Level of Internet use among Greek adolescents with type 1 diabetes

2017 ◽  
Vol 31 (1) ◽  
Author(s):  
Katerina Daniilidou ◽  
Panagiota Triantafyllou ◽  
Maria Resta ◽  
Meropi Dimitriadou ◽  
Athanasios Christoforidis
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Internet Use ◽  
Insulin Pump ◽  
Addictive Behavior ◽  
The Internet ◽  
Control Group ◽  
Healthy Children ◽  
Diabetes Clinic

Abstract Background Compulsive Internet use has emerged as a contemporary addictive behavior. Our aim was to investigate the reasons for Greek adolescents with type 1 diabetes mellitus (T1DM) and their families to use the Internet and additionally to investigate the level of Internet use and its associations to demographic, socio-economic parameters and glycemic control. Methods Patients with T1DM, aged >12 years and their parents were recruited during their regular visits to the Pediatric Diabetes Clinic. A similar group of healthy children, age- and sex-matched served as a control group. All participants were asked to fill out the Greek translated version of the Internet Addiction Test (IAT). Caregivers of patients with T1DM were asked to complete a second questionnaire consisting of questions regarding demographic and socio-economic data of the family and data concerning disease management. Results Thirty-five patients with T1DM (mean decimal age of 14.95 ± 1.90 years) and 35 controls participated in the study. Nine patients were on an insulin pump whereas the rest were on multiple daily injections. The mean total score of the patients’ IAT questionnaires was significantly lower compared to the controls (26.26 ± 12.67 vs. 39.91 ± 18.55, p = 0.003). Controls were characterized as exhibiting moderate addictive behavior at a significantly higher percentage than patients (31.43% vs. 2.86%, p = 0.002). All patients on insulin pumps demonstrated normal Internet use. Mild addictive behavior was associated with a lower parental educational level. Finally, level of Internet use (IAT score) was positively associated to glycemic control (HbA1c value) with a correlation that was approaching significance (r = 0.315, p = 0.065). Conclusions Adolescents with T1DM and especially those on an insulin pump exhibit normal Internet use compared to their healthy peers. Time consumed on Internet correlates reversibly with glycemic control.

Contrasting Challenges of Insulin Pump Therapy in a Toddler and Adolescent With Type 1 Diabetes

2005 ◽  
Vol 31 (4) ◽  
pp. 584-590 ◽  
Author(s):  
Elizabeth A. Doyle ◽  
Amy T. Steffen ◽  
William V. Tamborlane
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Diabetes Clinic ◽  
Physically Active ◽  
Parental Assistance ◽  
Life Improvement

Purpose To describe the challenges and outcomes of continuous subcutaneous insulin infusion (CSII) pump therapy in a toddler and adolescent with type 1 diabetes. Insight into patient-family aspects motivating pump use is provided. Methods Two cases treated at the Pediatric Diabetes Clinic at Yale University. Results Upon parental request, CSII was initiated to improve glycemic control in a 4-year-old boy (case 1) with unpredictable food intake. During 68 months of CSII therapy, hemoglobin A1C levels averaged 6.3% ± 0.6%. Severe hypoglycemic episodes ceased 36 months ago, and occasional postprandial hyperglycemia during early school years was corrected with school nurses’ reminders about premeal insulin bolus doses. Currently 9.5 years old, he independently manages all his insulin injections with parental assistance only to change the catheter site. Case 2 is a girl who was nearly 12 years of age when diagnosed with type 1 diabetes. Initially managed with daily injections, hypoglycemic episodes were interfering with her physically active lifestyle. At age 13 years, she elected CSII therapy, and glycemic control improved. Temporarily erratic in the immediate period pre- and postmenarche, metabolic control has since stabilized. At 15 years old, she successfully manages her diabetes independently. Conclusions To optimize glycemic control, CSII can be initiated and used effectively, both in children of all ages and in adolescents with type 1 diabetes. CSII may be ideal therapy for toddlers, with no apparent lower age boundary for initiating CSII; however, the parenting challenges and requirements for supportive education differ between toddlers and adolescents. When disease and pump management are appropriately individualized, CSII therapy can help children with diabetes achieve and sustain glycemic control. Lifestyle flexibility, quality-of-life improvement, and independence can thus begin early in childhood and be maintained throughout young adulthood.

scholarly journals Remote monitoring and treatment of children and adolescents with type 1 diabetes

2020 ◽  
Vol 66 (4) ◽  
pp. 50-60
Author(s):  
Dmitry N. Laptev ◽  
Andrey O. Emelyanov ◽  
Yulia G. Samoilova ◽  
Elena B. Khramova ◽  
Elena E. Petriaikina ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Children And Adolescents ◽  
Remote Monitoring ◽  
Insulin Pump ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Number Of Patients

