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Insulin adherence type 1 diabetes

Heather R Gilbertson, Kristen Reed, Sarah Clark, Kate L Francis, Fergus J Cameron
To understand what children with type 1 diabetes in a representative tertiary hospital clinic are eating compared to their peers and explore dietary intake impact on HbA1c outcome. An open cross-sectional dietary audit of children and adolescents with diabetes aged 2-17 years attending the Royal Children's Hospital, Melbourne was conducted using an age-appropriate validated Food Frequency Questionnaire. Total energy, macronutrient intake and diet quality were calculated and compared to dietary advice provided and national intake data...
March 9, 2018: Nutrition & Diabetes
Marion Waite, Clare Martin, Rachel Franklin, David Duce, Rachel Harrison
BACKGROUND: People with type 1 diabetes (T1D) undertake self-management to prevent short and long-term complications. Advanced technology potentially supports such activities but requires consideration of psychological and behavioral constructs and usability issues. Economic factors and health care provider capacity influence access and uptake of advanced technology. Previous reviews have focused upon clinical outcomes or were descriptive or have synthesized studies on adults with those on children and young people where human factors are different...
March 15, 2018: JMIR Human Factors
Mariusz Jaworski, Mariusz Panczyk, Małgorzata Cedro, Alicja Kucharska
Background: Adherence by diabetic patients to dietary recommendations is important for effective therapy. Considering patients' expectations in case of diet is significant in this regard. The aim of this paper was to analyze the relationship between selected independent variables (eg, regular blood glucose testing) and patients' adherence to dietary recommendations, bearing in mind that the degree of disease acceptance might play a mediation role. Subjects and methods: A cross-sectional study was conducted in 91 patients treated for type 2 diabetes mellitus in a public medical facility...
2018: Patient Preference and Adherence
Lisa Chu, Katherine M Morrison, Michael C Riddell, Sandeep Raha, Brian W Timmons
PURPOSE: The capacity to match carbohydrate (CHO) oxidation with CHO availability (deemed metabolic flexibility (MetFlex)) may be important for type 2 diabetes prevention. In adults, impaired MetFlex is associated with insulin resistance (IR), which can be improved with as little as 7 days of exercise. Whether this occurs similarly in children is unknown. We hypothesized 7 consecutive days of exercise would improve MetFlex and IR in children with obesity. METHODS: Twelve children (8 boys, 4 girls) completed 2 study visits before (PRE) and 2 study visits after (POST) exercise training...
February 2, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Sandra Zoni, Marie-Elise Verga, Michael Hauschild, Marie-Paule Aquarone-Vaucher, Teresa Gyuriga, Anne-Sylvie Ramelet, Andrew A Dwyer
PURPOSE: We aimed to evaluate patient self-management activities, patient perceptions of the therapeutic relationship and satisfaction with nurse-led consultations as part of a structured, pilot program transitioning young adults with type 1 diabetes (T1DM) to adult-oriented community-based practices. DESIGN AND METHODS: A descriptive, cross-sectional study of patients receiving nurse-led consultations. Patients provided sociodemographic/health information, glycated hemoglobin (HbA1c) measures and completed questionnaires assessing self-management (Revised Self-Care Inventory) and the therapeutic relationship (Caring Nurse-Patient Interaction - short scale)...
January 2018: Journal of Pediatric Nursing
Christina M Dieli-Conwright, Kerry S Courneya, Wendy Demark-Wahnefried, Nathalie Sami, Kyuwan Lee, Thomas A Buchanan, Darcy V Spicer, Debu Tripathy, Leslie Bernstein, Joanne E Mortimer
Purpose Metabolic syndrome is associated with an increased risk of cardiovascular disease, type 2 diabetes, and breast cancer recurrence in survivors of breast cancer. This randomized controlled trial assessed the effects of a 16-week combined aerobic and resistance exercise intervention on metabolic syndrome, sarcopenic obesity, and serum biomarkers among ethnically diverse, sedentary, overweight, or obese survivors of breast cancer. Methods Eligible survivors of breast cancer (N = 100) were randomly assigned to exercise (n = 50) or usual care (n = 50)...
March 20, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Mark Peyrot, Darlene Dreon, Vivien Zraick, Brett Cross, Meng H Tan
INTRODUCTION: A basal-bolus insulin regimen is needed to achieve glycated hemoglobin A1c (HbA1c) below 7.0% in people with type 1 (T1D) or type 2 (T2D) diabetes who have significant loss of beta-cell function. Nonadherence to therapy is common and negatively affects the ability to reach treatment goals. We examined patient assessment of a new, wearable mealtime insulin-delivery system (patch) relative to their current mealtime insulin-delivery system (syringe, pen, or pump). The patch is designed to deliver only boluses of fast-acting insulin (no basal insulin), mechanically controlled by the patient...
