scholarly journals An Analysis of Medtronic Minimed 670g Insulin Pump Use in Clinical Practice and the Impact on Glycemic Control, Quality of Life, and Compliance

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A455-A456
Author(s):  
Maxwell E Horowitz ◽  
William Kaye ◽  
Gary Pepper ◽  
Kathyrn Reynolds ◽  
Shital Patel ◽  
...  

Abstract Background: This study evaluated the use of the Medtronic MiniMed 670G system in adults with type 1 diabetes mellitus from a large endocrinology practice and its impact on glycemic control, quality of life (QoL), compliance and safety. Methods: 84 participants completed one site visit for data collection. Percentage of time in range (TIR: 70–180 mg/dL), hyperglycemia (>180 mg/dL), hypoglycemia (<70 mg/dL), HbA1c, average blood glucose (ABG), and other metrics were evaluated at the last visit using the system (LVMM) and compared between the last visit on previous insulin therapy (LVPT). Participants completed three questionnaires to assess QoL. Continuation of the auto mode feature was determined to assess compliance. Results: The mean percentage of TIR at the LVPT was 46.26 ± 18.82% while that at the LVMM was 73.39 ± 12.95%. This represents a significant increase in percentage of TIR of 27.13% (p < 0.001). The mean percentage of time in hyperglycemia at the LVPT was 47.42 ± 20.39% while that at the LVMM was 23.51 ± 11.65%, representing a significant decrease of 23.90% (p < 0.001). The mean percentage of time in hypoglycemia at the LVPT was 6.17 ± 7.91% while that at the LVMM was 2.94 ± 4.72%, representing a significant decrease of 3.22% (p = 0.004). The mean HbA1c at the LVPT was 7.36 ± 1.03% (57 mmol/mol) while that at the LVMM was 7.45 ± 0.85% (58 mmol/mol), representing an increase of 0.09% (p = 0.337). For those with HbA1c greater than or equal to 7.5% at LVPT, the mean HbA1c at the LVPT was 8.49 ± 0.78% (69 mmol/mol) while that at the LVMM was 8.00 ± 0.85% (64 mmol/mol), representing a significant decrease of 0.48% (p = 0.007). For those with HbA1c less than 7.5% at LVPT, the mean HbA1c at the LVPT was 6.78 ± 0.53% (51 mmol/mol) while that at the LVMM was 7.16 ± 0.69% (55 mmol/mol), representing a significant increase of 0.38% (p< 0.001). Patients with LVPT HbA1c less than 7.5% (58 mmol/mol) had a significant reduction in hypoglycemia (<70 mg/dL) from 7.40% to 2.56% (p = 0.001), whereas the reduction in patients with LVPT HbA1c greater than or equal to 7.5% (58 mmol/mol) was from 4.11% to 3.59% (p = 0.758). QoL questionnaires revealed good satisfaction with the system and 86% of participants continued use in auto mode. Conclusions: The use of the Medtronic MiniMed 670G system resulted in a TIR above the recommended target and a significant increase in the percentage of TIR compared to previous insulin therapy. While there was no significant change in HbA1c in the overall population, those with higher HbA1c values at baseline had a reduced percentage of time in hyperglycemia, while those with lower HbA1c values had a reduced percentage of time in hypoglycemia, indicating improvement in parameters specific to each subgroup. The system may be a reasonable choice for patients struggling with significant amounts of hypoglycemia. Use of the system resulted in a high degree of patient satisfaction and excellent compliance in the use of the system.

2020 ◽  
Vol 16 (6) ◽  
pp. 619-627
Author(s):  
Elisa Cipponeri ◽  
Cesare Blini ◽  
Christian Lamera ◽  
Valentina De Mori ◽  
Giovanni Veronesi ◽  
...  

