scholarly journals Continuous Glucose Monitoring Initiation Within First Year of Type 1 Diabetes Diagnosis Is Associated With Improved Glycemic Outcomes: 7-Year Follow-Up Study

2022 ◽  
Author(s):  
Anagha Champakanath ◽  
Halis Kaan Akturk ◽  
G. Todd Alonso ◽  
Janet K Snell-Bergeon ◽  
Viral N Shah
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Monitoring ◽  
First Year ◽  
Diabetes Diagnosis ◽  
One Year ◽  
Glycemic Outcomes ◽  
Design And Methods

Objective: To evaluate long-term glycemic outcomes of CGM initiation within the first year of type 1 diabetes. <p>Research Design and Methods: 396 patients with type 1 diabetes were divided into three groups; 1) CGM [CGM use within one year of diabetes and continued through the study], 2) no-CGM [no CGM use throughout the study], 3) new-CGM [CGM use after 3 years of diabetes] and were followed up to 7-years. </p> <p>Results: A1c was significantly lower in CGM compared to no-CGM group throughout 7 years of follow-up [LS mean A1cs (%): 6-month 7.3 vs 8.1, 1-year 7.4 vs 8.6, 2-year 7.7 vs 9.1, 3-year 7.6 vs 9.3, 4-year 7.4 vs 9.6, 5-year 7.6 vs 9.7, 6-year 7.5 vs 10.0 and 7-year 7.6 vs 9.8, all p<0.001] adjusting for age at diagnosis, sex, and insulin delivery method. </p> <p>Conclusion: CGM initiation within first year of type 1 diabetes results in long-term improvement in A1c. </p>

scholarly journals Continuous Glucose Monitoring Initiation Within First Year of Type 1 Diabetes Diagnosis Is Associated With Improved Glycemic Outcomes: 7-Year Follow-Up Study

2022 ◽  
Author(s):  
Anagha Champakanath ◽  
Halis Kaan Akturk ◽  
G. Todd Alonso ◽  
Janet K Snell-Bergeon ◽  
Viral N Shah
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Monitoring ◽  
First Year ◽  
Diabetes Diagnosis ◽  
One Year ◽  
Glycemic Outcomes ◽  
Design And Methods

Objective: To evaluate long-term glycemic outcomes of CGM initiation within the first year of type 1 diabetes. <p>Research Design and Methods: 396 patients with type 1 diabetes were divided into three groups; 1) CGM [CGM use within one year of diabetes and continued through the study], 2) no-CGM [no CGM use throughout the study], 3) new-CGM [CGM use after 3 years of diabetes] and were followed up to 7-years. </p> <p>Results: A1c was significantly lower in CGM compared to no-CGM group throughout 7 years of follow-up [LS mean A1cs (%): 6-month 7.3 vs 8.1, 1-year 7.4 vs 8.6, 2-year 7.7 vs 9.1, 3-year 7.6 vs 9.3, 4-year 7.4 vs 9.6, 5-year 7.6 vs 9.7, 6-year 7.5 vs 10.0 and 7-year 7.6 vs 9.8, all p<0.001] adjusting for age at diagnosis, sex, and insulin delivery method. </p> <p>Conclusion: CGM initiation within first year of type 1 diabetes results in long-term improvement in A1c. </p>

scholarly journals Continuous Glucose Monitoring Initiation Within First Year of Type 1 Diabetes Diagnosis Is Associated With Improved Glycemic Outcomes: 7-Year Follow-Up Study

2022 ◽  
Author(s):  
Anagha Champakanath ◽  
Halis Kaan Akturk ◽  
G. Todd Alonso ◽  
Janet K Snell-Bergeon ◽  
Viral N Shah
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Monitoring ◽  
First Year ◽  
Diabetes Diagnosis ◽  
One Year ◽  
Glycemic Outcomes ◽  
Design And Methods

