from statistics (10%) to machine learning (52%) and deep learning (38%). The algorithms employed most are the kalman filtering and classification models (SVM, KNN, random forests). The performance of the predictive models was found overall to be satisfactory, reaching accuracies between 70% and 99% which proves that such technologies are capable to facilitate the prediction of T1D hypoglycemia. CONCLUSIONS It is evident that CGM can improve the glucose control in diabetes but predictive models for hypo- and hyper- glycemia using only mainstream noninvasive sensors such as wristbands and smartwatches are foreseen to be the next step for mHealth in T1D. Prospective studies are required to demonstrate the value of such models in real-life mHealth interventions.

Programmed Cell Death-1 Monoclonal Antibody Therapy and Type 1 Diabetes Mellitus: A Review of the Literature

2019 ◽  
pp. 089719001985092 ◽  
Author(s):  
Kyle A. Farina ◽  
Michael P. Kane
Keyword(s):  
Diabetes Mellitus ◽  
Cell Death ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Programmed Cell Death ◽  
Type 1 Diabetes Mellitus ◽  
Inhibitor Therapy ◽  
Blood Glucose Monitoring ◽  
Programmed Cell Death 1

Two Food and Drug Administration-approved programmed cell death-1 (PD-1) inhibitors, nivolumab (Opdivo®), and pembrolizumab (Keytruda®), are indicated for treatment-resistant malignancies. Inhibition of PD-1 also inhibits T-cell peripheral tolerance, enhancing autoimmunity. Various autoimmune conditions have been reported with the use of these agents, including type 1 diabetes mellitus (T1DM). This article reviews literature regarding the development of T1DM in patients treated with PD-1 inhibitors and identifies strategies for the appropriate identification, monitoring, and follow-up of these patients. Published cases of T1DM related to PD-1 inhibitor therapy were identified using PubMed. Eighty-three identified publications were reviewed, of which 37 publications involving 42 cases of anti-PD-1 therapy-induced T1DM were identified. The average age of patients at presentation was 62 years and 59.5% were male. The mean number of PD-1 inhibitor doses received was 5, with a mean time to presentation of 11 weeks. Initial presentation of diabetic ketoacidosis was reported in 69% of cases, with an average blood glucose of 660 mg/dL and an average HbA1cof 8.7%. The exact mechanism PD-1 inhibitor therapy-induced T1DM is unknown. Blood glucose monitoring is recommended for all patients receiving anti-PD-1 therapy. Further research is needed to delineate the frequency of this adverse effect, as well as to evaluate potential risk factors and ideal management strategies.

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