Use of Digital Technologies in Pediatric Diabetes Management During the Pandemic

The outbreak of COVID-19 had created a significant impact on the medical community and has resulted in novel challenges to all the physicians. It is estimated by the International Diabetes Federation (IDF) that in 2019 there were 95,600 cases of type 1 diabetes (0 and 14 years of age) in India. Type 1 diabetes was identified to be an independent risk factor associated with in-hospital death in COVID-19. During the pandemic, due to fear of visiting the hospitals, there was an underrepresentation of new cases and due to delay in the diagnosis, there was a spike in the number of cases of diabetic ketoacidosis. The objective of the current review is to summarize the role of telemedicine in the management of pediatric diabetes. Various organizations such as the Research Society of Study of Diabetes in India (RSSDI), CDiC, and IFAC came forward to support the pediatric diabetes community through the supply of insulin, glucose strips and syringes. The efficiency of telehealth visits was enhanced by using diabetes technologies like insulin pumps, CGMs, and bluetooth glucose meters. As children got ample time to spend with their parents and perform the in-home physical activity, they had good glycemic control during the pandemic period in some cases.

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

Journal of Diabetes Science and Technology ◽

10.1177/19322968211021386 ◽

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.

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Self-efficacy scale for Brazilians with type 1 diabetes

Sao Paulo Medical Journal ◽

10.1590/s1516-31802007000200006 ◽

2007 ◽

Vol 125 (2) ◽

pp. 96-101 ◽

Cited By ~ 7

Author(s):

Daniela Alves Gastal ◽

Ricardo Tavares Pinheiro ◽

Débora Potter Vazquez

Keyword(s):

Type 1 Diabetes ◽

Psychometric Properties ◽

Self Efficacy ◽

Diabetes Management ◽

Public Health Problem ◽

Public Healthcare ◽

Southern Brazil ◽

Good Glycemic Control ◽

Diabetes Patients

CONTEXT AND OBJECTIVE: Diabetes is a public health problem and good glycemic control is able to prevent or contain its complications. Self-efficacy is a key factor in successfully achieving behavior goals. The aim of this study was to analyze the psychometric properties of the insulin management diabetes self-efficacy scale (IMDSES) on type 1 diabetes patients from southern Brazil. DESIGN AND SETTING: Validation study in two cities in southern Brazil. METHODS: The psychometric properties of IMDSES were evaluated in a population of type 1 diabetes patients (n = 213), from September to December 2004, who were attended within the Brazilian public healthcare system. Principal component analysis was conducted to develop the subscales. Cronbach’s alpha was used as the reliability coefficient. RESULTS: The analysis of psychometric properties resulted in an IMDSES consisting of 20 items and three subscales: diet (alpha: 0.83), insulin (alpha: 0.92) and general management (alpha: 0.78) and accounted for 53% of the variance. Criteria validity was investigated through two parameters: glycohemoglobin, which showed significant association with self-efficacy on the insulin subscale (p = 0.04), and the variable "adherence", which was significantly associated with self-efficacy on two subscales (p < 0.05). CONCLUSIONS: This study shows that the IMDSES is valid and reliable, and can be used to measure results from diabetes educational programs and to measure self-efficacy relating to diabetes management, for possible interventions.

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The Role of Cognitive and Psychosocial Maturity in Type 1 Diabetes Management

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2018.10.294 ◽

2019 ◽

Vol 64 (5) ◽

pp. 622-630 ◽

Cited By ~ 4

Author(s):

Karol Silva ◽

Victoria A. Miller

Keyword(s):

Type 1 Diabetes ◽

Diabetes Management ◽

Psychosocial Maturity

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The Role of Dietary Protein and Fat in Glycaemic Control in Type 1 Diabetes: Implications for Intensive Diabetes Management

Current Diabetes Reports ◽

10.1007/s11892-015-0630-5 ◽

2015 ◽

Vol 15 (9) ◽

Cited By ~ 22

Author(s):

Megan Paterson ◽

Kirstine J. Bell ◽

Susan M. O’Connell ◽

Carmel E. Smart ◽

Amir Shafat ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycaemic Control ◽

Dietary Protein ◽

Diabetes Management ◽

Intensive Diabetes Management

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The Role of Peers for Diabetes Management in Adolescents and Emerging Adults With Type 1 Diabetes: A Longitudinal Study

Diabetes Care ◽

10.2337/dc17-0643 ◽

2017 ◽

Vol 40 (12) ◽

pp. 1678-1684 ◽

Cited By ~ 21

Author(s):

Koen Raymaekers ◽

Leen Oris ◽

Sofie Prikken ◽

Philip Moons ◽

Eva Goossens ◽

...

Keyword(s):

Type 1 Diabetes ◽

Longitudinal Study ◽

Emerging Adults ◽

Diabetes Management

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Prevention of Hypoglycemia While Achieving Good Glycemic Control in Type 1 Diabetes: The role of insulin analogs

Diabetes Care ◽

10.2337/dc08-s227 ◽

2008 ◽

Vol 31 (Supplement 2) ◽

pp. S113-S120 ◽

Cited By ~ 33

Author(s):

P. Rossetti ◽

F. Porcellati ◽

G. B. Bolli ◽

C. G. Fanelli

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Insulin Analogs ◽

Good Glycemic Control

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The role of glycemic self-control in diabetes management: based on the American Diabetes Association guidelines (2021)

Medical Council ◽

10.21518/2079-701x-2021-12-286-292 ◽

2021 ◽

pp. 286-292

Author(s):

G. E. Runova

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

American Diabetes Association ◽

Diabetes Management ◽

Glucose Monitoring ◽

Self Monitoring ◽

Diabetes Technology

Glycemic control represents an integral part of diabetes mellitus (DM) therapy. It is not surprising that diabetes technology is evolving to not only create new routes of insulin administration, but also to improve the measurement of glycemia. A significant number of new glucose monitoring systems have been launched to the market over the past 10 years. Nevertheless, only 30% of patients with type 1 diabetes and very few patients with type 2 diabetes use continuous or flash glucose monitoring. The reason for this is not only the cost and technical difficulties of continuous glucose monitoring, but also its clinical appropriateness. There is indisputable evidence that patients who receive intensified insulin therapy, especially those with type 1 diabetes, need frequent self-monitoring / continuous glucose monitoring. As for patients with type 2 diabetes receiving basal insulin and / or other antihyperglycemic therapy, the data received seem to be contradictory and uncertain. However, most of the recommendations simmer down to the need for self-monitoring of blood glucose levels in patients with type 2 diabetes. The diabetes technology section of the American Diabetes Association guidelines 2021 goes into details about the role of self-monitoring of blood glucose in diabetes management, including the need for continuous patient education on the principles and rules of self-monitoring, interpretation and practical use of the results of self-monitoring, various standards of glucometers, factors affecting the accuracy of the results.

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