502-P: Introduction of a Gluten-Free Diet in Children with Type 1 Diabetes and Coeliac Disease Did Not Impact Glycemic Control, Nutrient Intake, or Quality of Life at Three Months

Abstract Context Celiac disease (CD) is a common comorbidity seen in patients with type 1 diabetes (T1D) and is frequently asymptomatic. As chronic conditions requiring significant lifestyle changes, there are limited reports assessing changes in health-related quality of life (HRQoL) during transition to a gluten-free diet (GFD) in patients with both T1D and who are asymptomatic for CD. Objective To prospectively assess HRQoL and health perception in children and adults with T1D and asymptomatic CD after randomization to GFD versus usual diet. Design, Setting, and Participants Patients with T1D aged 8-45 years without CD symptoms were serologically screened for CD, with positive results confirmed with intestinal biopsy. Participants were randomized in an open-label fashion to a GFD or gluten-containing diet (GCD) for 12 months. Generic and diabetes-specific HRQoL and self-perceived wellness (SPW) were assessed longitudinally. Results 2,387 T1D patients were serologically screened. CD was biopsy-confirmed in 82 patients and 51 participants were randomized to a GFD (N=27) or GCD (N=24). Excellent adherence to the assigned diets was observed. Overall, no changes in generic (P=0.73) or diabetes-specific HRQoL (P=0.30), or SPW (P=0.41) were observed between groups over 12 months. HemoglobinA1c (HbA1c) and GI symptoms were consistent predictors of HRQoL and SPW. Conclusions HRQoL and SPW were not significantly impacted by the adoption of a GFD over 12 months, but worsened with symptom onset and increased HbA1c. Our findings indicate that transition to a GFD can be made successfully in this population without adversely impacting quality of life.

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Quality of Life in Type 1 Diabetes and Celiac Disease: Role of the Gluten-Free Diet

The Journal of Pediatrics ◽

10.1016/j.jpeds.2016.08.105 ◽

2016 ◽

Vol 179 ◽

pp. 131-138.e1 ◽

Cited By ~ 11

Author(s):

Anna Pham-Short ◽

Kim C. Donaghue ◽

Geoffrey Ambler ◽

Sarah Garnett ◽

Maria E. Craig

Keyword(s):

Quality Of Life ◽

Type 1 Diabetes ◽

Celiac Disease ◽

Gluten Free Diet ◽

Gluten Free

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The impact of symptoms on quality of life before and after diagnosis of coeliac disease: the results from a Polish population survey and comparison with the results from the United Kingdom

BMC Gastroenterology ◽

10.1186/s12876-021-01673-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Emilia Majsiak ◽

Magdalena Choina ◽

Dominik Golicki ◽

Alastair M. Gray ◽

Bożena Cukrowska

Keyword(s):

Quality Of Life ◽

United Kingdom ◽

Coeliac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

The United Kingdom ◽

Before And After ◽

The Mean ◽

The Uk

Abstract Background Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients’ quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. Methods The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. Results The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p < 0.001), the EQ-Index by 0.149 (SD 0.23) and the EQ-VAS by 30.4 (SD 28.3) points. Conclusions Duration of symptoms prior to the diagnosis of CD in Poland, although shorter than in the UK, was long with an average of 7.3 years from first CD symptoms. Faster CD diagnosis after the onset of symptoms in Polish respondents may be related to a higher percentage of children in the Polish sample. Introduction of a gluten-free diet improves coeliac patients’ quality of life. These results suggest that doctors should be made more aware of CD and its symptoms across all age groups.

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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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Use of a do-it-yourself artificial pancreas system is associated with better glucose management and higher quality of life among adults with type 1 diabetes

Therapeutic Advances in Endocrinology and Metabolism ◽

10.1177/2042018820950146 ◽

2020 ◽

Vol 11 ◽

pp. 204201882095014

Author(s):

Zekai Wu ◽

Sihui Luo ◽

Xueying Zheng ◽

Yan Bi ◽

Wen Xu ◽

...