Background : There is no data available on the best insulin treatment to counteract the effects of glucose excursions due to a moderate alcohol intake associated with portions of slight fat and protein-containing food, as often the case during social happenings or “happy hours”. Introduction: This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif (“Spritz” and chips). Introduction : This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif (“Spritz” and chips). Methods: Patients consumed Spritz aperitif twice: using their habitual bolus, based on carbohydrates (CHO) counting (V1), or with a personalized, advanced bolus (V2) calculated from insulin/Kcal derived from Fats and Proteins (FPU). Post-prandial glucose was continuously monitored; glucose incremental areas (iAUC), glucose peak and time to peak, and estimated change from V1 to V2 from repeated- measures models were computed. Each patient fulfilled validated questionnaires on quality of life, knowledge about diabetes and CHO counting. Results : After the educational program, a reduced iAUC (0-80 min: -306, p=ns; 40-80 min: -400, p=0.07) due to greater (p=0.03) and prolonged double-wave insulin boluses was observed. Blood glucose peak and time to peak were also reduced. Moreover, improvements in the psycho-affective dimension, as well as in the alimentary knowledge were detected. Conclusion: Therefore, a personalized educational program on CHO + FPU counting together with insulin bolus management can improve glycemic control during social consumption of alcohol, with positive reflections on the psycho-affective dimension. Further studies are mandatory to confirm such preliminary results.


2021 ◽  
pp. 109980042110096
Author(s):  
Ruey-Hsia Wang ◽  
Chia-Chin Lin ◽  
Shi-Yu Chen ◽  
Hui-Chun Hsu ◽  
Chiu-Ling Huang

Purposes: Women with diabetes (WD) are more severely impacted by the consequence of suboptimal diabetes control. This study aims to examine the impact of demographic and disease characteristics, baseline self-stigma, role strain, diabetes distress on Hemoglobin A1C (A1C) levels, quality of life (D-QoL) and 6-month A1C levels in younger WD. Methods: This study was a 6-month prospective study. In total, 193 WD aged 20–64 years were selected by convenience sampling from three outpatient clinics in Taiwan. Demographic and disease characteristics, self-stigma, role strain, diabetes distress, A1C levels, and D-QoL were collected at baseline. A1C levels were further collected 6 months later. Structural equation modeling was conducted to test the hypothesized model. Results: The final model supported that higher baseline D-QoL directly associated with lower concurrent A1C levels and indirectly associated with lower 6-month A1C levels through baseline A1C levels. Higher baseline self-stigma, role strain, and diabetes distress directly associated with lower baseline D-QoL, and indirectly associated with higher 6-month A1C levels through D-QoL. Conclusion: Improving self-stigma, role strain, and diabetes distress should be considered as promising strategies to improve D-QoL in young WD. D-QoL plays a mediation role between baseline self-stigma, role strain, diabetes distress and subsequent glycemic control in younger WD. Enhancing baseline D-QoL is fundamental to improve subsequent glycemic control.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mina Pakkhesal ◽  
Elham Riyahi ◽  
AliAkbar Naghavi Alhosseini ◽  
Parisa Amdjadi ◽  
Nasser Behnampour

Abstract Background Childhood dental caries can affect the children’s and their parents’ oral health-related quality of life. The aim of the present study was to evaluate the impact of oral and dental health conditions on the oral health-related quality of life in preschool children and their parents. Methods In this descriptive-analytical cross-sectional study, samples were selected from children 3 to 6 years old enrolled in licensed kindergartens using "proportional allocation" sampling. Then, the parents of the children were asked to complete the Early Childhood Oral Health Impact Scale (ECOHIS). Results In this study, 350 children aged 3 to 6 years were evaluated with a mean age of 4.73 years. The mean dmft index (decayed, missed, and filled teeth) was 3.94 ± 4.17. The mean score of oral health-related quality of life was 11.88 ± 6.9, which 9.36 ± 5.02 belongs to the impact on children and 2.52 ± 3.20 to parents' impact. Conclusions The mean score of ECOHIS increased with the dmft index increase in children, indicating a significant relationship between the dmft and ECOHIS score. These outcomes can be used as proper resources to develop preventive policies and promote oral health in young children.