RATIONALE: Continuous subcutaneous insulin infusion (CSII) is an effective method for optimizing glycemic control in children with type 1 diabetes mellitus (DM1). However, the use of CSII does not always result in adequate glycemic control. Telehealth can be applied as one of the methods to improve the effectiveness of treatment.AIMS: To evaluate the use of remote medical support of children and adolescents with DM1 and its influence on glycemic control, quality of life, and incidence of acute complications of DM1.MATERIALS AND METHODS: We conducted a 24-week multi-institutional prospective open-label controlled clinical trial. 180 children and adolescents were included in this study and divided into the following categories: 1) age 8–18 years; 2) DM1 at least 1 year; 3) pump insulin therapy Medtronic Paradigm (Medtronic MiniMed, USA) at least 6 months; 4) self-monitoring of glycemia at least 4 times a day and replacement of the insulin pump infusion system at least once every 3 days; 5) inadequate glycemic control of DM1: the level of glycated hemoglobin (HbA1c) 7.5% or higher. Patients were assigned to a remote consultation group (RC; n=100) or a traditional control group (TC; n=80). All patients were trained on the basic principles of DM1 and CSII, and we measured initial HbA1c, then after 12 and 24 weeks, also registered and analyzed glycemic indicators and daily doses of insulin, evaluated and corrected the treatment. Patients or their parents in the RC group sent pump data via the Internet to the pump insulin therapy center at least once every 2 weeks at home and received treatment recommendations in response.RESULTS: The total number of patients included in the study in all institutions was 180 children at 8–18 years. Patients in both groups did not differ in age, gender, duration of DM1 and CSII, and HbA1c level. The total amount of remote consultations for all institutions was 949. The decrease in the level of HbA1c by the end of the study against the initial one was statistically significantly greater in the RC group: 1.17% compared to 0.59% in the TC group (p<0.05). The proportion of patients who reached the target level of HbA1c (<7.5%) was significantly higher in the RC group (32%) compared to the TC group (12.5%, p<0.05). During the study, the incidence of DKA and severe hypoglycemia in the RC group was statistically significantly lower.CONCLUSIONS: Remote monitoring in children with DM1 resulted in significant improvements in glycemic control (HbA1c, glycemic variability, and hypoglycemic frequency). The accumulation of evidence on the effectiveness and safety of telehealth in DM should contribute to implementing this approach in practical health care.

scholarly journals Monthly Video-Consultation for Children With Type 1 Diabetes Using a Continuous Glucose Monitoring System: Design of ViDiKi, a Multimethod Intervention Study to Evaluate the Benefit of Telemedicine

2019 ◽  
Vol 14 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Fabian-Simon Frielitz ◽  
Esther Müller-Godeffroy ◽  
Joachim Hübner ◽  
Nora Eisemann ◽  
Jana Dördelmann ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Cost Of Care ◽  
Insulin Pump Therapy ◽  
Control Group ◽  
Video Consultation

Background: The introduction of continuous glucose monitoring (CGM) implies new challenges for diabetes care. As CGM systems are often directly linked to a web-based software solution, structured telemedicine care using a video-consultation may be a new option for families who care for children with type 1 diabetes mellitus (T1DM). Methods: “ViDiKi” (Virtual Diabetes Outpatient Clinic for Children and Youth) is a multicenter controlled trial carried out in Northern Germany. ViDiKi will examine if monthly telemedical consultations, in addition to regular care, will improve glycemic control and psychosocial outcomes. The primary outcome is glycemic control as measured by a change in glycated hemoglobin (HbA1c). A total of 240 participants aged between one year and 16 years using a CGM with multiple daily injections (MDI) or insulin pump therapy were recruited and assigned to a starter group or a six-month waiting control group. The sample size is designed to detect a between-group difference of 0.5% in HbA1c change at six months. Secondary outcomes are variability of blood glucose, health-related quality of life, self-efficacy, and satisfaction with telemedicine. To gain deeper insight into the experience of using telemedicine, qualitative interviews will be conducted. In a health-economic analysis, the costs of telemedicine and a cost-of-care analysis will be calculated. Conclusions: The results from the ViDiKi study shall give important information on the feasibility and putative benefits of telemedicine in children with T1DM and their caregivers. German Clinical Trails Register (DRKS): DRKS00012645

scholarly journals Effects of Alternate Insulin Pump Settings in Patients With Type 1 Diabetes During Ramadan: A Randomized Pilot Study

2021 ◽  
pp. 193229682110592
Author(s):  
Ghufran AlGhatam ◽  
Derek O’Keeffe ◽  
Husain Taha
Keyword(s):  
Type 1 Diabetes ◽  
Pilot Study ◽  
Glycemic Control ◽  
Basal Insulin ◽  
Insulin Pump ◽  
Intervention Group ◽  
Control Group ◽  
Insulin Pumps ◽  
Significant Difference

