scholarly journals Pilot Study of a Novel Application for Data Visualization in Type 1 Diabetes

2017 ◽  
Vol 11 (4) ◽  
pp. 800-807 ◽  
Author(s):  
Jenise C. Wong ◽  
Aaron B. Neinstein ◽  
Howard Look ◽  
Brandon Arbiter ◽  
Nora Chokr ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
User Interface ◽  
Data Visualization ◽  
Management Practices ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Rapid Development ◽  
Shared Responsibility ◽  
Software Application

Background: A novel software application, Blip, was created to combine and display diabetes data from multiple devices in a uniform, user-friendly manner. The objective of this study was to test the usability of this application by adults and caregivers of children with type 1 diabetes (T1D). Methods: Patients (n = 35) and caregivers of children with T1D (n = 30) using an insulin pump for >1 year ± CGM were given access to the software for 3 months. Diabetes management practices and the use of diabetes data were assessed at baseline and at study end, and feedback was gathered in a concluding questionnaire. Results: At baseline, 97% of participants agreed it was important for patients to know how to interpret glucose data. Most felt that clinicians and patients should share the tasks of reviewing data, finding patterns, and making changes to their insulin plans. However, despite valuing shared responsibility, at baseline, 43% of participants never downloaded pump data, and only 9% did so at least once per month. At study end, 72% downloaded data at least once during the 3-month study, and 38% downloaded at least once per month. Regarding the software application, participants liked the central repository of data and the user interface. Suggestions included providing tools for understanding and interpreting glucose patterns, an easier uploading process, and access with mobile devices. Conclusions: Collaboration between developers and researchers prompted iterative, rapid development of data visualization software and improvements in the uploading process and user interface, which facilitates clinical integration and future clinical studies.

Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait

2019 ◽  
Vol 32 (8) ◽  
pp. 843-849 ◽  
Author(s):  
Kholoud Mohamed ◽  
Dalia Al-Abdulrazzaq ◽  
Amel Fayed ◽  
Eman El Busairi ◽  
Faisal Al Shawaf ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Control Level ◽  
Insulin Pump Therapy ◽  
Insulin Regimen ◽  
Pump Therapy ◽  
Significant Difference

Abstract Background To evaluate the safety of fasting during the holy month of Ramadan among children and adolescent with type 1 diabetes (T1D). Methods A retrospective cohort study of 50 children and adolescents with T1D whose mean age was 12.7 ± 2.1 years was conducted. Twenty-seven patients (54%) were on multiple daily injections (MDI) insulin regimen and 23 (46%) were on insulin pump therapy. Before fasting for Ramadan, children and their families were evaluated and educated about diabetes management during Ramadan. Hemoglobin A1c (HbA1c), weight, number of days fasted, hypoglycemia and hyperglycemia episodes, and emergency hospital visits were collected and analyzed after completing the month. Participants were compared according to the insulin treatment regimen and their glycemic control level before Ramadan. Results The children were able to fast 20 ± 9.9 days of Ramadan, and the most common cause for breaking the fast was mild hypoglycemia (7.8% among all cases). There was no significant difference between the two insulin regimen groups in breaking fast days, frequency of hypo- or hyperglycemia, weight and HbA1c changes post Ramadan. Patients with HbA1c ≤ 8.5% were able to fast more days during Ramadan with significantly less-frequent hypoglycemic attacks as compared to patients with HbA1c > 8.5 (1.2 ± 1.5 vs. 3.3 ± 2.9 days of hypoglycemia, p = 0.01, respectively). Conclusions Fasting for children with T1D above the age of 10 years is feasible and safe in both pump and non-pump users, and well-controlled patients are less likely to develop complications. Education of the families and their children before Ramadan, along with intensive monitoring of fasting children during the month are crucial.

scholarly journals Evolution of Do-It-Yourself Remote Monitoring Technology for Type 1 Diabetes

