MyT1DHero, an mHealth-Based Intervention, For Adolescents with Type 1 Diabetes and Their Parents: A Pilot Study (Preprint)

BACKGROUND Type 1 diabetes (T1D) impacts more than 165,000 individuals under the age of 20 in the United States. The transition from parent management to parent-child team management, with the child taking on increased levels of self-care, can be stressful and is associated with a deterioration in self-management behaviors. A mobile app intervention, MyT1DHero was designed to facilitate diabetes specific positive parent-adolescent communication. OBJECTIVE To conduct a pilot test to determine the efficacy of the MyT1DHero app intervention. METHODS This pilot study included 30 adolescent-parent pairs in a 12-week single arm clinical trial. RESULTS The final analysis included 25 families. The mean age of the adolescents was 12.281.62 years old. Half of the participants reported a diagnosis of fewer than five years. After 12-weeks, diabetes adherence significantly improved (P=.02) as did quality of life (P=0.01). HbA1c level (P=.51) and family conflict (P=0.14) changed in the hypothesized direction, but the change was not significant. However, higher use of the mobile app was associated with more improvement in HbA1c, (F(1, 20)=9.74, P<.01, R2=.33). Overall, the adolescents were satisfied with app intervention. CONCLUSIONS In a 12-week pilot study of the mobile app intervention designed to facilitate parent-adolescent communication, significant benefits were demonstrated in adherence and quality of life. A randomized controlled trial with a longer intervention is needed to replicate these findings and determine the stability of intervention effects. CLINICALTRIAL NCT03436628

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The Association between a Low Carbohydrate Diet, Quality of Life and Glycemic Control in Australian Adults living with Type 1 Diabetes: A Pilot Study Protocol (Preprint)

JMIR Research Protocols ◽

10.2196/25085 ◽

2020 ◽

Author(s):

Janine Paul ◽

Rati Jani ◽

Peter Davoren ◽

Cathy Knight-Agarwal

Keyword(s):

Quality Of Life ◽

Type 1 Diabetes ◽

Pilot Study ◽

Glycemic Control ◽

Diet Quality ◽

Carbohydrate Diet ◽

Low Carbohydrate Diet ◽

Low Carbohydrate

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The Future of Clinical Islet Transplantation in the United States

10.21926/obm.transplant.2101140 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Michael F Knoll ◽

Carmela A Knoll ◽

Rita Bottino ◽

Massimo Trucco ◽

Suzanne Bertera ◽

...

Keyword(s):

Quality Of Life ◽

United States ◽

Type 1 Diabetes ◽

Islet Transplantation ◽

Drug Administration ◽

The United States ◽

Clinical Islet Transplantation ◽

The World

Clinical islet transplantation was first realized over four decades ago at the University of Minnesota. Autologous islet transplantation is now widely recognized as a treatment to prevent diabetes in patients after pancreas excision and is offered at major transplant centers throughout the United States and the world. Type 1 diabetes represents a much larger demographic in which islet transplantation may benefit patients. Allogeneic islet transplantation can now offer similar outcomes to pancreas transplantation in a subset of patients with labile type 1 diabetes with less risk than whole organ transplantation. It is recognized as a standard of care in nations around the world but not in the United States, despite the important developmental role US scientists and physicians have played. Early reports of islet transplantation focused on insulin independence that proved to diminish over time. However, regardless of insulin status, islet transplantation provides benefits ranging from improved quality of life to reduction in diabetic complications. A National Institutes of Health sponsored multi-center Phase 3 Clinical Trial (CIT-07) demonstrated safety and efficacy, although the Food and Drug Administration chose to consider islets as a biologic that requires licensure, which makes offering the procedure in the clinic very challenging. Until regulations can be brought into communion with international standards, allogeneic islet transplantation in the United States is unlikely to match international levels of success and once promising programs are left to wither on the vine. Food and Drug Administration approval would open the door for third party medical reimbursement and allow many patients the opportunity to enjoy better health and quality of life. Establishment of clinical islet transplantation for type 1 diabetes would lead to optimizations in procedures making it more efficacious and cost effective while offering support for ongoing islet xenotransplantation studies that could bring islet transplantation to even more patients.

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

Diabetes Mellitus ◽

10.14341/dm12776 ◽

2022 ◽

Vol 24 (5) ◽

pp. 404-413

Author(s):

D. N. Laptev ◽

I. A. Eremina ◽

A. V. Karpushkina ◽

E. E. Petryaykina ◽

O. B. Bezlepkina ◽

...

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Type 1 Diabetes Mellitus ◽

Mobile Application ◽

Mobile App ◽

Target Range

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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