scholarly journals Travelling Across Time Zones With Type 1 Diabetes: A Pilot Study Comparing Insulin Degludec With Insulin Glargine U100

2021 ◽  
Author(s):  
Wendy C. Bevier ◽  
Kristin N. Castorino ◽  
Ceara Axelrod ◽  
Gal Haroush ◽  
Christian C. Farfan ◽  
...  
Keyword(s):  
New York ◽  
Type 1 Diabetes ◽  
Pilot Study ◽  
Insulin Degludec ◽  
Multiple Time ◽  
Time Zone ◽  
Significant Difference ◽  
Time Zones ◽  
Glycemic Outcomes

<b>Objective </b> <p>For people with type 1 diabetes, there are limited evidence-based resources to support self-management when traveling across multiple time zones<i>. </i>Here, we compared glycemic control on Insulin Degludec versus GlargineU100 as the basal insulin for adults using multiple daily injections (MDI) while travelling across multiple time zones.<i></i></p> <p> </p> <p><b>Research Design and Methods</b></p> <p>This randomized crossover pilot study compared Insulin Degludec versus Glargine U100 for adults with type 1 diabetes using MDI insulin during long-haul travel to and from Hawaii to New York. Insulin Degludec was administered daily at the same time regardless of time zone and Glargine was administered per travel algorithm. Primary endpoint was percent time in range (TIR) between 70-140 mg/dl during the initial 24 hours after each direction of travel. Secondary endpoints include standard continuous glucose monitoring metrics, jet lag, fatigue and sleep.</p> <p> </p> <p><b>Results</b></p> <p>A total of 25 participants were enrolled in the study [56% female, age 35 ±14.5 (mean ±SD) years, HbA<sub>1C</sub> of 7.4 ±1.2% (57±13.1 mmol/mol), diabetes duration of 20.6 ±15 years). There was no significant difference in glycemic outcomes between the two arms of the study including TIR, hypoglycemia or hyperglycemia. Neither group achieved >70% TIR 70-180 mg/dL during travel. Jetlag was greater on Glargine U100 in Eastward travel but not Westward. Fatigue was greater after Westward travel on Glargine. Sleep was not significantly different between basal insulins.</p> <p><b> </b></p> <p><b>Conclusion</b></p> <p>In adults with type 1 diabetes using MDI of insulin and travelling across multiple time zones, glycemic outcomes were similar comparing Insulin Degludec and Glargine U100.</p>

scholarly journals Travelling Across Time Zones With Type 1 Diabetes: A Pilot Study Comparing Insulin Degludec With Insulin Glargine U100

2021 ◽  
Author(s):  
Wendy C. Bevier ◽  
Kristin N. Castorino ◽  
Ceara Axelrod ◽  
Gal Haroush ◽  
Christian C. Farfan ◽  
...  
Keyword(s):  
New York ◽  
Type 1 Diabetes ◽  
Pilot Study ◽  
Insulin Degludec ◽  
Multiple Time ◽  
Time Zone ◽  
Significant Difference ◽  
Time Zones ◽  
Glycemic Outcomes

<b>Objective </b> <p>For people with type 1 diabetes, there are limited evidence-based resources to support self-management when traveling across multiple time zones<i>. </i>Here, we compared glycemic control on Insulin Degludec versus GlargineU100 as the basal insulin for adults using multiple daily injections (MDI) while travelling across multiple time zones.<i></i></p> <p> </p> <p><b>Research Design and Methods</b></p> <p>This randomized crossover pilot study compared Insulin Degludec versus Glargine U100 for adults with type 1 diabetes using MDI insulin during long-haul travel to and from Hawaii to New York. Insulin Degludec was administered daily at the same time regardless of time zone and Glargine was administered per travel algorithm. Primary endpoint was percent time in range (TIR) between 70-140 mg/dl during the initial 24 hours after each direction of travel. Secondary endpoints include standard continuous glucose monitoring metrics, jet lag, fatigue and sleep.</p> <p> </p> <p><b>Results</b></p> <p>A total of 25 participants were enrolled in the study [56% female, age 35 ±14.5 (mean ±SD) years, HbA<sub>1C</sub> of 7.4 ±1.2% (57±13.1 mmol/mol), diabetes duration of 20.6 ±15 years). There was no significant difference in glycemic outcomes between the two arms of the study including TIR, hypoglycemia or hyperglycemia. Neither group achieved >70% TIR 70-180 mg/dL during travel. Jetlag was greater on Glargine U100 in Eastward travel but not Westward. Fatigue was greater after Westward travel on Glargine. Sleep was not significantly different between basal insulins.</p> <p><b> </b></p> <p><b>Conclusion</b></p> <p>In adults with type 1 diabetes using MDI of insulin and travelling across multiple time zones, glycemic outcomes were similar comparing Insulin Degludec and Glargine U100.</p>

scholarly journals Travelling Across Time Zones With Type 1 Diabetes: A Pilot Study Comparing Insulin Degludec With Insulin Glargine U100

Diabetes Care ◽  
2021 ◽  
pp. dc211524
Author(s):  
Wendy C. Bevier ◽  
Kristin N. Castorino ◽  
Ceara Axelrod ◽  
Gal Haroush ◽  
Christian C. Farfan ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Pilot Study ◽  
Insulin Glargine ◽  
Insulin Degludec ◽  
Time Zones

800-P: Sleep Quality for Adults with Type 1 Diabetes Using Multiple Daily Injections (MDI) of Insulin Flying across Multiple Time Zones: A Pilot Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 800-P
Author(s):  
WENDY C. BEVIER ◽  
KRISTIN N. CASTORINO ◽  
CHRISTIAN C. FARFAN ◽  
GAL HAROUSH ◽  
MIKAYLA R. MEFFORD ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Pilot Study ◽  
Sleep Quality ◽  
Multiple Time ◽  
Multiple Daily Injections ◽  
Time Zones