Keyword(s):

Quality Of Life ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Artificial Pancreas ◽

Pump Therapy ◽

Quality Of Life Scale ◽

Do It Yourself ◽

Glucose Management

Background: Previous studies show that the use of do-it-yourself artificial pancreas system (DIYAPS) may be associated with better glycemic control characterized by improved estimated hemoglobin A1c (eHbA1c) and time in range among adults with type 1 diabetes (T1D). However, few studies have demonstrated the changes in laboratory-measured HbA1c, which is a more accepted index for glycemic control, after using a DIYAPS. Methods: This is a retrospective before-after study approaching patients who reported self-use of AndroidAPS. The main inclusion criteria included: T1D; aged ⩾18 years; having complete record of ⩾3 months of continuous AndroidAPS use; with laboratory-measured HbA1c and quality of life scale data before and after 3 months of AndroidAPS use; and not pregnant. The primary outcome was the change in HbA1c between baseline and 3 months after initiation of AndroidAPS use. Results: Overall, 15 patients (10 females) were included; the median age was 32.2 years (range: 19.2–69.4), median diabetes duration was 9.7 years (range: 1.8–23.7) and median baseline HbA1c was 7.3% (range: 6.4–10.1). The 3 months of AndroidAPS use was associated with substantial reductions in HbA1c [6.79% (SD: 1.29) versus 7.63% (SD: 1.06), p = 0.002] and glycemic variability when compared with sensor-augmented pump therapy. A lower level of fear of hypoglycemia [22.13 points (SD: 6.87) versus 26.27 points (SD: 5.82), p = 0.010] was also observed after using AndroidAPS. Conclusions: The 3 months of AndroidAPS use was associated with significant improvements in glucose management and quality of life among adults with T1D.

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Impact of Real-Time CGM Data Sharing on Quality of Life in the Caregivers of Adults and Children with Type 1 Diabetes

Journal of Diabetes Science and Technology ◽

10.1177/1932296820978423 ◽

2020 ◽

pp. 193229682097842

Author(s):

William H. Polonsky ◽

Addie L. Fortmann

Keyword(s):

Quality Of Life ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Health Outcomes ◽

Real Time ◽

Data Sharing ◽

Diabetes Management ◽

Health Benefits

Background: To examine caregivers’ experiences with real-time continuous glucose monitoring (RT-CGM) data sharing and its impact on quality of life (QoL) and health outcomes. Methods: Parents of children with type 1 diabetes (T1D) ( N = 303) and spouses/partners of T1D adults ( N = 212) using the Dexcom G5 Mobile or G6 RT-CGM system and who were actively following their T1Ds’ RT-CGM data completed a survey examining their perceived value of data sharing, the impact of sharing on their own QoL and their child/partner’s health, and how they used RT-CGM data to support their T1Ds’ diabetes management. Regression analyses examined whether their actions were linked to reported changes in QoL and health outcomes. Results: Respondents were predominantly non-Hispanic White (91.1% parents; 88.7% partners), female (78.2% parents; 54.7% partners), and college-educated (65.3% parents; 61.8% partners). The majority reported that data sharing had enhanced hypoglycemic confidence (97.7% parents; 98.1% partners), overall well-being (60.4% parents; 63.2% partners), and sleep quality (78.0% parents; 61.3% partners). Of note, three positive caregiver actions were broadly consistent and significant predictors of QoL and health benefits for both parents and partners: celebrating success related to glycemic control, providing encouragement when glycemic control is challenging, and teamwork discussions about how the caregiver should respond to out-of-range values. Conclusions: RT-CGM data sharing was associated with a range of QoL and health benefits for caregivers. Degree of benefits was influenced by the collaborative actions taken by caregivers to support their child’s or partner’s diabetes management. To determine the most effective strategies for collaborative data sharing, longitudinal trials are needed.

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