Impact of Information Technology on the Therapy of Type-1 Diabetes: A Case Study of Children and Adolescents in Germany

Abstract

Being able to manage and adjust insulin doses is a key part of managing type-1 diabetes. Children and adolescents with type-1 diabetes mellitus often have serious difficulties with this dosage adjustment. Therefore, this paper aims to investigate the impact of using novel mobile, web and communication technologies in assisting their therapy and treatment. A trial was conducted in the north-eastern part of Germany to evaluate the impact of the “Mobil Diab”, a mobile diabetes management system, on the clinical outcome. 68 subjects aged between 8 and 18 years, divided randomly into control and intervention groups, were included into the study. Metrics such as changes in the quality of metabolic control, changes in psychological parameters, usability and acceptance of the technology were used for evaluation purpose. Metabolic control was mainly assessed by the mean HbAlc. Analysis showed a good acceptance of the proposed system. An overall improvement in mean levels of HbA1c was observed, however further studies will be conducted to prove evidence of the weight and BMI improvements. Moreover, initial indications of positive impact on the improvement in psychological parameters were presumed based on the result of the conducted study. The system appeared to be an efficient and time saving tool in diabetes management.

The role of digital communication in patient–clinician communication for NHS providers of specialist clinical services for young people [the Long-term conditions Young people Networked Communication (LYNC) study]: a mixed-methods study

“…275,278,283,285 Of these, improvements were also seen in the control group, 275 and no significant differences between the intervention and control were reported after 6 months. 283 Three studies reported no reduction in HbA 1c levels following DCC interventions 279,281,284 and five studies found no differences when the intervention was compared with a control.…”

“…Two studies reported no differences in quality of life between the intervention and control groups. 250,276,283 There were also mixed findings in relation to self-efficacy: two studies found that self-efficacy and self-management increased in the intervention group, 275,277 whereas one found no differences. 276 In the qualitative pilot study, patients reported benefits to the intervention.…”

“…250,276,282,284,286 Additionally, one study found that low-density lipoprotein cholesterol concentrations decreased significantly in the intervention arm and high-density lipoprotein cholesterol concentrations increased significantly in both the experimental and control groups. 285 Five studies reported positive impacts of DCC interventions on patients' physical health (BMI and weight stabilised, whereas they increased in the control group, 275 glucose testing increased, 277 DKA admission rates decreased 279 and the number of urgent clinic appointments decreased). 283 Findings were less clear regarding psychological outcomes, however.…”

“…275 Berndt et al 275 reported that health-care staff identified several benefits to their application, focusing on the daily diabetes mellitusrelated records uploaded by patients: having regular data input creates a complete disease history, which is Intervention users (n = 9) mean age was 11.5 years; intervention non-users (n = 7) mean age was 10.9 years Website The Paediatric Diabetes Education Portal was designed to supplement the education delivered during clinic appointments and to improve access to care. The portal provided educational materials, and allowed users to post questions and read responses from their physician and diabetes mellitus education NA BFST-D, behavioural family systems therapy for diabetes; NA, not applicable.…”

Testing a Smartphone App (Young with Diabetes) to Improve Self-Management of Diabetes Over 12 Months: Randomized Controlled Trial (Preprint)

“…At a mandatory consultation, the diary was discussed and patients and providers reflected on its recordings (n=12; ages 13-19). Berndt et al [33] tested an application to collect data and provide clinical support in a four-week RCT (n=68; ages 8-18). Finally, Goyal et al [34] tested an mHealth application in a 12-month RCT (n=92; ages 12-15).…”