Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: type 1 diabetes education in lifestyle and self adjustment (TELSA)

Xie, Yuting; Liu, Fang; Huang, Fansu; Lan, Chunna; Guo, Jia; He, Jing; Li, Lezhi; Li, Xia; Zhang, Zhou

doi:10.1186/s12902-020-0514-9

Cited by 14 publications

(7 citation statements)

References 33 publications

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“…To achieve desired glycemic targets in T1DM individuals undergoing MDI therapy during the Chinese New Year public holiday, it is important to enhance the health education of compliance with SMBG, MDI therapy and meals for T1DM patients. Our research team has established a structured T1DM self-management education program entitled, ‘Type 1 Diabetes Education in Lifestyle and Self Adjustment (TELSA)’, which is adapted to medical and cultural practices in China ( 25 ). Therefore, the TELSA program and other similar programs may help T1DM individuals to experience a safe traditional Chinese Lunar New Year with better glycemic control.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Chinese New Year Public Holiday on the Glycemic Control of T1DM With Intensive Insulin Therapy

Guo

Zhang

et al. 2022

Front. Endocrinol.

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AimsThere is limited evidence that evaluates the glycemic control of type 1 diabetes mellitus (T1DM) during the Chinese New Year public holiday in China. The Chinese New Year public holiday represents various challenges to glycemic control, especially in T1DM patients, in China. We aimed to assess the effect of the Chinese New Year public holiday on several glucose metrics using flash glucose monitoring (FGM) in patients with T1DM.MethodsComplete FGM data for 1 week before, 1 week during and 1 week after the Chinese New Year public holiday were available for 71 T1DM patients treated with multiple daily insulin injection (MDI) therapy (n = 51) or continuous subcutaneous insulin infusion (CSII) treatment (n = 20). The mean age of the study participants was 13 (9, 30) years. Of note, 59.2% of the patients (n = 42) were adults, and 40.8% of the patients (n = 29) were minors. The interval between each two adjacent periods was one week. The indicators of mean glucose, glucose variability and time in different glycemic ranges were analyzed.ResultsThe Chinese New Year public holiday was associated with an increase in mean blood glucose (8.4 ± 1.7 vs. 9.2 ± 2.5; P < 0.001) and time above range (TAR) (27.9% ± 16.6% vs. 35.0% ± 22.3%; P< 0.001) but a decrease in time in range (TIR) (65.1% ± 15.5% vs. 58.0% ± 19.0%; P < 0.001) and coefficient of variation (CV) (65.1% ± 15.5% vs. 58.0% ± 19.0%; P < 0.001). There was no significant difference in time below range (TBR). The glycemic control deteriorated during the Chinese New Year public holiday in our study population regardless of age. Interestingly, in the CSII group, none of the metrics of glucose control significantly changed during the Chinese New Year public holiday.ConclusionsThese results suggested that less self-management may worsen glycemic control in the short term, indicating a need for more refined management algorithms during the Chinese New Year public holiday for T1DM patients.

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Section: Discussionmentioning

confidence: 99%

Effect of the Chinese New Year Public Holiday on the Glycemic Control of T1DM With Intensive Insulin Therapy

Guo

Zhang

et al. 2022

Front. Endocrinol.

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“…Children newly diagnosed with T1DM and their families should receive intensive diabetes education from an interprofessional paediatric diabetes care team [ 13 ]. This team should include either an endocrinologist or a paediatrician knowledgeable in diabetes management, a dietician, a nurse specialized in diabetes education, a social worker, and a mental health professional, to help them acquire the skills and knowledge needed to manage this disease [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with school failure in children with type 1 diabetes

Nouira,

Ach,

Ammar

et al. 2024

pedm

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Introduction Type 1 diabetes mellitus (T1DM) is a health problem that can be difficult for young people to accept. The aim of this study is to determine the prevalence and characteristics of school failure in children with T1DM and to identify the associated factors. Material and methods This is a retrospective study conducted in the endocrinology department of the Farhat Hached Hospital in Sousse, regarding T1DM patients, by analysing their school and career paths according to their clinicobiological and social data. School failure was defined in our study by the presence of at least one year's repetition and/or exclusion from school. Results Our study included 70 patients. School failure was recorded in 71.4% of cases. School drop-out was observed in 47.1% of patients. The reasons for school drop-out were iterative hospitalizations in 31.4% of cases and glycaemic instability with hyper/hypoglycaemic fluctuations in 17.1%. Multivariate analysis showed that the risk factors significantly associated with school failure were, respectively, number of hospitalizations for ketosis ≥ 5 ( p = 0.037) and higher mean HbA1c at the last consultations ( p = 0.001). Use of functional insulin therapy ( p = 0.031) and use of insulin analogue ( p = 0.004) were significantly protective factors. Conclusions The risk of school failure in T1DM is real and should not be underestimated. Socioeconomic factors such as lack of financial resources, limited family support, and an unfavourable social environment can contribute to school avoidance.