1031-P: Comparison of Two Approaches to Basal Insulin Management for Adults with Type 1 Diabetes Flying across Multiple Time Zones

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1031-P
Author(s):  
CEARA AXELROD ◽  
KRISTIN N. CASTORINO ◽  
WENDY C. BEVIER ◽  
GAL HAROUSH ◽  
CHRISTIAN C. FARFAN ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Basal Insulin ◽  
Multiple Time ◽  
Time Zones

scholarly journals A Pilot Study of Flat and Circadian Insulin Infusion Rates in Continuous Subcutaneous Insulin Infusion (CSII) in Adults with Type 1 Diabetes (FIRST1D)

2020 ◽  
pp. 193229682090619
Author(s):  
Siân Rilstone ◽  
Monika Reddy ◽  
Nick Oliver
Keyword(s):  
Type 1 Diabetes ◽  
Pilot Study ◽  
Insulin Infusion ◽  
Insulin Dose ◽  
Total Daily Dose ◽  
Subcutaneous Insulin ◽  
Basal Rate ◽  
Absolute Change ◽  
Significant Difference

Background: Initiation of continuous subcutaneous insulin therapy (CSII) in type 1 diabetes requires conversion of a basal insulin dose into a continuous infusion regimen. There are limited data to guide the optimal insulin profile to rapidly achieve target glucose and minimize healthcare professional input. The aim of this pilot study was to compare circadian and flat insulin infusion rates in CSII naïve adults with type 1 diabetes. Methods: Adults with type 1 diabetes commencing CSII were recruited. Participants were randomized to circadian or flat basal profile calculated from the total daily dose. Basal rate testing was undertaken on days 7, 14 and 28 and basal rates were adjusted. The primary outcome was the between-group difference in absolute change in insulin basal rate over 24 hours following three rounds of basal testing. Secondary outcomes included the number of basal rate changes and the time blocks. Results: Seventeen participants (mean age 33.3 (SD 8.6) years) were recruited. There was no significant difference in absolute change in insulin basal rates between groups ( P = .85). The circadian group experienced significant variation in the number of changes made with the most changes in the morning and evening ( P = .005). The circadian group received a greater reduction in total insulin (−14.1 (interquartile range (IQR) −22.5-12.95) units) than the flat group (−7.48 (IQR −11.90-1.23) units) ( P = .021). Conclusion: The initial insulin profile does not impact on the magnitude of basal rate changes during optimization. The circadian profile requires changes at specific time points. Further development of the circadian profile may be the optimal strategy.

Basal and Bolus Insulin Dose Changes after Switching Basal Insulin to Insulin Degludec in Patients with Type 1 Diabetes Mellitus: A Pilot Study

2017 ◽  
Vol 37 (9) ◽  
pp. 845-852 ◽  
Author(s):  
Yoshiyuki Hamamoto ◽  
Sachiko Honjo ◽  
Kanta Fujimoto ◽  
Shinsuke Tokumoto ◽  
Hiroki Ikeda ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Pilot Study ◽  
Type 1 Diabetes Mellitus ◽  
Basal Insulin ◽  
Insulin Dose ◽  
Insulin Degludec ◽  
Bolus Insulin

scholarly journals Transition Education for Young Adults With Type 1 Diabetes: Pilot Feasibility Study for a Group Telehealth Intervention (Preprint)

2018 ◽  
Author(s):  
Anastasia Albanese-O'Neill ◽  
Giovanna Beauchamp ◽  
Nicole Thomas ◽  
Sarah C Westen ◽  
Nicole Johnson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Self Efficacy ◽  
Diabetes Education ◽  
Diabetes Distress ◽  
Mobile Web ◽  
Significant Difference ◽  
Patient Reported ◽  
Glycemic Outcomes

BACKGROUND Young adults with type 1 diabetes (T1D) experience a decline in glycemic outcomes and gaps in clinical care. A diabetes education and support program designed for young adults was delivered through group videoconference and mobile Web. OBJECTIVE The objective of our study was to assess the feasibility, acceptability, and preliminary efficacy of the program as measured by attendance and webpage views, satisfaction, and pre- and postintervention psychosocial outcomes, respectively. METHODS Young adults aged 18-25 years were recruited to attend five 30-minute group diabetes education videoconferences during an 8-week period. Videoconferences included an expert presentation followed by a moderated group discussion. Within 48 hours of each videoconference, participants were sent a link to more information on the study website. Feasibility was assessed using data on videoconference attendance and webpage views. Acceptability was assessed via a Satisfaction Survey completed at the conclusion of the study. Descriptive statistics were generated. Preliminary efficacy was assessed via a survey to measure changes in diabetes-specific self-efficacy and diabetes distress. Pre- and postintervention data were compared using paired samples t tests. RESULTS In this study, 20 young adults (mean age 19.2 [SD 1.1] years) attended an average of 5.1 (SD 1.0) videoconferences equivalent to 153 (SD 30.6) minutes of diabetes education per participant during an 8-week period. Average participant satisfaction scores were 62.2 (SD 2.6) out of a possible 65 points. A total of 102 links sent via text message (short message service) or email resulted in 504 webpage views. There was no statistically significant difference between pre- and postintervention diabetes-specific self-efficacy or diabetes-related distress. CONCLUSIONS Delivery of diabetes education via group videoconference using mobile Web follow-up is feasible and acceptable to young adults with T1D. This model of care delivery has the potential to improve attendance, social support, and patient-reported satisfaction. Nevertheless, further research is required to establish the effect on long-term psychosocial and glycemic outcomes.

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