Objective: To evaluate long-term glycemic outcomes of CGM initiation within the first year of type 1 diabetes. <p>Research Design and Methods: 396 patients with type 1 diabetes were divided into three groups; 1) CGM [CGM use within one year of diabetes and continued through the study], 2) no-CGM [no CGM use throughout the study], 3) new-CGM [CGM use after 3 years of diabetes] and were followed up to 7-years. </p> <p>Results: A1c was significantly lower in CGM compared to no-CGM group throughout 7 years of follow-up [LS mean A1cs (%): 6-month 7.3 vs 8.1, 1-year 7.4 vs 8.6, 2-year 7.7 vs 9.1, 3-year 7.6 vs 9.3, 4-year 7.4 vs 9.6, 5-year 7.6 vs 9.7, 6-year 7.5 vs 10.0 and 7-year 7.6 vs 9.8, all p<0.001] adjusting for age at diagnosis, sex, and insulin delivery method. </p> <p>Conclusion: CGM initiation within first year of type 1 diabetes results in long-term improvement in A1c. </p>

scholarly journals Continuous Glucose Monitoring Initiation Within First Year of Type 1 Diabetes Diagnosis Is Associated With Improved Glycemic Outcomes: 7-Year Follow-Up Study

Diabetes Care ◽  
2022 ◽  
Author(s):  
Anagha Champakanath ◽  
Halis Kaan Akturk ◽  
G. Todd Alonso ◽  
Janet K. Snell-Bergeon ◽  
Viral N. Shah
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
First Year ◽  
Diabetes Diagnosis ◽  
Glycemic Outcomes ◽  
Design And Methods

OBJECTIVE To evaluate long-term glycemic outcomes of continuous glucose monitoring (CGM) initiation within the first year of type 1 diabetes diagnosis. RESEARCH DESIGN AND METHODS Patients with type 1 diabetes (N = 396) were divided into three groups: 1) CGM (CGM use within 1 year of diabetes diagnosis and continued through the study); 2) no-CGM (no CGM use throughout the study); and 3) new-CGM (CGM use after 3 years since diabetes diagnosis). Patients were followed up to 7 years. RESULTS A1c was significantly lower in the CGM compared with the no-CGM group throughout 7 years of follow-up (least squares mean A1c values: 6 months, 7.3% vs. 8.1%; 1 year, 7.4% vs. 8.6%; 2 years, 7.7% vs. 9.1%; 3 years, 7.6% vs. 9.3%; 4 years, 7.4% vs. 9.6%; 5 years, 7.6% vs. 9.7%; 6 years, 7.5% vs. 10.0%; and 7 years, 7.6% vs. 9.8%; for all, P &lt; 0.001) adjusting for age at diagnosis, sex, and insulin delivery method. CONCLUSION CGM initiation within first year of type 1 diabetes diagnosis results in long-term improvement in A1c.

scholarly journals Screening and Treatment Outcomes in Adults and Children with Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study

2020 ◽  
Author(s):  
Farid H. Mahmud ◽  
Antoine B.M. Clarke ◽  
Kariym C. Joachim ◽  
Esther Assor ◽  
Charlotte McDonald ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Glucose Monitoring ◽  
Gluten Free ◽  
Asymptomatic Patients ◽  
Adults And Children ◽  
Diet Study ◽  
Glycemic Outcomes ◽  
Design And Methods

<b>Objective</b>: To describe Celiac Disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in type 1 diabetes patients asymptomatic for CD. <p><b>Research Design and Methods</b>: Asymptomatic patients (8-45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA1c and continuous glucose monitoring (CGM) over 12 months. </p> <p><b>Results</b>: Adults had higher CD-seropositivity rates than children (6.8%, 95%CI 4.9% to 8.2%, N=1298 vs. 4.7%; 95%CI 3.4% to 5.9%, N=1089, p=0.035) with lower rates of prior CD-screening (6.9% vs 44.2%, p<0.0001). 51 participants were randomized to a GFD (N=27) or GCD (N=24). No HbA1c differences were seen between groups (+0.14%, 1.5mmol/mol; 95%CI: -0.79 to 1.08; p=0.76) although greater post-prandial glucose increases (4-hr +1.5mmol/L; 95%CI: 0.4 to 2.7; p=0.014) emerged with a GFD.</p> <p><b>Conclusions</b>: CD is frequently observed in asymptomatic patients with type 1 diabetes and clinical vigilance is warranted with initiation of a GFD. </p>

scholarly journals Long-Term Occupational Consequences for Families of Children With Type 1 Diabetes: The Mothers Take the Burden