2021 ◽  
Vol 12 (4) ◽  
pp. 462-463
Author(s):  
Kaoutar Sof ◽  
Soraya Aouali ◽  
Sara Bensalem

Sir, Dermatological pathologies may be responsible for the creation of a real handicap, affecting the patient’s self-esteem and their professional and social life. The aim of this study was to assess the impact of diseases on the quality of life of patients hospitalized at the dermatology department. The following was a retrospective study that included patients over eighteen years of age, hospitalized at the dermatology department of Hospital Mohammed VI in Oujda from January 2018 through December 2019. The Arabic version of the validated DLQI was used for all patients [1]. A total of 294 patients were collected, with a mean age of 53.95 years and a male-to-female ratio of 0.85. The most frequent reasons for hospitalization were infectious dermo-hypodermitis (n = 51), autoimmune bullous dermatosis (n = 23), severe drug eruption (n = 20), genodermatosis (n = 17), melanocytic (n = 9) and non-melanocytic skin tumors (n = 17), severe psoriasis (n = 17), cutaneous lymphoma (n = 11), alopecia areata (n = 10), dermatomyositis (n = 8), and Verneuil’s disease (n = 5). The DLQI was impossible to calculate in eleven patients. The mean DLQI in all patients was 10.20, corresponding to a moderate effect on quality of life. The mean DLQI was as follows: Verneuil’s disease at 17.4, severe psoriasis at 16.6, dermatomyositis at 14.42, genodermatosis at 12.37, cutaneous lymphoma at 11.45, severe drug eruption at 11, alopecia areata at 10.5, AIBD at 9.67, skin tumors at 7.76, and infectious dermo-hypodermitis at 7.52. The DLQI was the first index measuring quality of life in dermatology and is still widely used today[2]. The number of publications concerning the impact of dermatological pathologies on quality of life has increased in recent years [3]. Our results showed that the DLQI was higher in patients with Verneuil’s disease, severe psoriasis, and dermatomyositis. These results agree with the data of the literature, many publications have shown that psoriasis seriously impaired the quality of life and was responsible of social anxiety in patients [4]. Verneuil’s disease is also responsible of a significant impairment on quality of life mainly due to the sexual disorders caused by this pathology [5]. Another study on dermatomyositis showed that there is a significant correlation between the severity of skin signs and the quality of life of patients [6]. Dermatological pathologies are distinguished from other pathologies by their displaying character, which is responsible for a significant impact on the patient’s quality of life. The management of dermatology patients requires psychological support in addition to conventional therapy. However, these pathologies are still not recognized as long-term illnesses in Morocco.


2021 ◽  
pp. 1-6
Author(s):  
Shivani Saini ◽  
◽  
Agarwal Shail ◽  
Jain Manish ◽  
Yadav Devendra ◽  
...  

Background: Dermatophytosis is a common fungal infection affecting 20-25% of the world population. Aims: Our study was aimed to assess its impact on health-related quality of life(QoL), mental health, and various variables. Materials and Methods: A cross-sectional study was done from April 2019 to September 2019 on 174 patients of dermatophytosis of aged more than 16 years with their informed consent. The impact of infection on the quality of life was assessed by using the Dermatology life quality index questionnaire and General health questionnaire-12 was used to assess psychological impact. A visual analogue scale was used to assess the severity of pruritus. Appropriate statistical tests were applied. Results: Males to females ratio was 1.4:1. The age group of 21-30 was having the highest number of patients with the mean age of 27.8±9.97. Most patients had BSA under 10%. The mean value of DLQI and GHQ-12 were found 15.989±7.407 and 2.8563±2.8964, respectively. We found that dermatophytosis had a very large effect on the quality of life as the maximum number of patients(39%) were within this category. The “work and school” part in the questionnaire gained maximum importance(52.8%). The mean VAS score was 6±2.733 with most patients(32.7%) had moderate itching. We found a positive correlation between VAS and DLQI, VAS and GHQ-12, DLQI, and GHQ-12 with the statistical significance. Conclusion: In our study dermatophytosis affected the quality of life as well as the psychological health of patients. Therefore proper treatment of superficial dermatophtytosis is essential to prevent it from further complications


2018 ◽  
Vol 4 (2) ◽  
pp. 129
Author(s):  
Nadya Puspita Dewi ◽  
Tetti Solehati ◽  
Nur Oktavia Hidayati

