scholarly journals The Management of Pediatric Type-1 Diabetes; A Case Study

2020 ◽  
Vol 19 (2) ◽  
pp. 326-332
Author(s):  
Kiran Rafiq ◽  
Zafar Saied Saify ◽  
Aleeza Raza ◽  
Alisha Hassan ◽  
Alina Rizvi

Diabetes mellitus is co-morbid with various metabolic and psychological disorders characterized by high blood glucose levels due to defects in insulin availability in body. Glucose work as a fuel to provide energy for all physical activities whereas in type 1 diabetes, the beta cells in the pancreas becomes unable to make insulin because of autoimmune disease, consequently there is no insulin to convert glucose leading to low energy level and other metabolic disorders. The disease is also called juvenile diabetes as usually starts to appear in childhood, that cannot be controlled but can be managed by timely diagnosis and care. The present study covers the case of a young child having type 1 diabetes in childhood and its consequences. The child inherited from paternal grandmother however other siblings were deficit. The case was become complicated because of poor timely investigations and management. Furthermore weak awareness and inappropriate healthcare practices made the disease more knotty. The work also covers the measures that should be taken by the health care providers through proper counseling and educating the parents and family, furthermore an accurate guidelines regarding nutrition, medications should be utmost. Self identification of having diabetes is necessary for school going children in order to manage abrupt hypoglycemic corollaries. Bangladesh Journal of Medical Science Vol.19(2) 2020 p.326-332

2020 ◽  
Vol 10 (22) ◽  
pp. 8037
Author(s):  
Phuong Ngo ◽  
Miguel Tejedor ◽  
Maryam Tayefi ◽  
Taridzo Chomutare ◽  
Fred Godtliebsen

Background. Since physical activity has a high impact on patients with type 1 diabetes and the risk of hypoglycemia (low blood glucose levels) is significantly higher during and after physical activities, an automatic method to provide a personalized recommendation is needed to improve the blood glucose management and harness the benefits of physical activities. This paper aims to reduce the risk of hypoglycemia and hyperglycemia (high blood glucose levels), and empowers type 1 diabetes patients to make decisions regarding food choices connected with physical activities. Methods. Traditional and Bayesian feedforward neural network models are developed to provide accurate predictions of the blood glucose outcome and the risks of hyperglycemia and hypoglycemia with uncertainty information. Using the proposed models, safe actions that minimize the risk of both hypoglycemia and hyperglycemia are provided as food recommendations to the patient. Results. The predicted blood glucose responses to the optimal and safe food recommendations are significantly better and safer than by taking random food. Conclusions. Simulations conducted on the state-of-the-art UVA/Padova simulator combined with Brenton’s physical activity model show that the proposed methodology is safe and effective in managing blood glucose during and after physical activities.


2019 ◽  
Vol 43 (6) ◽  
pp. 417-423 ◽  
Author(s):  
E Bimstein ◽  
D Zangen ◽  
W Abedrahim ◽  
J Katz

Objective: To describe the significance of type 1 diabetes mellitus (juvenile diabetes) to the pediatric oral health provider. Relevance: The oral health provider must be aware of type 1 diabetes mellitus (T1DM) characteristics, influence of on oral health, each patient pre-operative diabetic management, symptoms and treatment of hypo and hyper-glycemia, and the clinical implications before, during and after treatment of children with T1DM. Study design: A review of the scientific literature about the T1DM influence on dental development, caries prevalence, gingival and periodontal diseases, wound healing, salivary and taste dysfunction, oral infections, and the factors that must be taken in consideration before, during and after oral treatment of children with T1DM is presented. Conclusion: The increasing prevalence of T1DB in children strongly emphasizes the need for oral health providers to be aware of the complicacy of the treatment aimed to obtain and maintain acceptable blood glucose levels in diabetic children, the effect of diabetes on the oral cavity, the possible serious complications due to hypo- or hyper glycemia before, during and after oral treatments, the effect of stress on blood glucose levels, and the special behavioral interaction between the diabetic child, his/her family and the oral health providers.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 776-P
Author(s):  
RACHEL BRANDT ◽  
MINSUN PARK ◽  
LAURIE T. QUINN ◽  
MINSEUNG CHU ◽  
YOUNGKWAN SONG ◽  
...  

2020 ◽  
Author(s):  
Martina Parise ◽  
Linda Tartaglione ◽  
Antonio Cutruzzolà ◽  
Maria Ida Maiorino ◽  
Katherine Esposito ◽  
...  

