scholarly journals Patient Perspectives on Use of Video Telemedicine for Type 1 Diabetes Care in the United States during the COVID-19 Pandemic

Endocrines ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 449-456
Author(s):  
Stephanie S. Crossen ◽  
Crystal C. Romero ◽  
Lindsey A. Loomba ◽  
Nicole S. Glaser
Keyword(s):  
Type 1 Diabetes ◽  
Online Community ◽  
The United States ◽  
Perceived Quality Of Care ◽  
Continued Use ◽  
Few Data ◽  
First Time

The COVID-19 pandemic has resulted in widespread adoption of telemedicine for management of chronic conditions such as type 1 diabetes (T1D), but few data have been collected about the patient experience and perceived quality of care during this time. We surveyed members of the T1D Exchange patient registry and online community regarding their experiences with and opinions about telemedicine care during the pandemic. Among 2235 survey respondents, 65% had utilized telemedicine. The most common reasons for adopting telemedicine were providers not offering in-person care (66%), concerns about the health risks of in-person care (59%), providers offering (52%) or insurance covering (19%) telemedicine for the first time, and local or state orders to stay home (33%). Among telemedicine users, 62% felt video care was as effective as or more effective than in-person care, and 82% hoped to use telemedicine in the future. The most-cited reason for non-use of telemedicine was that providers were not offering it (49%). Our findings highlight the role of telemedicine in maintaining access to T1D care during the COVID-19 pandemic. Respondents’ satisfaction with telemedicine and interest in its continued use signifies the need for ongoing access to this care modality and for the development of telemedicine best practices within T1D care.

Can Innovative Technologies Overcome HbA1c Disparity for African-American Youth with Type 1 Diabetes?

2021 ◽  
pp. 193229682110213
Author(s):  
Stuart Chalew ◽  
Alan M. Delamater ◽  
Sonja Washington ◽  
Jayalakshmi Bhat ◽  
Diane Franz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Racial Disparity ◽  
Diabetes Management ◽  
New Technology ◽  
African American Youth ◽  
Glucose Monitoring ◽  
Supportive Role

Achieving normal or near-normal glycemic control as reflected by HbA1c levels in patients with type 1 diabetes (T1D) is important for preventing the development and progression of chronic complications. Despite delineation and dissemination of HbA1c management targets and advances in insulin pharmacology, insulin delivery systems, and glucose monitoring, the majority of children with T1D do not achieve HbA1c goals. In particular, African Americans are more likely not to reach HbA1c goals and have persistently higher HbA1c than Non-Hispanic Whites. Availability of pumps and other technology has not eliminated the disparity in HbA1c. Multiple factors play a role in the persisting racial disparity in HbA1c outcome. The carefully designed application and deployment of new technology to help the patient/family and facilitate the supportive role of the diabetes management team may be able to overcome racial disparity in glycemic outcome and improve patient quality of life.

scholarly journals The Future of Clinical Islet Transplantation in the United States

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Michael F Knoll ◽  
Carmela A Knoll ◽  
Rita Bottino ◽  
Massimo Trucco ◽  
Suzanne Bertera ◽  
...  
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Type 1 Diabetes ◽  
Islet Transplantation ◽  
Drug Administration ◽  
The United States ◽  
Clinical Islet Transplantation ◽  
The World

Clinical islet transplantation was first realized over four decades ago at the University of Minnesota. Autologous islet transplantation is now widely recognized as a treatment to prevent diabetes in patients after pancreas excision and is offered at major transplant centers throughout the United States and the world. Type 1 diabetes represents a much larger demographic in which islet transplantation may benefit patients. Allogeneic islet transplantation can now offer similar outcomes to pancreas transplantation in a subset of patients with labile type 1 diabetes with less risk than whole organ transplantation. It is recognized as a standard of care in nations around the world but not in the United States, despite the important developmental role US scientists and physicians have played. Early reports of islet transplantation focused on insulin independence that proved to diminish over time. However, regardless of insulin status, islet transplantation provides benefits ranging from improved quality of life to reduction in diabetic complications. A National Institutes of Health sponsored multi-center Phase 3 Clinical Trial (CIT-07) demonstrated safety and efficacy, although the Food and Drug Administration chose to consider islets as a biologic that requires licensure, which makes offering the procedure in the clinic very challenging. Until regulations can be brought into communion with international standards, allogeneic islet transplantation in the United States is unlikely to match international levels of success and once promising programs are left to wither on the vine. Food and Drug Administration approval would open the door for third party medical reimbursement and allow many patients the opportunity to enjoy better health and quality of life. Establishment of clinical islet transplantation for type 1 diabetes would lead to optimizations in procedures making it more efficacious and cost effective while offering support for ongoing islet xenotransplantation studies that could bring islet transplantation to even more patients.

scholarly journals The role of insulin analogs in the achievement of compensation and improvement of quality of life in children and adolescents with type 1 diabetes mellitus

2010 ◽  
Vol 13 (3) ◽  
pp. 147-152
Author(s):  
Tamara Leonidovna Kuraeva
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Self Control ◽  
Self Management ◽  
Insulin Analogs ◽  
Substantial Progress

Despite substantial progress in the treatment of type 1 diabetes mellitus achieved by the end of the last century due to the advent of human insulins,intensive insulinotherapy, means of glycemia self-control, and active patient self-management education, compensation of the diseases in childrenand adolescents remains a challenging problem. This paper is focused on the use of insulin analogs in these patients and main difficulties encounteredby pediatricians in the correction of therapy.

