931-P: Supporting Physical Activity in Children with Type 1 Diabetes: A Survey of Health Care Professionals

In people with type 1 diabetes mellitus (T1DM), obtaining good glycemic control is essential to reduce the risk of acute and chronic complications. Frequent glucose monitoring allows the adjustment of insulin therapy to improve metabolic control with near-normal blood glucose concentrations. The recent development of innovative technological devices for the management of T1DM provides new opportunities for patients and health care professionals to improve glycemic control and quality of life. Currently, in addition to traditional self-monitoring of blood glucose (SMBG) through a glucometer, there are new strategies to measure glucose levels, including the detection of interstitial glucose through Continuous Glucose Monitoring (iCGM) or Flash Glucose Monitoring (FGM). In this review, we analyze current evidence on the efficacy and safety of FGM, with a special focus on T1DM. FGM is an effective tool with great potential for the management of T1DM both in the pediatric and adult population that can help patients to improve metabolic control and quality of life. Although FGM might not be included in the development of an artificial pancreas and some models of iCGM are more accurate than FGM and preferable in some specific situations, FGM represents a cheaper and valid alternative for selected patients. In fact, FGM provides significantly more data than the intermittent results obtained by SMBG, which may not capture intervals of extreme variability or nocturnal events. With the help of a log related to insulin doses, meal intake, physical activity and stress factors, people can achieve the full benefits of FGM and work together with health care professionals to act upon the information provided by the sensor. The graphs and trends available with FGM better allow an understanding of how different factors (e.g., physical activity, diet) impact glycemic control, consequently motivating patients to take charge of their health.

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Health care professionals talking: Are services for young adults with type 1 diabetes fit for purpose?

Journal of Evaluation in Clinical Practice ◽

10.1111/jep.13210 ◽

2019 ◽

Vol 26 (1) ◽

pp. 335-342 ◽

Cited By ~ 1

Author(s):

Margaret Harris ◽

Steven James ◽

Lin Perry ◽

Julia Lowe ◽

Janet Dunbabin ◽

...

Keyword(s):

Health Care ◽

Type 1 Diabetes ◽

Young Adults ◽

Health Care Professionals ◽

Fit For Purpose

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Facilitation of motivation to self-management in pediatric diabetes health care consultations with adolescents with type 1 diabetes. A qualitative triangulation study

10.21203/rs.2.15261/v2 ◽

2020 ◽

Author(s):

Rose Marie Teyken ◽

Johanne Jeppesen Lomholt ◽

Anders Jørgen Schou

Keyword(s):

Health Care ◽

Type 1 Diabetes ◽

Health Care Professionals ◽

Developmental Process ◽

Self Management ◽

Care Clinic ◽

Qualitative Research Design ◽

Pediatric Diabetes ◽

The Impact

Abstract Background. The impact of health care professionals on the motivation for self-management in adolescents with type 1 diabetes has been highlighted as important. It is, however, not well understood how pediatric diabetes health care practitioners can help adolescents become more motivated to self-management. The aim of the study was to investigate how practitioners can motivate their patients to self-management in consultation and how adolescents with type 1 diabetes experienced that consultation could facilitate motivation to self-management. Methods. Based on a qualitative research design, the study triangulated participant observations of 11 consultations at a pediatric health care clinic and 10 interviews of the adolescents (15-17 years of age) about their experiences of consultations. Using Giorgi’s phenomenological method, the analysis showed five categories important to consultation-facilitated motivation to self-management: 1. Consultation setting, 2. Consultation conversation, 3. Roles in treatment, 4. Assuming consultation-facilitated responsibility for self-management, and 5. Relationship in treatment. Results from the analysis were compared to fulfilment of the motivational needs for autonomy, competence and relatedness described in Self-Determination Theory. Results. Overall findings showed that the adolescent’s developmental process of becoming autonomous in relation to self-management was influenced by consultations, and that the need for relatedness was experienced as valued by the adolescents. Conclusions. The conclusion of the study was that relatedness and development of autonomy were experienced as important for how consultations could facilitate motivation to self-management in 15-17-year-olds and may be fundamental to adolescents’ experience of competence in relation to self-management.

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Diabetes Technological Revolution: Winners and Losers?

Journal of Diabetes Science and Technology ◽

10.1177/1932296818788872 ◽

2018 ◽

Vol 12 (6) ◽

pp. 1227-1230 ◽

Cited By ~ 3

Author(s):

Katharine D. Barnard ◽

Marc D. Breton

Keyword(s):

Health Care ◽

Type 1 Diabetes ◽

Glycemic Control ◽

Health Care Professionals ◽

Self Management ◽

Technology Access ◽

Technological Revolution ◽

Insurance Costs ◽

Technology Revolution

Over recent years there has been an explosion in availability of technical devices to support diabetes self-management. But with this technology revolution comes new hurdles. On paper, the available diabetes technologies should mean that the vast majority of people with type 1 diabetes have optimal glycemic control and are using their preferred therapy choices. Yet, it does not appear to be universally the case. In parallel, suboptimal glycemic control remains stubbornly widespread. Barriers to improvement include access to technology, access to expert diabetes health care professionals, and prohibitive insurance costs. Until access can be improved to ensure the technologies are available and usable by those that need them, there are many people with diabetes who are still losing out.

