Achievement of metabolic control goals set by the American Diabetes Association and the International Society for Pediatric and Adolescent Diabetes in pediatric patients with type 1 diabetes from Spain

Enes, Patricia; Martín-Frías, Maria; Álvarez, Ma Ángeles; Yelmo, Rosa; Alonso, Milagros; Barrio, Raquel

doi:10.1016/j.diabres.2014.08.033

Cited by 10 publications

(4 citation statements)

References 17 publications

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“…Despite increased insulin pump and continuous glucose monitoring (CGM) use, only 17% of adolescents with type 1 diabetes (T1D) meet glycemic targets as measured by glycosylated hemoglobin (HbA1c) 1 . Insulin pump therapy can improve glycemic control and quality of life; 2,3 however, adolescents typically achieve little to no HbA1c reductions with insulin pump therapy 4 . Insulin pump therapy is a more physiologic form of insulin delivery than multiple daily injections, yet achieving successful outcomes depends in large part on individual proficiency, surveillance, and self‐management behaviors 5 …”

Section: Introductionmentioning

confidence: 99%

Self‐management among pre‐teen and adolescent diabetes device users

et al. 2020

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Objective: Despite increased diabetes device use, few adolescents with type 1 diabetes (T1D) meet glycemic targets. We examine associations between utilization of insulin pumps and continuous glucose monitoring (CGM) and glycemic control. Research Design and Methods: This prospective cohort study included 80 youths (10-18 years of age) with T1D. Multiple linear regression and linear mixed models (LMM) were used to estimate the effects of device self-management on HbA1c and daily time in range (70-180 mg/dL), respectively. Results: Every blood glucose (BG) input/day was associated with a 0.2% decrease in HbA1c (95% CI: −0.297, −0.013), each bolus/day was associated with a 0.2% decrease (−0.327, −0.057), and use of CGM was associated with a 0.5% decrease (−1.00, −0.075). Among CGM users (n = 45) every 10% increase in CGM use was associated with a 0.3% decrease in HbA1c (−0.390, −0.180). In LMM accounting for within subject and between subject variability, there was a negative association between BG input/day frequency (coefficient = −1.880, [−2.640, −1.117]) and time in range. Residual random effects for CGM users were large showing time in range varied between youth with a SD of 15.0% (3 hours and 36 minutes) (SE 2.029, [11.484, 19.530]). Time in range varied significantly from day-today with SD of 18.6% (4 hours and 40 minutes) (SE0.455, [17.690, 19.473]). Conclusions: Device self-management behaviors among youth are significantly associated with both HbA1c and time in range. Our findings showing an association between reduced time in range and increased self-management behaviors is novel and deserves further investigation. K E Y W O R D S adolescent, diabetes technology, insulin pump therapy, self-management, type 1 diabetes 1 | INTRODUCTION Despite increased insulin pump and continuous glucose monitoring (CGM) use, only 17% of adolescents with type 1 diabetes (T1D) meet glycemic targets as measured by glycosylated hemoglobin (HbA1c). 1 Insulin pump therapy can improve glycemic control and quality of life; 2,3 however, adolescents typically achieve little to no HbA1c reductions with insulin pump therapy. 4 Insulin pump therapy is a more physiologic form of insulin delivery than multiple daily injections, yet achieving successful outcomes depends in large part on individual proficiency, surveillance, and self-management behaviors. 5 Suboptimal management and unsafe pump behaviors can lead to a decline in glycemic control and contribute to adverse events. 6,7 Previous studies of adolescents' insulin pump utilization and self

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Section: Introductionmentioning

confidence: 99%

Self‐management among pre‐teen and adolescent diabetes device users

et al. 2020

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“…Patients. A total of 120 patients at the Xinqiao Hospital of the Third Military Medical University (Chongqing, China), who had been diagnosed with DM2 [based on the 2010 ADA criteria (12)] for ≥6 months, were enrolled in the present study between December 2012 and February 2013 (clinical trial registration no. ChiCTR-TRC-12002580).…”

Section: Methodsmentioning

confidence: 99%

“…Lifestyle interventions consisted of individualized dietary counseling and encouragements to increase daily physical activity. Each patient received an individualized recommended intake of daily energy according to the ADA guidelines (12). After one month of treatment, 37 patients remained in the control group, 3 patients quit for personal reasons and 40 patients remained in the 10DF and 20DF groups, respectively.…”

Section: Methodsmentioning

confidence: 99%

Therapeutic effects of soluble dietary fiber consumption on type 2 diabetes mellitus