2021 ◽  
Author(s):  
Andrea Dehn-Hindenberg ◽  
Heike Saßmann ◽  
Verena Berndt ◽  
Torben Biester ◽  
Bettina Heidtmann ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Financial Burden ◽  
Working Hours ◽  
Age At Diagnosis ◽  
First Year ◽  
Diabetes Diagnosis ◽  
Negative Consequences

<b>OBJECTIVE</b> <p>To investigate the occupational and financial consequences for parents following the onset of type 1 diabetes in their child. </p> <p><b>RESEARCH DESIGN AND METHODS</b> </p> <p>A questionnaire assessing occupational and financial situations before and in the first year after the onset of diabetes was distributed to all families with a child ≤14 years of age at diagnosis with a diabetes duration of at least 12 months in nine German pediatric diabetes centers. </p> <p><b>RESULTS</b></p> <p>Data of 1,144 children (mean age at diagnosis 6.7 (3.6) years, 46.5% female) and their families were obtained. Mothers’ occupational status reflected in paid working hours was significantly reduced in the first year after their child's diabetes diagnosis (<i>P</i> < 0.001). Overall, 15.1% of mothers stopped working, and 11.5% reduced working hours. Mothers of preschool children were particularly affected. Fathers’ working status hardly changed (<i>P</i> = 0.75). Nearly half of the families (46.4%) reported moderate to severe financial losses. Compared to an earlier similar study in 2003, significant negative occupational consequences for mothers and financial burden on families remain unchanged in 2018 (<i>P</i> = 0.59 & 0.31, respectively).</p> <p><b>CONCLUSIONS</b></p> <p>Mothers of young children with newly diagnosed diabetes experienced negative consequences in their occupational situation. This inequality for mothers can have long-term negative consequences for their mental health and future economic situation. There is an urgent need for action to reduce the burden on families and to provide professional, social, and regulatory support especially for mothers of young children with diabetes. </p>

scholarly journals Long-Term Effects of Initiating Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring (CGM) in People with Type 1 Diabetes and Unsatisfactory Diabetes Control

2019 ◽  
Vol 8 (3) ◽  
pp. 394 ◽  
Author(s):  
Jon-Duri Senn ◽  
Stefan Fischli ◽  
Lea Slahor ◽  
Susanne Schelbert ◽  
Christoph Henzen
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Glucose Monitoring ◽  
Subcutaneous Insulin ◽  
Long Term Effects ◽  
The Mean

Background: We aimed to assess the long-term effects of the introduction of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) in people with type 1 diabetes (T1D). Methods: A prospective single-centre cohort study including participants with T1D and HbA1c > 7.5%. After completing a course in flexible intensified insulin treatment (FIT), participants were offered treatment change to CSII/CGM. FIT participants with HbA1c ≤ 7.5% who remained on multiple daily injections (MDI) and without CGM were monitored as a separate cohort to compare the cumulative incidence of diabetic complications. Results: The study cohort included 41 participants with T1D (21 male/20 female). The mean age (±SD) at inclusion was 24.2 ± 10.9 years, the mean follow-up was 8.9 ± 2.8 years, and the mean diabetes duration at the end of the study was 15.9 ± 10.1 years. The mean HbA1c level before the introduction of CSII was 8.8 ± 1.3% (73 ± 8 mmol/mol), and decreased significantly thereafter to 8.0 ± 1.1% (63 ± 7 mmol/mol) (p = 0.0001), and further to 7.6 ± 1.1% (59 ± 11 mmol/mol) after the initiation of CGM (p = 0.051). In the MDI group the HbA1c levels did not change significantly during a mean follow-up of 6.8 ± 3.2 years. The frequency of severe hypoglycaemia after the introduction of CSII/CGM declined significantly (from 9.7 to 2.2 per 100 patient-years, p = 0.03), and the cumulative incidence of newly diagnosed diabetic microvascular complications were comparable between the study group and the observational cohort. Conclusion: In people with T1D and unsatisfactory diabetes control the introduction of CSII and CGM results in a substantial and long-term improvement.

