scholarly journals Possibilities of using continuous glycemic monitoring to assess the effectiveness of therapy in patients with MODY-diabetes

2020 ◽  
pp. 26-31
Author(s):  
A. K. Ovsyannikova ◽  
M. V. Ryabets ◽  
O. D. Rymar
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Young People ◽  
Glycemic Variability ◽  
Clinical Consequence ◽  
Normal Ranges ◽  
Pathogenetic Therapy ◽  
Oral Hypoglycemic Drugs ◽  
Glycemic Monitoring

Verification of the type of diabetes mellitus in young people is of high clinical significance in the clinical practice since the purpose of treatment depends on this: from the correction of carbohydrate metabolism by a rational diet to the administration of oral hypoglycemic drugs and insulin therapy. The chosen therapy has a significant impact on the quality of life of the patient. With the most common types of diabetes in young people the appointment of therapy is not in doubt, since with type 1 diabetes mellitus there is an absolute need for the maintenance of exogenous insulin, and with type 2 the administration of metformin is pathogenetically substantiated. In more rare forms of diabetes which MODY belongs to sulfonylurea preparations are recommended in most cases and there are few conflicting data on the effects of newer classes (DPP4, SGLT2 inhibitors, GLP1 agonists) with monogenic forms. Using the method of continuous monitoring of glucose (CGMS) and glycemic variability indicators it is possible to determine the effectiveness of various classes of sugar-lowering drugs for rare types of diabetes mellitus which will help practitioners in choosing therapy. In the literature single studies using CGMS have been described in this group of patients. In Turkey CGMS was performed for 8 patients with GCK-MODY; it was shown that in 50% of patients the glucose values during the day exceeded the normal ranges. Italian scientists conducted a study in which they diagnosed glycemic variability, in particular episodes of hypoglycemia, in patients with HNF4AMODY diabetes (MODY1) using CGMS. The clinical consequence of episodes of asymptomatic hypoglycemia in the MODY cohort remains unknown. Diagnosing the predominance of fasting or postprandial hyperglycemia, the determination of hypoglycemia can help in the appointment of pathogenetic therapy and improve the quality of life of people diagnosed with MODY-diabetes.

Effectiveness of mobile applications on healthy lifestyles aimed at diabetic patients: review of systematic reviews. (Preprint)

2019 ◽  
Author(s):  
Francisco Jesús Represas Carrera Sr ◽  
Ángel Alfredo Martínez Ques Sr ◽  
Ana Clavería Fontán Sr
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Systematic Reviews ◽  
Mobile Applications ◽  
Control Group ◽  
Diabetic Patients ◽  
Healthy Lifestyles ◽  
Major Public Health Problem

BACKGROUND Diabetes mellitus is currently a major public health problem worldwide. It is traditionally approached in a clinical inpatient relationship between the patient and the healthcare professional. However, the rise of new technologies, particularly mobile applications, is revolutionizing the traditional healthcare model through the introduction of telehealthcare. OBJECTIVE (1) To assess the effects of mobile applications for improving healthy lifestyles on the quality of life and metabolic control of diabetes mellitus in adult patients. (2) To describe the characteristics of the mobile applications used, identify the healthy lifestyles they target, and describe any adverse effects their use may have. METHODS Review of systematic reviews and meta-analysis, following the guidelines of the Cochrane Collaboration and the Joanna Briggs Institute. We included studies that used any mobile application aimed at helping patients improve self-management of diabetes mellitus by focusing on healthy lifestyles. Studies needed to include a control group receiving regular care without the use of mobile devices. In May 2018, a search was conducted in Medline, Embase, Cochrane, LILACS, PsychINFO, Cinahl and Science Direct, updated in May 2019. The methodological quality of the studies was assessed using the Amstar-2 tool. RESULTS Seven systematic reviews of 798 articles were initially selected for analysis. The interventions had a duration of between 1 and 12 months. Mobile applications focused singly or simultaneously on different lifestyles aspects (diet, physical exercise, motivation, blood glucose levels, etc.). There are significant changes in HbA1c values, body weight and BMI, although in others, such as lipid profile, quality of life, or blood pressure, there is no clear improvement. CONCLUSIONS There is clear evidence that the use of mobile applications improves glycemic control in diabetic patients in the short term. There is a lack of evidence in its long-term benefits. It is thus necessary to carry out further studies to learn about the long-term effectiveness of mobile applications aimed at promoting the healthy lifestyles of diabetic patients. CLINICALTRIAL PROSPERO Register: CRD42019133685

Co-Design and Open Trial of Starship Rescue, a Cognitive Behavior Therapy, Biofeedback, and Game-Based eHealth Intervention to Treat Anxiety in Children and Young People with Long-Term Physical Conditions (Preprint)

2020 ◽  
Author(s):  
Hiran Thabrew ◽  
Karolina Stasiak ◽  
Harshali Kumar ◽  
Tarique Naseem ◽  
Christopher Frampton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
New Zealand ◽  
Young People ◽  
Preliminary Evidence ◽  
Children And Young People ◽  
Physical Conditions ◽  
System Usability Scale ◽  
Ehealth Intervention