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Text Messaging and Type 1 Diabetes Management: Qualitative Study Exploring Interactions Among Patients and Health Care Professionals (Preprint)

10.2196/preprints.11343 ◽

2018 ◽

Author(s):

Francesco Miele ◽

Silvia Clementi ◽

Renzo Gennaro ◽

Ilaria Nicolao ◽

Tiziana Romanelli ◽

...

Keyword(s):

Health Care ◽

Type 1 Diabetes ◽

Pregnant Women ◽

Health Care Professionals ◽

Text Messaging ◽

Text Messages ◽

Adult Patients ◽

Specific Patient ◽

The Impact

BACKGROUND The diffusion of information and communication technologies (ICTs) in type 1 diabetes (T1D) management has generated a debate on the ways in which ICTs can support the patient-provider relationship. Several studies have focused on text messages. Most of the literature proposes quantitative analysis of the impact of text messaging on the clinical conditions of patients and/or their satisfaction with the technology, while the qualitative studies have focused mainly on patients’ perceptions about strengths and weaknesses of this technology. OBJECTIVE In contrast to past studies, we adopted a qualitative approach for the in-depth examination of patient-health care professionals’ interactions in text messaging. METHODS The study focused on the use of the Trento Cartella Clinica del Cittadino Diabetes System (TreC-DS), a digital platform with a built-in messaging system, in two diabetes centers, integrating message analysis with interviews with patients and health care professionals. Each center focused on a specific patient profile: the first one focused on pregnant women with T1D and the second one focused on adult patients with poorly controlled diabetes. RESULTS The main results of the study were as follows: (1) Health care professionals and patients perceived the messaging system as useful for sharing information (ie, pregnant women for prescriptions and adults with poorly controlled diabetes for advice); (2) The content and communication styles of the two centers differed: in the case of pregnant women, interactions via text messaging were markedly prescriptive, while in the case of adult patients with poorly controlled diabetes, they were conceived as open dialogues; and (3) Conversations were initiated mainly by professionals; in the cases considered, it was mainly the diabetes center that decided whether a messaging conversation was needed. CONCLUSIONS The results show how the features of interactions of text messaging changed based on the patient profiles in two different centers. In addition, in both diabetes centers that were involved, the system seems to have laid a foundation for a closer relationship between patients and health care professionals.

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Text Messaging and Type 1 Diabetes Management: Qualitative Study Exploring Interactions Among Patients and Health Care Professionals

JMIR Diabetes ◽

10.2196/11343 ◽

2019 ◽

Vol 4 (2) ◽

pp. e11343

Author(s):

Francesco Miele ◽

Silvia Clementi ◽

Renzo Gennaro ◽

Ilaria Nicolao ◽

Tiziana Romanelli ◽

...

Keyword(s):

Health Care ◽

Type 1 Diabetes ◽

Qualitative Study ◽

Health Care Professionals ◽

Text Messaging ◽

Diabetes Management

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Consultation-dependent motivation to self-management in adolescents with type 1 diabetes: a qualitative triangulation study

10.21203/rs.2.15261/v1 ◽

2019 ◽

Author(s):

Rose Marie Teyken ◽

Johanne Jeppesen Lomholt ◽

Anders Jørgen Schou

Keyword(s):

Health Care ◽

Type 1 Diabetes ◽

Health Care Professionals ◽

Developmental Process ◽

Self Management ◽

Care Clinic ◽

Pediatric Health Care ◽

Qualitative Research Design ◽

The Impact

Abstract Background. The impact of health care professionals on the motivation for self-management in adolescents with type 1 diabetes has been highlighted as important. It is, however, not well understood how pediatric diabetes health care practitioners can help adolescents become more motivated to self-management. The aim of the study was to investigate how practitioners can motivate their patients to self-management in consultation and how adolescents with type 1 diabetes experienced consultation-dependent motivation to self-management. Methods. Based on a qualitative research design, the study triangulated participant observations of 11 consultations at a pediatric health care clinic and 10 interviews of the adolescents (15-17 years of age) about their experiences of consultations. Using Giorgi’s phenomenological method, the analysis showed five categories important to consultation-dependent motivation to self-management: 1. Consultation setting, 2. Consultation conversation, 3. Roles in treatment, 4. Assuming consultation-dependent responsibility for self-management, and 5. Relationship in treatment. Results from the analysis were compared to fulfilment of the motivational needs for autonomy, competence and relatedness described in Self-Determination Theory. Results. Overall findings showed that the adolescent’s developmental process of becoming autonomous in relation to self-management was influenced by consultations, and that the need for relatedness was experienced as valued by the adolescents. Conclusions. The conclusion of the study was that relatedness and development of autonomy were experienced as important for consultation-dependent motivation to self-management in 15-17-year-olds and may be fundamental to adolescents’ experience of competence in relation to self-management.

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