Remote monitoring of adolescents with type 1 diabetes mellitus using a mobile application

Background: The prevalence of type 1 diabetes mellitus (T1DM) in childhood is increasing every year. Adolescence is the most challenging age for achieving optimal metabolic control of T1DM. Telemedicine has already been shown to be effective in children with the condition, but there are not enough studies in adolescents. The use of mobile apps may be associated with better glycemic control in patients with type 1 diabetes.Aims: To assess the effectiveness and safety of a model of medical care for adolescents with type 1 diabetes using remote counseling and a mobile application.Materials and methods: Were included adolescents aged ≥14 and 18 years with a T1DM duration> 3 months, a glycated hemoglobin level (HbA1c)> 7%. The duration of the study was 26 weeks. There were 3 face-to-face and at least 4 remote visits using a mobile application. All patients underwent standard examination and anthropometry, study of HbA1c, registration and analysis of indicators, assessment and correction of the treatment. The quality of life of adolescents was assessed at baseline and at the end of the study. Adolescents and physicians were interviewed about program evaluation.Results: 56 patients were included, 7 adolescents withdrew. HbA1c significantly decreased by the 12th week of the study (–0.3%; p = 0.005), by the end of the study the change in HbA1c was –0.5% (p <0.001). There was an increase in the percentage of glucose measurements in the target range (+5.3 pp; p = 0.016) and a decrease in blood glucose variability (-3.1 pp; p = 0.015). There was a significant improvement in both the total assessment of the quality of life by patients (+2.9 points; p = 0.008) and individual components of its indicators: attitude to diabetes (+3.0 points; p = 0.049), attitude to treatment (+4.6 points; p = 0.010) and communication with others (+4.5 points; p = 0.015). The majority of doctors and patients assessed their participation in the study positively. The incidence of adverse events did not change significantly during the study from baseline.Conclusion: Remote counseling using a mobile app is a safe and effective approach for adolescents with T1DM in terms of glycemic control and quality of life, and provides convenience and speed of interaction.

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Evolving Pharmacotherapeutic Strategies for Type 1 Diabetes Mellitus

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-23.5.351 ◽

2018 ◽

Vol 23 (5) ◽

pp. 351-361

Author(s):

Samie Sabet ◽

Michelle E. Condren ◽

Angela F. Boston ◽

Lauren C. Doak ◽

Laura J. Chalmers

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Type 1 Diabetes Mellitus ◽

Review Article ◽

The Past ◽

Clinical Profiles

Despite pharmacotherapeutic advancements in the management of type 1 diabetes mellitus during the past several decades, patients struggle to achieve glycemic goals. Additionally, hypoglycemia, especially in extremes of age, decreases quality of life. The lack of optimal glycemic control and risk for hypoglycemia are multifactorial. Nevertheless, endeavors aiming to develop pharmacotherapeutic options with enhanced pharmacokinetic, pharmacodynamic, and clinical profiles continue. This review article discusses recent ventures in 3 categories of insulin, non-insulin, and glucagon products.

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Use of telemedicine improves glycemic control and quality of life in type 1 diabetes children on insulin pump therapy

Diabetes Mellitus ◽

10.14341/dm8677 ◽

2018 ◽

Vol 20 (6) ◽

pp. 420-426 ◽

Cited By ~ 1

Author(s):

Dmitry N. Laptev ◽

Valentina A. Peterkova

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Type 1 Diabetes Mellitus ◽

Children And Adolescents ◽

Insulin Pump ◽

Insulin Pump Therapy

Rationale: Healthcare access plays a significant role in the improvement and maintaining of glycemic control and quality of life in type 1 diabetes mellitus (T1DM) patients on continuous subcutaneous insulin infusion (CSII). Aims: The aim of the study was to evaluate the feasibility of remote support in children and adolescents with type 1 diabetes mellitus (T1DM) and its effect on glycemic control and quality of life. Materials and methods: In 40 children and adolescents (132,7 years, 18/22 m/f) on CSII with inadequately controlled T1DM (HbA1c7,5%) we evaluated the effectiveness of telemedical support (TS), as compared with conventional support (CS). Parameters of glycemic control (HbA1c, average glycemia, SD, etc.) and quality of a life were obtained on follow-up visits. Patients and their parents in ТМ group twice a month sent their insulin pump data using to CSII center and diabetologists sent back their advice via e-mail, phone or Skype. The primary end point was the change from the baseline HbA1c level and the proportion of patients achieving HbA1c of less than 7.5%. Results: At 24 weeks, the baseline mean HbA1c (8.7% in the two study groups) had decreased to 7.7% in the TS group, as compared with 8.4% in the CS group (P0,05). The proportion of patients who reached the HbA1c target (7,5%) was greater in the TS group (50%) than in the CS group (20%, p0,05). A number of quality of life indicators for both parents and children with T1DM at the end of the study compared to baseline significantly increased in the TS group compared with the TC group (p0.05). During the study period rate of severe hypoglycemia and DKA in TS group (0 and 10 cases per 100 person-years) did not differ significantly from that in CS group (0 and 20 cases per 100 person-years, P0,05). Conclusion: In children with inadequately controlled T1DM, telemedical support proved to be feasible and resulted in significant improvement in glucose control (HbA1c, glucose variability) and quality of life without the increase in the incidence of DKA and severe glycemia.