Dysmenorrhea is a pain before or during the menstrual period. The impact of dysmenorrhea are the disruption on physical function, emotional, social and school activities and disruption of quality of life. The study purpose is to detect the quality of life of adolescents with dysmenorrhea.The research method was a quantitative descriptive with total sampling technique to 195 students which selected using dysmenorrhea screening. The data were collected using the pediatric quality of life 4.0 generic module (PedsQL) teens report in Indonesian version which the validity and reliability have been tested. Analysis of data has been done to find out the mean value in each dimension and frequency distribution. The results showed that the mean value of the quality of life of adolescents with dysmenorrhea in general was 62,04 ± 8,15 and 51,8% was in the low. The mean value in physical dimension was 49,36 ± 9,19, emotional dimension was 57,62 ± 13,16, social dimension was 86,38 ± 13,28, and in the school dimension was 62,41 ± 14,77. The quality of life in high categories were in the emotional dimension (60,0%), social dimension (64,1%), and school dimension (60,5%). Meanwhile, the quality of life in low category was in the physical dimension (57,4%). It showed that the quality of life of adolescents with dysmenorrhea in SMK Negeri 2 Sumedang were low. It was recommended to the school and the health office in Sumedang district to provide the reproductive health education, specifically about the prevention and the treatment of dysmenorrhea on adolescents.  


Author(s):  
Cynthia Comella ◽  
Joaquim J. Ferreira ◽  
Emilie Pain ◽  
Marion Azoulai ◽  
Savary Om

Abstract Background Botulinum neurotoxin type A (BoNT-A) is an effective pharmacological treatment for the management of cervical dystonia (CD) that requires repeated administration at variable intervals. We explored patient perceptions of the impact of CD and the waning of BoNT-A therapeutic effects. Methods An internet-based survey was conducted through Carenity, a global online patient community, from May to September 2019. Eligible respondents were adults with CD who had ≥ 2 previous BoNT-A injections. Results 209 respondents (81% females; mean age of 49.7 years) met the screening criteria. The mean BoNT-A injection frequency was 3.9 injections/year. The mean reported onset of BoNT-A therapeutic effect was 11.7 days and the time to peak effect was 4.5 weeks. Symptom re-emergence between injections was common (88%); the time from injection to symptom re-emergence was 73.6 days (~ 10.5 weeks). Treatment was not reported to completely abolish symptoms, even at peak effect. However, symptom severity was rated (0 = no symptoms; 10 = very strong symptoms) as lowest at the peak of treatment effects (mean scores ~ 3/10), increasing as the effects of treatment start waning (~ 5.5/10) and was strongest one day before the next session (~ 7–8/10). The impact of CD on quality of life followed the same ‘rollercoaster’ pattern. Conclusions This survey highlights the burden of CD symptoms, even in patients undergoing regular treatment. Symptom re-emergence is common and has significant impact on daily activities and quality of life. Greater awareness of the therapeutic profile of BoNT-A treatment should lead to better informed therapeutic discussions and planning.


2018 ◽  
Vol 31 (1) ◽  
pp. 30-34
Author(s):  
Mahcube Cubukcu

This study aims to evaluate the impact of urinary incontinence on the quality of life in those receiving home care services and the factors that influence this. This cross-descriptive study was performed in 180 patients who were served from Home Care Services between 01 and 28 February 2018. An International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) was implemented in person to those who gave their informed consent with orientation and cooperation. The mean age of a 180 patients was 74.40 ± 7.80 years (min = 18, max = 104), of which 55.2% were women. The mean ICIQ-SF score was found to be 12.42 ± 4.83 (min = 0, max = 21). The lowest points were given as responses to the question, “In your opinion, what amount of leakage do you experience?” The highest points, however, were given to the question of “How much does urinary leakage interfere with your everyday life?” It was seen that when quality of life is assessed with a visual analog scale within the ICIQ-SF, the quality of life for 66.6% of elderly individuals was affected moderately or significantly. The mean ICIQ-SF scores were higher in those with chronic diseases ( p < .005). Urinary Incontinence negatively affects quality of life to a moderate and significant degree in those receiving home care. The quality of life for those who have chronic diseases was worse. In this respect, there is a need to support patients in those receiving home care services.


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