scholarly journals Long-Term Occupational Consequences for Families of Children With Type 1 Diabetes: The Mothers Take the Burden

2021 ◽  
Author(s):  
Andrea Dehn-Hindenberg ◽  
Heike Saßmann ◽  
Verena Berndt ◽  
Torben Biester ◽  
Bettina Heidtmann ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Financial Burden ◽  
Working Hours ◽  
Age At Diagnosis ◽  
First Year ◽  
Diabetes Diagnosis ◽  
Negative Consequences

<b>OBJECTIVE</b> <p>To investigate the occupational and financial consequences for parents following the onset of type 1 diabetes in their child. </p> <p><b>RESEARCH DESIGN AND METHODS</b> </p> <p>A questionnaire assessing occupational and financial situations before and in the first year after the onset of diabetes was distributed to all families with a child ≤14 years of age at diagnosis with a diabetes duration of at least 12 months in nine German pediatric diabetes centers. </p> <p><b>RESULTS</b></p> <p>Data of 1,144 children (mean age at diagnosis 6.7 (3.6) years, 46.5% female) and their families were obtained. Mothers’ occupational status reflected in paid working hours was significantly reduced in the first year after their child's diabetes diagnosis (<i>P</i> < 0.001). Overall, 15.1% of mothers stopped working, and 11.5% reduced working hours. Mothers of preschool children were particularly affected. Fathers’ working status hardly changed (<i>P</i> = 0.75). Nearly half of the families (46.4%) reported moderate to severe financial losses. Compared to an earlier similar study in 2003, significant negative occupational consequences for mothers and financial burden on families remain unchanged in 2018 (<i>P</i> = 0.59 & 0.31, respectively).</p> <p><b>CONCLUSIONS</b></p> <p>Mothers of young children with newly diagnosed diabetes experienced negative consequences in their occupational situation. This inequality for mothers can have long-term negative consequences for their mental health and future economic situation. There is an urgent need for action to reduce the burden on families and to provide professional, social, and regulatory support especially for mothers of young children with diabetes. </p>

scholarly journals Mothers’ Experiences of Maze Path of Type 1 Diabetes Diagnosis in Children

1970 ◽  
Vol 28 (5) ◽  
Author(s):  
Maryam Khandan ◽  
Batool Tirgari ◽  
Farokh Abazari ◽  
Mohammad Ali Cheraghi
Keyword(s):  
Type 1 Diabetes ◽  
Health Professionals ◽  
Qualitative Interviews ◽  
Diabetes Type ◽  
Diabetes Diagnosis ◽  
Diabetes Type 1 ◽  
Medical File ◽  
One Year

BACKGROUND: Incidence of diabetes Type 1 in children with non-classic symptoms is one of the reasons for the delay in their follow-up. Failure in its diagnosis by the health professional exposes the mothers tomany challenges. This study was conducted to exploremothers’ experiences in the diagnosis pathway of diabetes Type 1 in children.METHODS: Semi-structured qualitative interviews were conducted with fifteen mothers of children with Type 1 diabetes.theywere selected by the purposefull sampling method.Their child had a medical file in diabetes centers in Kerman, Iran, at least one year has passed of diabetes diagnosis in their child and the maximum age of the child is 14 years. Data were analyzed using content analysis.Three themes and nine sub-themes emerged during dataanalysis.RESULTS: The extracted themes included “presence in the maze path to the child's disease”, “facing the reality of the child's disease”, and “to grin and bear with new conditions”.CONCLUSIONS: According to the finding, these mothers experienced various challenges. Therefore, identification of thesechallenges by health professionals to prevent and decrease of Them, is necessary. 