2020 ◽  
Vol 14 (5) ◽  
pp. 854-859
Author(s):  
Michelle Ng ◽  
Emily Borst ◽  
Ashley Garrity ◽  
Emily Hirschfeld ◽  
Joyce Lee
Keyword(s):  
Type 1 Diabetes ◽  
Open Source ◽  
Remote Monitoring ◽  
Diabetes Management ◽  
Rapid Development ◽  
Artificial Pancreas ◽  
Commercial Space ◽  
Technology Innovations ◽  
Do It Yourself

Background: The Nightscout Project is a leading example of patient-designed, do-it-yourself (DIY), open-source technology innovations to support type 1 diabetes management. We are unaware of studies that have described the evolution of patient-driven innovations from the Nightscout Project to date. Methods: We identified patient-driven, DIY innovations from posts and comments in the “CGM in the Cloud” private Facebook group as well as data from Twitter, GitHub, and the Nightscout website. For each innovation, we described its intent or its unaddressed need as well as the associated features and improvements. We conducted a thematic analysis to identify overarching patterns among the innovations, features, and improvements, and compared the timeline of innovations in the DIY space with the timing of similar innovations in the commercial space. Results: We identified and categorized innovations in Nightscout with the most commonly appearing themes of: visualization improvements, equipment improvements, and user experience improvements. Other emerging themes included: Care Portal support, safety, remote monitoring, decision support, international support, artificial pancreas, pushover notifications, and open-source collaboration. Conclusions: This rapid development of patient-designed DIY innovations driven by unmet needs in the type 1 diabetes community reflects a revolutionary, bottom–up approach to medical innovation. Nightscout users accessed features earlier than if they had waited for commercial products, and they also personalized their tools and devices, empowering them to become the experts of their own care.

scholarly journals Technology for Augmenting Type 1 Diabetes Mellitus Management

2019 ◽  
Vol 24 (2) ◽  
pp. 99-106
Author(s):  
Michelle Condren ◽  
Samie Sabet ◽  
Laura J. Chalmers ◽  
Taylor Saley ◽  
Jenna Hopwood
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Continuous Glucose Monitoring ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Insulin Delivery ◽  
Diabetes Mellitus Management

Type 1 diabetes mellitus has witnessed significant progress in its management over the past several decades. This review highlights technologic advancements in type 1 diabetes management. Continuous glucose monitoring systems are now available at various functionality and cost levels, addressing diverse patient needs, including a recently US Food and Drug Administration (FDA)–approved implantable continuous glucose monitoring system (CGMS). Another dimension to these state-of-the-art technologies is CGMS and insulin pump integration. These integrations have allowed for CGMS-based adjustments to basal insulin delivery rates and suspension of insulin delivery when a low blood glucose event is predicted. This review also includes a brief discussion of upcoming technologies such as patch-based CGMS and insulin-glucagon dual-hormonal delivery.

scholarly journals Generic and disease-specific quality of life in adolescents with type 1 diabetes: comparison to age-matched healthy peers

2016 ◽  
Vol 29 (7) ◽  
Author(s):  
Andrea Lukács ◽  
Péter Sasvári ◽  
András Török ◽  
László Barkai
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Regular Exercise ◽  
Pump Therapy

AbstractThis study aimed to evaluate the health-related quality of life (HRQoL) of adolescents with type 1 diabetes (T1DM) on the basis of the pediatric quality of life inventory™ (PedsQL™) generic and diabetes-specific modules, and to compare it to that of healthy peers.This retrospective case-control study involved 650 participants between ages of 13 and 19 years including 296 adolescents with T1DM from four diabetes centers and 354 healthy peers matched for age and gender from three different cities of the country. Participants completed the validated PedsQL™ for assessing the HRQoL. The analysis included an independent t-test to compare the means of the total and subscales of the PedsQL™ between boys and girls as well as between a healthy group and a group with T1DM. Gender differences in exercise, insulin therapy modalities were evaluated with the Pearson χAdolescents with T1DM have similar HRQoL in all domains when compared to their healthy counterparts. Females report worse HRQoL regardless of the presence of the disease. Insulin pump therapy facilitates better glycemic control and HRQoL. Regular exercise positively correlates with the generic HRQoL in both groups; however, it has no relationship with glycemic control.Optimal metabolic control and improved HRQoL are the eventual goals of diabetes management. Despite the difficulties, adolescents with diabetes can manage their disease well and live normal lives, similar to their healthy peers. Although diabetes-related problems exist, it seems that regular exercise and staying physically active, as well as promoting insulin pump therapy where it is applicable are related to favorable HRQoL.