Chen

Zeng

et al. 2016

Experimental and Therapeutic Medicine

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Soluble dietary fiber (DF) reduces the risk of developing diabetes and may have therapeutic effects in patients with type 2 diabetes mellitus (DM2). The present study aimed to investigate the effect of soluble DF on metabolic control in patients with DM2. A total of 117 patients with DM2 between the ages of 40 and 70 were assessed. Patients were randomly assigned to one of two groups, and administered extra soluble DF (10 or 20 g/day), or to a control group (0 g/day) for one month. Blood glucose, serum insulin and connecting peptide (C-peptide) levels, and the insulin resistance index, as determined using the homeostatic model assessment method, were measured during fasting and up to 2-h postprandially prior to and following one month of treatment. Other measurements included serum levels of glycated albumin (GA), blood lipid profiles, and an analysis of the blood pressure, body weight and waist/hip ratio of all patients. Following intervention, the levels of 2-h blood glucose, fasting insulin and lipoprotein(a), and the insulin resistance index, were significantly improved in all groups. Furthermore, the fasting blood glucose, 2-h insulin, fasting C-peptide, 2-h C-peptide, GA and triglyceride (TG) levels were significantly improved in the soluble DF groups. The 20 g/day soluble DF group exhibited significantly improved fasting blood glucose and low-density lipoprotein levels, as well as a significantly improved insulin resistance index. In addition, 10 and 20 g/day soluble DF significantly improved the waist and hip circumferences and levels of TGs and apolipoprotein A. The results of the present study suggested that increased and regular consumption of soluble DF led to significant improvements in blood glucose levels, insulin resistance and metabolic profiles, without improving the secretory function of the islets of Langerhans, over a short-term intervention period in patients with DM2.

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“…1 However, most individuals do not meet glucose targets 2,3 despite advances in therapeutics and technologies. Diabetes technologies (ie, insulin pump, continuous glucose monitor [CGM], automated insulin delivery [AID]) improve quality of life, glycemic control, 4-7 and possibly mortality 8 ; however, safe and effective use requires technological sophistication, foundational diabetes self-management knowledge and access to care. 7,9-14 Benefit from insulin pumps, even those providing AID, depends greatly on individual utilization and self-management behavior including frequency of self-monitored blood glucose (SMBG), 15 use of bolus calculators 15-18 and utilization of advanced features.…”

Section: Introductionmentioning

confidence: 99%

Simulation Platform Development for Diabetes and Technology Self-Management

Faulds

Rayo

Lewis

et al. 2021

J Diabetes Sci Technol

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Background: Specialized education is critical for optimal insulin pump use but is not widely utilized or accessible. We aimed to (1) test the usability and acceptability of A1Control, a simulation platform supporting insulin pump education, and (2) determine predictors of performance. Method: Rural adult insulin pump users with type 1 diabetes (T1D) participated in a mixed methods usability study in 2 separate rounds. Participants navigated 3 simulations (ie, infusion site occlusion, hypoglycemia, exercise). Net Promoter Score (NPS) and Systems Usability Scale (SUS) were administered. Semi-structured interviews and direct observation were used to assess perceived usability, acceptability and performance. Synthetic Minority Oversampling Technique was used to fit predictive models for visualization of patterns leading to good or poor A1Control performance. Results: Participants ( N = 13) were 28-70 years old, 10 used automated insulin delivery and 12 used continuous glucose monitoring (CGM). Mean NPS was 9.5 (range 9-10) and positive sentiment during interviews indicated very high acceptability. SUS (mean 88.5, range 70-100) indicted a high perceived usability. CGM percent wear ≥ 94%, time spent in hypoglycemia ≤ 54 mg/dl of <0.01%, and <70 mg/dl of 0.5% predicted successful site-occlusion scenario performance with 100% accuracy. BOLUS score ≥ 2, TDD ≥ 34, and technology brand predicted exercise scenario success with 100% accuracy. There were an insufficient number of failed hypoglycemia scenarios to assess predictors. Conclusion: A1Control shows potential to increase access and frequency of self-management and technology education. Additional study is needed to determine sustained engagement and benefit.

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Achievement of metabolic control goals set by the American Diabetes Association and the International Society for Pediatric and Adolescent Diabetes in pediatric patients with type 1 diabetes from Spain

Cited by 10 publications

References 17 publications

Self‐management among pre‐teen and adolescent diabetes device users

Self‐management among pre‐teen and adolescent diabetes device users

Therapeutic effects of soluble dietary fiber consumption on type 2 diabetes mellitus

Simulation Platform Development for Diabetes and Technology Self-Management

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