scholarly journals Screening and Treatment Outcomes in Adults and Children with Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study

2020 ◽  
Author(s):  
Farid H. Mahmud ◽  
Antoine B.M. Clarke ◽  
Kariym C. Joachim ◽  
Esther Assor ◽  
Charlotte McDonald ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Glucose Monitoring ◽  
Gluten Free ◽  
Asymptomatic Patients ◽  
Adults And Children ◽  
Diet Study ◽  
Glycemic Outcomes ◽  
Design And Methods

<b>Objective</b>: To describe Celiac Disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in type 1 diabetes patients asymptomatic for CD. <p><b>Research Design and Methods</b>: Asymptomatic patients (8-45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA1c and continuous glucose monitoring (CGM) over 12 months. </p> <p><b>Results</b>: Adults had higher CD-seropositivity rates than children (6.8%, 95%CI 4.9% to 8.2%, N=1298 vs. 4.7%; 95%CI 3.4% to 5.9%, N=1089, p=0.035) with lower rates of prior CD-screening (6.9% vs 44.2%, p<0.0001). 51 participants were randomized to a GFD (N=27) or GCD (N=24). No HbA1c differences were seen between groups (+0.14%, 1.5mmol/mol; 95%CI: -0.79 to 1.08; p=0.76) although greater post-prandial glucose increases (4-hr +1.5mmol/L; 95%CI: 0.4 to 2.7; p=0.014) emerged with a GFD.</p> <p><b>Conclusions</b>: CD is frequently observed in asymptomatic patients with type 1 diabetes and clinical vigilance is warranted with initiation of a GFD. </p>

scholarly journals HbA1c response and hospital admissions following commencement of flash glucose monitoring in adults with type 1 diabetes

2020 ◽  
Vol 8 (1) ◽  
pp. e001292
Author(s):  
Roland H Stimson ◽  
Anna R Dover ◽  
Stuart A Ritchie ◽  
Rohana J Wright ◽  
John A McKnight ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Prospective Observational Study ◽  
Hospital Admissions ◽  
Glucose Monitoring ◽  
First Year ◽  
Baseline Hba1c ◽  
Flash Glucose Monitoring ◽  
Period 2 ◽  
Design And Methods

IntroductionOur aim was to assess the effect of introducing flash monitoring in adults with type 1 diabetes with respect to change in hemoglobin A1c (HbA1c) and frequency of hospital admissions.Research design and methodsProspective observational study of adults with type 1 diabetes in our center, in whom a prescription for a flash monitoring sensor was collected. Primary outcome was change in HbA1c between 2016 and after flash monitoring. Rates of hospital admission were compared between the first year after flash monitoring and the corresponding 12-month period 2 years earlier.ResultsApproximately half of all adults with type 1 diabetes, attending our center, collected prescriptions for flash monitoring sensors (n=2216). Median fall in HbA1c was −1 (−0.1) mmol/mol (%) (p<0.001) and was greatest in those with baseline HbA1c >75 (9.0) mmol/mol (%): −10 (−0.9) mmol/mol (%), p<0.001. 43% of those with a baseline HbA1c >53 mmol/mol (7%) experienced a ≥5 mmol/mol (0.5%) fall in HbA1c. In addition to higher HbA1c, early commencement within 1 month of NHS-funded flash monitoring (p<0.001), and male gender (p=0.013) were associated with a fall in HbA1c of ≥5 (0.5) mmol/mol (%). Socioeconomic deprivation (p=0.009) and collecting fewer than 2 sensors per month (p=0.002) were associated with lack of response. Overall, hospital admissions did not change but an increase in admissions for hypoglycemia was observed (1.1% vs 0.3%, p=0.026).ConclusionsFlash monitoring is associated with reduction in HbA1c in individuals with HbA1c >58 mmol/mol. Numerous clinical features are independently associated with HbA1c response. An increase in hypoglycemia admissions occurred following flash monitoring.

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