MyT1DHero, an mHealth-Based Intervention, For Adolescents with Type 1 Diabetes and Their Parents: A Pilot Study (Preprint)

2020 ◽  
Author(s):  
Bree E Holtz ◽  
Katharine M Mitchen ◽  
Amanda J Holmstrom ◽  
Shelia R Cotten ◽  
Julie K Dunneback ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Pilot Study ◽  
Controlled Trial ◽  
Final Analysis ◽  
The United States ◽  
Mobile App ◽  
The Stability

BACKGROUND Type 1 diabetes (T1D) impacts more than 165,000 individuals under the age of 20 in the United States. The transition from parent management to parent-child team management, with the child taking on increased levels of self-care, can be stressful and is associated with a deterioration in self-management behaviors. A mobile app intervention, MyT1DHero was designed to facilitate diabetes specific positive parent-adolescent communication. OBJECTIVE To conduct a pilot test to determine the efficacy of the MyT1DHero app intervention. METHODS This pilot study included 30 adolescent-parent pairs in a 12-week single arm clinical trial. RESULTS The final analysis included 25 families. The mean age of the adolescents was 12.281.62 years old. Half of the participants reported a diagnosis of fewer than five years. After 12-weeks, diabetes adherence significantly improved (P=.02) as did quality of life (P=0.01). HbA1c level (P=.51) and family conflict (P=0.14) changed in the hypothesized direction, but the change was not significant. However, higher use of the mobile app was associated with more improvement in HbA1c, (F(1, 20)=9.74, P<.01, R2=.33). Overall, the adolescents were satisfied with app intervention. CONCLUSIONS In a 12-week pilot study of the mobile app intervention designed to facilitate parent-adolescent communication, significant benefits were demonstrated in adherence and quality of life. A randomized controlled trial with a longer intervention is needed to replicate these findings and determine the stability of intervention effects. CLINICALTRIAL NCT03436628

First report on the nationwide prevalence of paediatric type 1 diabetes in Serbia and temporal trends of diabetes ketoacidosis at diagnosis—a multicentre study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sandra Stankovic ◽  
Rade Vukovic ◽  
Ivana Vorgucin ◽  
Vera Zdravkovic ◽  
Nevena Folic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Temporal Trends ◽  
Percentage Increase ◽  
Newly Diagnosed ◽  
First Report ◽  
High Prevalence ◽  
First Time

AbstractWe aimed to collect data on all paediatric patients who were diagnosed with type 1 diabetes mellitus (T1DM) between the years 2000 and 2019 in Serbia and estimate for the first time its prevalence. Also, the trends of diabetes ketoacidosis (DKA) occurrence at the time of diagnosis are monitored. We collected and retrospectively analysed the data of patients <19 years with newly diagnosed T1DM. T1DM was diagnosed in 3134 patients (53.2% male). Total number of youth <19 years with T1DM was 1735 with prevalence of 135.25/100000 at the end of study period. T1DM was diagnosed most frequently between the ages of 5 and 11 years (42.1%). At the time of diagnosis, 35.7% presented in DKA. The incidence and severity of DKA were more significant at the youngest age (p<0.001). There were significant annual percentage increase (2.2%) in the number of new cases of DKA (p=0.007). Conclusion: This first report of nationwide prevalence of T1DM in youth shows that Serbia is among countries with high prevalence of T1DM in youth. System changes are needed in order to provide better quality of health care to these patients.

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

2016 ◽  
Vol 179 ◽  
pp. 131-138.e1 ◽  
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

scholarly journals Age and Hospitalization Risk in People with Type 1 Diabetes and COVID-19: Data from the T1D Exchange Surveillance Study

2021 ◽  
Author(s):  
Carla Demeterco-Berggren ◽  
Osagie Ebekozien ◽  
Saketh Rompicherla ◽  
Laura Jacobsen ◽  
Siham Accacha ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age Groups ◽  
The United States ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Study Population ◽  
Few Data

Abstract Context COVID-19 morbidity and mortality are increased in type 1 diabetes (T1D), but few data focus on age-based outcomes. Objective To quantify the risk for COVID-19 related hospitalization and adverse outcomes by age in people with T1D. Design, Setting and Patients For this observational, multisite, cross-sectional study of patients with T1D and laboratory-confirmed COVID-19 from 56 clinical sites in the United States, data were collected from April 2020 to March 2021. The distribution of patient factors and outcomes across age groups (0-18, 19-40 and &gt; 40 years) was examined. Descriptive statistics were used to describe the study population, and multivariate logistic regression models were used to analyze the relationship between age, adverse outcomes, and hospitalization. Main Outcome Measures Hospitalization for COVID-19. Results A total of 767 patients were analyzed. Fifty-four percent (n=415) were aged 0-18 years, thirty-two percent (n=247) were aged 19-40 years and fourteen percent (n=105) were aged &gt;40 years. One-hundred and seventy patients were hospitalized, and 5 patients died. Compared to the 0-18 years age group, those &gt;40 years of age had an adjusted odds ratio of 4.2 (95% confidence interval 2.28-7.83) for hospitalization after adjustment for gender, A1c, race, insurance type and comorbidities. Conclusions Age &gt;40 years is a risk factor for patients with T1D and COVID-19, with children and younger adults experiencing milder disease and better prognosis. This indicates a need for age-tailored treatments, immunization, and clinical management of individuals affected by T1D.

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