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The influence of a program of structured diabetes education on the glycemic control and quality of life during transition of the patients with type 1 diabetes mellitus to insulin pump therapy with continuous real-time monitoring blood glucose leve

Problems of Endocrinology ◽

10.14341/probl201460139-45 ◽

2014 ◽

Vol 60 (1) ◽

pp. 39-45

Author(s):

L I Ibragimova ◽

Yu I Philippov ◽

A Yu Mayorov

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Type 1 Diabetes Mellitus ◽

Diabetes Education ◽

Well Being ◽

Control Group

Aim of the study. To estimate the effectiveness of the new program of structured diabetes education for the groups of the patients with type 1 diabetes mellitus (DM1) during their transition to sensor-augmented pump (SAP) therapy in terms of improvement of the glycemic control and quality of life (QL). Material and methods. The study included 35 patients presenting with DM1: 14 men, mean age 26.5 years (24; 36). The patients were divided into two groups. Those in the study group received a structured diabetes education (n=19), those in the control group were given conventional education (n=16). The patients of group 1 were transferred to SAP therapy in the framework of group education based on the specialized structured program. The education of control patients was carried out on an individual basis in the previous period at the places of residence. Quality of life and emotional well-being were estimated with the use of the validated Russian versions of the SF-36, ADDQoL, and WB-Q12 questionnaires. The effectiveness of glycemic control and QL were evaluated within 4 months after the completion of education and transition to SAP. Results. The patients of both groups were not initially different in the HbA1c level: 8.1 (8.0; 9.2) versus 8.8 (7.7; 9.0) (p>0.05). The HbA1c level: decreased in the two groups within 4 months after the initiation of SAP therapy: 7.3 (6.3; 7.8) versus 8.0 (6.3; 8.5) (p>0.05). The decrease was more pronounced in the group of the patients who received the structured diabetes education than in the control group (p=0.036). The patients transferred to SAP in the framework of the structured education program tended to have higher indices of QL and emotional well-being than the patients given the standard education. Conclusion. The use of the specialized structured program for the education for the groups of the patients with type 1 diabetes mellitus during transition to SAP therapy results not only in a more pronounced improvement of glycemic control indices but also in the positive changes of certain QL characteristics.

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Correlation between glycemic control and quality of life of adolescents aged 13-18 years with type 1 diabetes mellitus

International Journal of Pediatric Endocrinology ◽

10.1186/1687-9856-2013-s1-p30 ◽

2013 ◽

Vol 2013 (Suppl 1) ◽

pp. P30

Author(s):

Elina Waiman ◽

Bambang Tridjaja ◽

Bambang Supriyatno

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Type 1 Diabetes Mellitus

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Evaluation of glycemic control, quality of life and psychological characteristics in patients with type 1 diabetes mellitus

Diabetes Mellitus ◽

10.14341/dm2013458-65 ◽

2013 ◽

Vol 16 (4) ◽

pp. 58-65 ◽

Cited By ~ 3

Author(s):

Yuliya Andreevna Shishkova ◽

Oleg Gennad'evich Motovilin ◽

Elena Viktorovna Surkova ◽

Alexander Yur'evich Mayorov

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Locus Of Control ◽

Glycemic Control ◽

Type 1 Diabetes Mellitus ◽

Psychological Characteristics ◽

Self Assessment

Aim. To identify psychological characteristics associated with better glycemic control and higher quality of life (QoL) in patients with type 1 diabetes mellitus (T1DM). Materials and Methods. The study included 140 T1DM patients (47 males) aged 18 to 28 years. Assessment of the QoL and associated emotional state (ES) was performed by validated localized questionnaires, supplemented with the inventories for evaluation of psychological characteristics. Based on the acquired data we performed a trilateral analysis of glycemic control, QoL and ES, followed by testing of these parameters for correlation with certain psychological characteristics, including disease attitude, mindfulness, self-attitude and self-assessment, coping strategies, autoregulation parameters and the locus of control. Results. In the studied sample, better glycemic control was associated with higher QoL and more favourable ES. We also identified several psychological characteristics associated with an improvement in all three primary parameters, namely: higher level of mindfulness, internal locus of control and ergopathic attitude. Conclusion. The diagnostic inventory for QoL and ES evaluation used in the present study may be helpful for psychological testing in patients with T1DM.

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