State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016–2018

Foster, Nicole C.; Beck, Roy W.; Miller, Kellee M.; Clements, Mark A.; Rickels, Michael R.; DiMeglio, Linda A.; Maahs, David M.; Tamborlane, William V.; Bergenstal, Richard M.; Smith, E. O’Brian; Olson, Beth A.; Garg, Satish K.

doi:10.1089/dia.2018.0384

Cited by 1,519 publications

(1,454 citation statements)

References 19 publications

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“…The use of CGM increased from 6% of people with diabetes in 2012 to 38% in 2017. In children, the use of insulin pump therapy rose to 63% ; however, despite the wide adoption of new technologies, longitudinal real‐world data from the type 1 registry showed that HbA 1c values rose from 61.7 mmol/mol to 68.3 mmol/mol during this period. This might indicate that technology alone is not a remedy for poor glycaemic control.…”

Section: What Has the Past 25 Years Of Research Told Us?mentioning

confidence: 99%

Trends in diabetes self‐management education: where are we coming from and where are we going? A narrative review

et al. 2020

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Aims To summarize the history, development and efficacy of diabetes self‐management education on glycaemic control and mental health in adults and children or adolescents with type 1 diabetes and people with type 2 diabetes. A further aim was to review the status of implementation of diabetes self‐management education into routine care and outline current gaps in implementation and research. Methods We searched PubMed and Google scholar for German‐ and English‐language articles regarding diabetes self‐management education, glycaemic control and mental health, and restricted this search to meta‐analyses. Results Diabetes education has evolved from a compliance‐ and knowledge‐oriented approach to an empowerment‐ and self‐management‐oriented approach. Diabetes self‐management education seems to have a greater impact on glycaemic outcomes than on mental health outcomes, but the latter are rarely assessed. Technological development and digitalization can provide chances and challenges for diabetes self‐management education. Digital solutions show promising results and great potential for improving the efficacy of diabetes self‐management education further and providing ongoing support. The implementation of diabetes self‐management education into routine clinical care frequently remains a challenge. Conclusion Diabetes self‐management education has been acknowledged as an essential part of diabetes therapy; however, current gaps regarding the efficacy of diabetes self‐management education on mental health, and the need for education on the use of diabetes technology, are future avenues for research.

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Section: What Has the Past 25 Years Of Research Told Us?mentioning

confidence: 99%

Trends in diabetes self‐management education: where are we coming from and where are we going? A narrative review

et al. 2020

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“…These concerns continue to this day with an average hemoglobin A1C (HbA1c) >8% in children 8 and above, reaching 9% by 16 years of age . Less than 20% of youth achieve HbA1c levels in target range per current American Diabetes Association guidelines (HbA1c ≤7.5%) . In addition, about 10% suffer from one or more episodes of diabetes ketoacidosis (DKA) per year and 6% have one or more severe hypoglycemic events per year …”

Section: Introductionmentioning

confidence: 99%

Closed loop control in adolescents and children during winter sports: Use of the Tandem Control‐IQ AP system

et al. 2019

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Objective Artificial pancreas (AP) systems have been shown to improve glycemic control throughout the day and night in adults, adolescents, and children. However, AP testing remains limited during intense and prolonged exercise in adolescents and children. We present the performance of the Tandem Control‐IQ AP system in adolescents and children during a winter ski camp study, where high altitude, low temperature, prolonged intense activity, and stress challenged glycemic control. Methods In a randomized controlled trial, 24 adolescents (ages 13‐18 years) and 24 school‐aged children (6‐12 years) with Type 1 diabetes (T1D) participated in a 48 hours ski camp (∼5 hours skiing/day) at three sites: Wintergreen, VA; Kirkwood, and Breckenridge, CO. Study participants were randomized 1:1 at each site. The control group used remote monitored sensor‐augmented pump (RM‐SAP), and the experimental group used the t: slim X2 with Control‐IQ Technology AP system. All subjects were remotely monitored 24 hours per day by study staff. Results The Control‐IQ system improved percent time within range (70‐180 mg/dL) over the entire camp duration: 66.4 ± 16.4 vs 53.9 ± 24.8%; P = .01 in both children and adolescents. The AP system was associated with a significantly lower average glucose based on continuous glucose monitor data: 161 ± 29.9 vs 176.8 ± 36.5 mg/dL; P = .023. There were no differences between groups for hypoglycemia exposure or carbohydrate interventions. There were no adverse events. Conclusions The use of the Control‐IQ AP improved glycemic control and safely reduced exposure to hyperglycemia relative to RM‐SAP in pediatric patients with T1D during prolonged intensive winter sport activities.

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“…Despite the advantages of CGM systems, their adoption has been slow to grow, increasing from only 9% in 2014 to 38% in 2018 . Their use is even lower among individuals with type 2 diabetes.…”

Section: Introductionmentioning

confidence: 99%

First assessment of the performance of an implantable continuous glucose monitoring system through 180 days in a primarily adolescent population with type 1 diabetes

Aronson

Abitbol

Tweden

2019

Diabetes Obesity Metabolism

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Aim To investigate the performance of the Eversense XL implantable continuous glucose monitoring (CGM) system through 180 days in a primarily adolescent population with type 1 diabetes (T1D). Materials and methods This prospective, single‐centre, single‐arm, 180‐day study evaluated the effectiveness and safety of the implantable CGM system in Canadian adolescent and adult subjects with T1D. Accuracy measures included mean absolute relative difference (MARD), 15/15% agreement between CGM glucose and blood glucose measured by Yellow Springs Instruments and surveillance error grid analysis. Adolescent subjects received one sensor in the upper arm and adult subjects received one sensor in each upper arm. In‐clinic CGM system accuracy studies were performed every 30 days. The safety assessment included the incidence of adverse events related to either device or the insertion/removal procedure through 180 days. Results Thirty‐six subjects (30 adolescent/6 adult, 13 female/23 male, mean age 17 ± 9.2 years, mean body mass index 22 ± 4 kg/m 2 ) received the CGM system. Overall MARD was 9.4% (95% CI: 8.6%‐10.5%). CGM system agreement at 15/15% (N = 7163) through 60, 120 and 180 days was 82.9% (95% CI: 78.4%‐86.1%), 83.6% (95% CI: 80.4%‐85.7%) and 83.4% (95% CI: 79.7%‐85.5%), respectively. Surveillance error grid analysis showed 98.4% of paired values in clinically acceptable error zones A and B. No insertion/removal or device‐related serious adverse events were reported. Conclusion The Eversense XL CGM system is safe and accurate through 180 days in a primarily adolescent population of subjects with T1D.

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State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016–2018

Cited by 1,519 publications

References 19 publications

Trends in diabetes self‐management education: where are we coming from and where are we going? A narrative review

Trends in diabetes self‐management education: where are we coming from and where are we going? A narrative review

Closed loop control in adolescents and children during winter sports: Use of the Tandem Control‐IQ AP system

First assessment of the performance of an implantable continuous glucose monitoring system through 180 days in a primarily adolescent population with type 1 diabetes

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