BACKGROUND Approximately 10% to 12% of New Zealand children and young people have long-term physical conditions (also known as chronic illnesses) and are more likely to develop psychological problems, particularly anxiety and depression. Delayed treatment leads to worse physical and mental healthcare, school absence, and poorer long-term outcomes. Recently, electronic health (eHealth) interventions, especially those based on the principles of Cognitive Behavior Therapy (CBT), have been shown to be as good as face-to-face therapy. Biofeedback techniques have also been shown to enhance relaxation during the treatment of anxiety. However, these modalities have rarely been combined. Young people with long-term physical conditions have expressed a preference for well-designed and technologically-based support to deal with psychological issues, especially anxiety. OBJECTIVE This study aimed to co-design and evaluate the (i) acceptability and (ii) usability of a CBT and biofeedback-based, 5-module eHealth game called ‘Starship Rescue’ and (iii) to provide preliminary evidence regarding its effectiveness in addressing anxiety and quality of life in young people with long-term physical conditions. METHODS Starship Rescue was co-designed with children and young people from a tertiary hospital in Auckland, New Zealand. Following this, 24 young people aged 10 to 17 years were enrolled in an open trial, during which they were asked to use the game for an 8-week period. Acceptability of the game to all participants was assessed using a brief, open-ended questionnaire, and more detailed feedback was obtained from a subset of 10 participants via semi-structured interviews. Usability was evaluated via the System Usability Scale (SUS) and device-recorded frequency and duration of access on completion of the game. Anxiety levels were measured prior to commencement, on completion of the game, and 3 months later using the Generalized Anxiety Disorder 7-item scale (GAD-7) and Spence Child Anxiety Scales (SCAS), and at the start of each module and at the end of the game using an embedded Likert/visual analog scale. Quality of life was measured prior to commencement and on completion of the game using the Pediatric Quality of Life Scale (PEDS-QL). RESULTS Users gave Starship Rescue an overall rating of 5.9 out of 10 (range 3-10 and a mean score of 71 out of 100 (SD 11.7; min 47.5; max 90) on the System Usability Scale (SUS). The mean time period for use of the game was just over 11-weeks (78.8 days, 13.5 hours, 40 minutes). Significant reductions in anxiety were noted between the start and end of the game on the GAD-7 (-4.6 (p=0.000)), SCAS (-9.6 (p=0.005)), and the Likert/visual analogue scales (-2.4 (p=0.001)). Quality of life also improved on the PedsQL scale (+4.3 (p=0.042)). All changes were sustained at 3-month follow-up. CONCLUSIONS This study provides preliminary evidence for Starship Rescue being an acceptable, usable and effective eHealth intervention for addressing anxiety in young people with long-term physical conditions. Further evaluation is planned via a more formal randomized controlled trial. CLINICALTRIAL Australian New Zealand Clinical Trials Network Registry (ANZCTR): ACTRN12616001253493p;https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371443 (Archived by WebCite at http://www.webcitation.org/6sYB716lf)

Self Management Menentukan Kualitas Hidup Pasien Diabetes Mellitus

2019 ◽  
Vol 4 (2) ◽  
pp. 402
Author(s):  
Iskim Luthfa ◽  
Nurul Fadhilah
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Correlation Study ◽  
Self Management ◽  
Rank Test ◽  
P Value ◽  
Cross Sectional ◽  
Spearman Rank ◽  
Consecutive Sampling

<p><em>People with diabetes mellitus are at risk of developing complications, so that it affects the quality of life. These complications can be minimized through self-care management. This study aims to determine the relationship between self management with the quality of life for people with diabetes mellitus. This research is a kind of quantitative research with correlation study. This research used cross sectional design. The sampling technique uses non probability with estimation consecutive sampling. The number of respondents in this research are 118 respondents. Instrument for measuring self management used diabetes self management questionnaire (DSMQ), and instruments to measure quality of life used quality of life WHOQOL-BREEF. The data obtained were processed statistically by using spearman rank test formula and p value of 0,000 There is a significant relationship of self management with the quality of life of people with diabetes mellitus.</em></p><p> </p><p><em>Penderita </em><em>Diabetes mellitus </em><em>beresiko mengalami komplikasi yang dapat mempengaruhi kualitas hidupnya. Komplikasi tersebut dapat diminimalkan melalui manajemen perawatan diri (self management). Penelitian ini bert</em><em>ujuan </em><em>untuk</em><em> menganalisis hubungan self management dengan kualitas hidup pasien diabetes melitus. </em><em>Jenis p</em><em>enelitian ini </em><em>adalah</em><em> deskriptif korelasi</em><em> dengan desain cross sectional</em><em>. Teknik pengambilan sampel menggunakan non probability </em><em>sampling </em><em>dengan pendeka</em><em>t</em><em>an consecutive sampling</em><em>.</em><em> </em><em>J</em><em>umlah </em><em>sampel sebanyak</em><em> </em><em>118 responden.</em><em> </em><em>Instrumen </em><em>penelitian </em><em>untuk mengukur self management </em><em>menggunakan</em><em> </em><em>diabetes self management questionnaire</em><em> (DSMQ), </em><em>dan instrumen untuk mengukur kualitas hidup menggunakan </em><em>quality of life </em><em>WHOQOL-BREEF.</em><em> Analisis data menggunakan spearman rank dan didapatkan hasil nilai </em><em>p value 0,000</em><em> dan r 0,394.Terdapat </em><em>hubungan </em><em>antara </em><em>self management</em><em> dengan kualitas hidup pasien diabetes mellitus</em><em> dengan arah korelasi positif.</em></p>

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