Background: Various studies have evaluated the safety and efficacy of using insulin pumps during Ramadan; some of them demonstrated favorable outcomes in reducing hypoglycemia and hyperglycemia. However, there is no consensus on the recommendations for basal insulin adjustments and the utilization of technical features of insulin pumps to improve glycemic control. Objectives: We aimed to investigate the effects of different insulin pump settings on time in range in patients with type 1 diabetes during Ramadan. Methods: In this randomized pilot study, 30 patients classified to have low to moderate risk for fasting were assigned to either a control group to receive basal insulin adjustments only or an intervention group to use the temporary basal rate and extended bolus features in addition to the basal insulin modifications. The percentage of time spent at different glucose ranges was measured by continuous glucose monitoring. Results: The percentage of time spent within target (70-180 mg/dL) increased significantly in the intervention group from 63.0 ± 10.7 to 76 ± 16.2% (mean difference, 27% points; P < .001). The percentage of time spent in hyperglycemia level 1 (>180 mg/dL) and level 2 (>250 mg/dL) met the criterion of significance, indicating that the intervention group spent less time in hyperglycemia. However, there was no significant difference in the percentage of time spent in hypoglycemia ranges. Conclusions: Incorporating technological approaches of pump therapy with clinical practice guidelines could improve glycemic control during Ramadan.

Glycemic Control in Transition‐Aged Versus Early Adults with Type 1 Diabetes and the Effect of a Government‐Funded Insulin Pump Program

2021 ◽  
Author(s):  
Shane P Mooney ◽  
Gillian L Booth ◽  
Rayzel Shulman ◽  
Yingbo Na ◽  
Alanna Weisman ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Insulin Pump

823-P: Insulin Pump Use and Glycemic Control among Patients with Type 1 Diabetes: Trends from the T1DX-QI Cohort

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 823-P
Author(s):  
NUDRAT NOOR ◽  
RYAN MCDONOUGH ◽  
EMILY CARLSON ◽  
ALLISON B. MEKHOUBAD ◽  
SUSAN HSIEH ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Insulin Pump ◽  
Diabetes Trends

scholarly journals Effect of high-intensity interval training on glycemic control in adults with type 1 diabetes with overweight or obesity: a randomized controlled trial with partial cross-over

2020 ◽  
Author(s):  
Angela S Lee ◽  
Nathan A Johnson ◽  
Margaret McGill ◽  
Jane Overland ◽  
Connie Luo ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
High Intensity ◽  
Intervention Group ◽  
Interval Training ◽  
Control Group ◽  
High Intensity Interval Training ◽  
High Intensity Interval ◽  
Overweight Or Obesity

<b>Objective:</b> To study the effect of 12 weeks of high-intensity interval training (HIIT) on glycemic control in adults with type 1 diabetes with overweight or obesity. <p> </p> <p><b>Research Design and Methods:</b> Thirty inactive adults with type 1 diabetes who had BMI≥25kg/m<sup>2</sup> and HbA1c≥7.5% were randomized to 12 weeks of either: HIIT exercise intervention consisting of 4x4 minutes HIIT (85-95% HRpeak) performed thrice weekly, or usual care control. In a partial cross-over design, the control group subsequently performed the 12-week HIIT intervention. The primary endpoint was the change in HbA1c from baseline to 12 weeks. Glycemic and cardiometabolic outcomes were measured at 0, 12, and 24 weeks.</p> <p> </p> <p><b>Results:</b> Participants were aged 44±10 years, with diabetes duration 19±11 years, and BMI 30.1±3.1 kg/m<sup>2</sup>.<sup> </sup>HbA1c decreased from 8.63 ± 0.66% at baseline to 8.10 ± 1.04% at 12 weeks in the HIIT intervention group (p=0.01), however this change was not significantly different to the control group (HIIT -0.53 ± 0.61%, control -0.14 ± 0.48%, p=0.08). In participants who undertook at least 50% of the prescribed HIIT intervention, the HbA1c reduction was significantly greater than control (HIIT -0.64 ± 0.64% (n=9), control -0.14 ± 0.48% (n=15), p=0.04). There were no differences in insulin dose, hypoglycemia on continuous glucose monitoring, blood pressure, blood lipids, body weight or body composition between groups. </p> <p> </p> <p><b>Conclusions:</b> <a>Overall, there was no significant reduction in HbA1c with a 12-week HIIT intervention in adults with type 1 diabetes. However glycaemic control may improve for people who undertake HIIT with greater adherence.</a></p>

Factors associated with glycemic control in adult type 1 diabetes patients treated with insulin pump therapy

Endocrine ◽  
2014 ◽  
Vol 48 (1) ◽  
pp. 164-169 ◽  
Author(s):  
Bartłomiej Matejko ◽  
Jan Skupien ◽  
Sandra Mrozińska ◽  
Małgorzata Grzanka ◽  
Katarzyna Cyganek ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Adult Type ◽  
Factors Associated ◽  
Diabetes Patients
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