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“…In addition, an intensive contact between physicians and T1DM patients undergoing CSII therapy is essential to achieve a greater level of knowledge to appropriately carry out insulin dose adjustment for dietary intake, specifically carbohydrate counting, lifestyle factors, and in particular, disease management. An intensive educational program has been developed by our research team via a structured T1DM self-management educational system, namely “Type 1 Diabetes Education in Lifestyle and Self Adjustment' (TELSA)”, which could be adapted to medical, social, and cultural practices in China ( 32 ). The TELSA program and other intensive educational programs may improve outcomes in Chinese T1DM patients undergoing CSII therapy ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

Comparing the effectiveness of continuous subcutaneous insulin infusion with multiple daily insulin injection for patients with type 1 diabetes mellitus evaluated by retrospective continuous glucose monitoring: A real-world data analysis

Guo

Zhang

et al. 2022

Front. Public Health

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ObjectiveRegarding the effects and practical application of insulin pumps on patients with type 1 diabetes mellitus (T1DM), the real-world evidence is limited especially concerning the incidence of hypoglycemia. This study aimed to compare the efficacy of continuous subcutaneous insulin infusion (CSII) therapy with multiple daily injection (MDI) therapy on glycemic metrics evaluated by retrospective continuous glucose monitoring (CGM) in Chinese patients with T1DM.MethodsIn total, 362 T1DM Chinese patients from the outpatient department of the Second Xiangya Hospital, Central South University, who underwent intensive insulin therapy and used a retrospective CGM system were included in this retrospective cross-sectional study. Comprehensive analysis of clinical and biological features and retrospective CGM derived-metrics was performed on the 362 enrolled T1DM patients who underwent CSII (n = 61) or MDI (n = 301) therapy (defined as 4 or more insulin injections per day).ResultsOur findings demonstrated that patients who underwent CSII therapy, compared with those who received MDI therapy, had lower levels of hemoglobin A1c (HbA1c) and fasting blood glucose; moreover, CSII therapy was associated with better glycemic outcomes in terms of increasing time in range (TIR), decreasing time above range (TAR), and achieving CGM-associated targets of TIR ≥70% and TAR <25%. However, patients who underwent CSII therapy did not experience decreasing time below range (TBR), achieving CGM-associated targets of TBR <4%, and reduction of the risk of hypoglycemia as evidenced by comparing TBR and low blood glucose index (LBGI) between the two treatment regimens. The parameters of glycemic variability, such as standard deviation of glucose (SD), mean amplitude glycemic excursion (MAGE), and large amplitude glycemic excursion (LAGE) in T1DM patients who underwent CSII therapy outperformed.ConclusionOur results provided further evidence that CSII therapy is safe and effective for management of Chinese T1DM patients, which was confirmed by a lower HbA1c level and better CGM-derived metrics but no demonstration of improvment in the risk of hypoglycemia. To achieve more satisfactory glycemic outcomes through the utilization of CSII therapy for Chinese T1DM patients, a strong physician-patient relationship is essential.

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Establishment of a type 1 diabetes structured education programme suitable for Chinese patients: type 1 diabetes education in lifestyle and self adjustment (TELSA)

Cited by 14 publications

References 33 publications

Effect of the Chinese New Year Public Holiday on the Glycemic Control of T1DM With Intensive Insulin Therapy

Effect of the Chinese New Year Public Holiday on the Glycemic Control of T1DM With Intensive Insulin Therapy

Prevalence and factors associated with school failure in children with type 1 diabetes

Comparing the effectiveness of continuous subcutaneous insulin infusion with multiple daily insulin injection for patients with type 1 diabetes mellitus evaluated by retrospective continuous glucose monitoring: A real-world data analysis

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