scholarly journals Adjustment of Insulin Pump Settings in Type 1 Diabetes Management: Advisor Pro Device Compared to Physicians’ Recommendations

2020 ◽  
pp. 193229682096556
Author(s):  
Revital Nimri ◽  
Tal Oron ◽  
Ido Muller ◽  
Ivana Kraljevic ◽  
Montserrat Martín Alonso ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Insulin Dose ◽  
Absolute Difference ◽  
Study Endpoint ◽  
Data Sets ◽  
Self Monitoring ◽  
Basal Rate

Aims: To compare insulin dose adjustments made by physicians to those made by an artificial intelligence-based decision support system, the Advisor Pro, in people with type 1 diabetes (T1D) using an insulin pump and self-monitoring blood glucose (SMBG). Methods: This was a multinational, non-interventional study surveying 17 physicians from 11 countries. Each physician was asked to provide insulin dose adjustments for the settings of the pump including basal rate, carbohydrate-to-insulin ratios (CRs), and correction factors (CFs) for 15 data sets of pumps and SMBG of people with T1D (mean age 18.4 ± 4.8 years; eight females; mean glycated hemoglobin 8.2% ± 1.4% [66 ± 11mmol/mol]). The recommendations were compared among the physicians and between the physicians and the Advisor Pro. The study endpoint was the percentage of comparison points for which there was an agreement on the direction of insulin dose adjustments. Results: The percentage (mean ± SD) of agreement among the physicians on the direction of insulin pump dose adjustments was 51.8% ± 9.2%, 54.2% ± 6.4%, and 49.8% ± 11.6% for the basal, CR, and CF, respectively. The automated recommendations of the Advisor Pro on the direction of insulin dose adjustments were comparable )49.5% ± 6.4%, 55.3% ± 8.7%, and 47.6% ± 14.4% for the basal rate, CR, and CF, respectively( and noninferior to those provided by physicians. The mean absolute difference in magnitude of change between physicians was 17.1% ± 13.1%, 14.6% ± 8.4%, and 23.9% ± 18.6% for the basal, CR, and CF, respectively, and comparable to the Advisor Pro 11.7% ± 9.7%, 10.1% ± 4.5%, and 25.5% ± 19.5%, respectively, significant for basal and CR. Conclusions: Considerable differences in the recommendations for changes in insulin dosing were observed among physicians. Since automated recommendations by the Advisor Pro were similar to those given by physicians, it could be considered a useful tool to manage T1D.

scholarly journals Parents’ experiences of caring for a young child with type 1 diabetes: a systematic review and synthesis of qualitative evidence

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
B. Kimbell ◽  
J. Lawton ◽  
C. Boughton ◽  
R. Hovorka ◽  
D. Rankin
Keyword(s):  
Type 1 Diabetes ◽  
Management Practices ◽  
Diabetes Management ◽  
Sociodemographic Factors ◽  
Future Research ◽  
Perceived Need ◽  
Qualitative Evidence ◽  
Practical Support ◽  
Parents Experiences