BACKGROUND Telemedicine use in chronic disease management has markedly increased during health emergencies due to COVID-19. Diabetes and technologies supporting diabetes care, including glucose monitoring devices, software analyzing glucose data, and insulin delivering systems, would facilitate remote and structured disease management. Indeed, most of the currently available technologies to store and transfer web-based data to be shared with health care providers. OBJECTIVE During the COVID-19 pandemic, we provided our patients the opportunity to manage their diabetes remotely by implementing technology. Therefore, this study aimed to evaluate the effectiveness of 2 virtual visits on glycemic control parameters among patients with type 1 diabetes (T1D) during the lockdown period. METHODS This prospective observational study included T1D patients who completed 2 virtual visits during the lockdown period. The glucose outcomes that reflected the benefits of the virtual consultation were time in range (TIR), time above range, time below range, mean daily glucose, glucose management indicator (GMI), and glycemic variability. This metric was generated using specific computer programs that automatically upload data from the devices used to monitor blood or interstitial glucose levels. If needed, we changed the ongoing treatment at the first virtual visit. RESULTS Among 209 eligible patients with T1D, 166 completed 2 virtual visits, 35 failed to download glucose data, and 8 declined the visit. Among the patients not included in the study, we observed a significantly lower proportion of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) users (n=7/43, 16% vs n=155/166, 93.4% and n=9/43, 21% vs n=128/166, 77.1%, respectively; <i>P</i>&lt;.001) compared to patients who completed the study. TIR significantly increased from the first (62%, SD 18%) to the second (65%, SD 16%) virtual visit (<i>P</i>=.02); this increase was more marked among patients using the traditional meter (n=11; baseline TIR=55%, SD 17% and follow-up TIR=66%, SD 13%; <i>P</i>=.01) than among those using CGM, and in those with a baseline GMI of ≥7.5% (n=46; baseline TIR=45%, SD 15% and follow-up TIR=53%, SD 18%; <i>P</i>&lt;.001) than in those with a GMI of &lt;7.5% (n=120; baseline TIR=68%, SD 15% and follow-up TIR=69%, SD 15%; <i>P</i>=.98). The only variable independently associated with TIR was the change of ongoing therapy. The unstandardized beta coefficient (B) and 95% CI were 5 (95% CI 0.7-8.0) (<i>P</i>=.02). The type of glucose monitoring device and insulin delivery systems did not influence glucometric parameters. CONCLUSIONS These findings indicate that the structured virtual visits help maintain and improve glycemic control in situations where in-person visits are not feasible.


2020 ◽  
pp. 13-49
Author(s):  
Eileen O'Donnell ◽  
Liam O'Donnell

The diagnosis of Type 1 Diabetes (T1D) will come as an unwelcome surprise to most people. Within a short period of time, the person will have to come to understand and manage this chronic illness. The terminology associated with the T1D condition will also be totally new to the person: diabetes mellitus, pancreas, hyperglycaemia (hyper), hypoglycaemia (hypo), bolus (fast acting insulin), basal (slow acting insulin), ketones and blood glucose levels. The purpose of this article is to assist newly diagnosed patients' understanding of T1D, people who are already living with T1D, carers of people with T1D, partners and family members of someone with T1D, work colleagues, and friends who participate in the same sporting activities or go on holiday with a person who has T1D. In addition, this article reviews how people living with T1D can still enjoy exercise and maintain the best quality of life possible; whilst controlling the blood glucose levels in their body for the rest of their lives to prevent the onset of complications associated with diabetes.


2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Arthur Bertachi ◽  
Lyvia Biagi ◽  
Aleix Beneyto ◽  
Josep Vehí

The artificial pancreas (AP) is a system intended to control blood glucose levels through automated insulin infusion, reducing the burden of subjects with type 1 diabetes to manage their condition. To increase patients’ safety, some systems limit the allowed amount of insulin active in the body, known as insulin-on-board (IOB). The safety auxiliary feedback element (SAFE) layer has been designed previously to avoid overreaction of the controller and thus avoiding hypoglycemia. In this work, a new method, so-called “dynamic rule-based algorithm,” is presented in order to adjust the limits of IOB in real time. The algorithm is an extension of a previously designed method which aimed to adjust the limits of IOB for a meal with 60 grams of carbohydrates (CHO). The proposed method is intended to be applied on hybrid AP systems during 24 h operation. It has been designed by combining two different strategies to set IOB limits for different situations: (1) fasting periods and (2) postprandial periods, regardless of the size of the meal. The UVa/Padova simulator is considered to assess the performance of the method, considering challenging scenarios. In silico results showed that the method is able to reduce the time spent in hypoglycemic range, improving patients’ safety, which reveals the feasibility of the approach to be included in different control algorithms.


2009 ◽  
Vol 86 (2) ◽  
pp. e31-e33 ◽  
Author(s):  
Daniela Elleri ◽  
Carlo L. Acerini ◽  
Janet M. Allen ◽  
Anne-Mette F. Larsen ◽  
Malgorzata E. Wilinska ◽  
...  

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