Abstract Aims To synthesise the qualitative evidence on parents’ experiences of caring for a child aged ≤8 years with type 1 diabetes to identify: the challenges they encounter; their views about support received; ways in which support could be improved; and, directions for future research. Methods We searched Medline, EMBASE, CINAHL, PsycINFO and Web of Science databases to identify qualitative studies reporting parents’ views and experiences of caring for a child with type 1 diabetes aged ≤8 years. Key analytical themes were identified using thematic synthesis. Results Fourteen studies were included. The synthesis resulted in the generation of two overarching themes. Monopolisation of life describes the all-encompassing impact diabetes could have on parents due to the constant worry they experienced and the perceived need for vigilance. It describes how parents’ caring responsibilities could affect their wellbeing, relationships and finances, and how a lack of trusted sources of childcare and a desire to enable a ‘normal’ childhood constrained personal choices and activities. However, use of diabetes technologies could lessen some of these burdens. Experiences of professional and informal support describes how encounters with healthcare professionals, while generally perceived as helpful, could lead to frustration and anxiety, and how connecting with other parents caring for a child with type 1 diabetes provided valued emotional and practical support. Conclusions This synthesis outlines the challenges parents encounter, their views about support received and ways in which support might be improved. It also highlights significant limitations in the current literature and points to important areas for future research, including how sociodemographic factors and use of newer diabetes technologies influence parents’ diabetes management practices and experiences. PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019128710

scholarly journals Screening, prevalence, treatment and control of kidney disease in patients with type 1 and type 2 diabetes in low-to-middle-income countries (2005–2017): the International Diabetes Management Practices Study (IDMPS)

Diabetologia ◽  
2021 ◽  
Author(s):  
Jean Claude Mbanya ◽  
Pablo Aschner ◽  
Juan J. Gagliardino ◽  
Hasan İlkova ◽  
Fernando Lavalle ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Management Practices ◽  
Diabetes Management ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Control

Abstract Aims/hypothesis Diabetes is the leading cause of kidney disease worldwide. There is limited information on screening, treatment and control of kidney disease in patients with diabetes in low-to-middle-income countries (LMICs). Methods The International Diabetes Management Practices Study is an ongoing, non-interventional study of clinical profiles and practices among patients receiving outpatient care mainly by internal medicine physicians and endocrinologists in LMICs. We examined screening, prevalence, treatment and control of kidney disease across seven waves (W) of data collection between 2005 and 2017. Results Among 15,079 patients with type 1 and 66,088 patients with type 2 diabetes, screening for kidney disease increased between W2 and W3 followed by a plateau (type 1 diabetes: W2, 73.7%; W3, 84.1%; W7, 83.4%; type 2 diabetes: W2, 65.1%; W3, 82.6%; W7, 86.2%). There were also decreasing proportions of patients with microalbuminuria (type 1 diabetes: W1, 27.1%; W3, 14.7%; W7, 13.8%; type 2 diabetes: W1, 24.5%; W3, 12.6%; W7, 11.9%) and proteinuria (type 1 diabetes: W1, 14.2%; W3, 8.7%; W7, 8.2%; type 2 diabetes: W1, 15.6%; W3, 9.3%; W7, 7.6%). Fewer patients were reported as receiving dialysis for both type 1 diabetes (W2, 1.4%; W7, 0.3%) and type 2 diabetes (W2, 0.9%; W7, 0.2%) over time. While there was no change in mean HbA1c or prevalence of diagnosed hypertension (type 1 diabetes: W1, 22.7%; W7, 19.9%; type 2 diabetes: W1, 60.9%; W7, 66.2%), the use of statins had increased among patients diagnosed with dyslipidaemia (type 1 diabetes: W1, 77.7%; W7, 90.7%; type 2 diabetes: W1, 78.6%; W7, 94.7%). Angiotensin II receptor blockers (type 1 diabetes: W1, 18.0%; W7, 30.6%; type 2 diabetes: W1, 24.2%; W7, 43.6%) were increasingly used over ACE inhibitors after W1 (type 1 diabetes: W1, 65.0%; W7, 55.9%; type 2 diabetes: W1, 55.7%, W7, 41.1%) among patients diagnosed with hypertension. Conclusions/interpretation In LMICs, real-world data suggest improvement in screening and treatment for kidney disease in patients with type 1 and type 2 diabetes attending non-nephrology clinics. This was accompanied by decreasing proportions of patients with microalbuminuria and proteinuria, with fewer patients who reported receiving dialysis over a 12-year period. Graphical abstract

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