January 11, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Hang Ding, Farhad Fatehi, Anthony W Russell, Mohan Karunanithi, Anish Menon, Dominique Bird, Leonard C Gray
BACKGROUND: Many patients with diabetes require insulin therapy to achieve optimal glycemic control. Initiation and titration of insulin often require an insulin dose adjustment (IDA) program, involving frequent exchange of blood glucose levels (BGLs) and insulin prescription advice between the patient and healthcare team. This process is time consuming with logistical barriers. OBJECTIVE: To develop an innovative mobile health (m-Health) mobile-based IDA program (mIDA) and evaluate the user adherence and experience through a proof-of-concept trial...
December 20, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Carine Sousa Andrade, Guilherme Sousa Ribeiro, Carlos Antonio Souza Teles Santos, Raimundo Celestino Silva Neves, Edson Duarte Moreira
OBJECTIVE: Long-term complications of type 1 diabetes mellitus (DM1) can be prevented with adequate glycaemic control. However, high levels of glycated haemoglobin (HbA1c) occur in 60%-90% of the patients with DM1. Thus, we aimed to investigate the role of sociodemographic, behavioural and clinical factors on the HbA1c levels of patients with DM1 in Brazil. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional study was conducted in ambulatory patients with DM1 aged ≥18 years from 10 Brazilian cities...
December 14, 2017: BMJ Open
Rudolf Chlup, Sarah Runzis, Javier Castaneda, Scott W Lee, Xuan Nguyen, Ohad Cohen
BACKGROUND: This prospective single-center study recruited insulin-resistant continuous subcutaneous insulin infusion (CSII) therapy-naive patients with type 2 diabetes (T2D) using insulin analog-based multiple daily injections (MDI) therapy and metformin. METHODS: A total of 23 individuals with T2D (70% male), aged a mean ± standard deviation 57.2 ± 8.03 years, with body mass index of 36.2 ± 7.02 kg/m2 , diabetes duration of 13.3 ± 4.64 years, and HbA1c of 10...
February 2018: Diabetes Technology & Therapeutics
Clare Bradley, Eveline Eschwège, Pedro de Pablos-Velasco, Klaus G Parhofer, Dominique Simon, Hans Vandenberghe, Linda Gönder-Frederick
OBJECTIVE: PANORAMA, a nine-country cross-sectional type 2 diabetes study, investigated factors associated with quality of life (QoL), health status, and other patient-reported outcome measures (PROMs). RESEARCH DESIGN AND METHODS: Patients were randomly or consecutively selected from primary/secondary care. PROMs included the Audit of Diabetes-Dependent Quality of Life (ADDQoL) (generic QoL item and average weighted impact [AWI] scores), Diabetes Treatment Satisfaction Questionnaire (DTSQ) (patient- and physician-completed), Hypoglycemia Fear Survey-II worry subscale, and the EuroQoL-5 Dimension visual analog scale (EQ-VAS) measuring patient-reported health...
February 2018: Diabetes Care
Sarah S Jaser, Nicole C Foster, Bryce A Nelson, Julie M Kittelsrud, Linda A DiMeglio, Maryanne Quinn, Steven M Willi, Jill H Simmons
OBJECTIVES: Sleep has physiological and behavioral impacts on diabetes outcomes, yet little is known about the impact of sleep disturbances in children with type 1 diabetes. The current study sought to characterize sleep in children with type 1 diabetes and in their parents and to examine the associations between child sleep, glycemic control and adherence, parent sleep and well-being, parental fear of hypoglycemia, and nocturnal caregiving behavior. METHODS: Surveys were emailed to parents of 2- to 12-year-old participants in the Type 1 Diabetes (T1D) Exchange clinic registry...
November 2017: Sleep Medicine
Daniel Miteku Yigazu, Tigestu Alemu Desse
OBJECTIVE: The aim of this study was to assess the rate of glycemic control and factors affecting glycemic control in type 2 diabetic patients. RESULTS: A total of 174 type 2 diabetic patients were interviewed and were studied. Mean age of the patients was 48.98 ± 14.96 years (range 18-80 years). More than half (51.7%) of the patients were males. About a third of patients, 53 (30.5%), were on antidiabetic medications for less than 5 years. The most common prescribed antidiabetic medications were insulin, 48 (27...
November 15, 2017: BMC Research Notes
Andrew McGovern, Zayd Tippu, William Hinton, Neil Munro, Martin Whyte, Simon de Lusignan
Limited medication adherence and persistence with treatment are barriers to successful management of type 2 diabetes (T2D). We searched MEDLINE, EMBASE, the Cochrane Library, the Register of Controlled Trials, PsychINFO and CINAHL for observational and interventional studies that compared the adherence or persistence associated with 2 or more glucose-lowering medications in people with T2D. Where 5 or more studies provided the same comparison, a random-effects meta-analysis was performed, reporting mean difference (MD) or odds ratio (OR) for adherence or persistence, depending on the pooled study outcomes...
April 2018: Diabetes, Obesity & Metabolism
Robert L Whitener, Lisa Gallo Knight, Jianwei Li, Sarah Knapp, Shuyao Zhang, Mani Annamalai, Vadim M Pliner, Dongtao Fu, Ilian Radichev, Christina Amatya, Alexei Savinov, Arif Yurdagul, Shuai Yuan, John Glawe, Christopher G Kevil, Jing Chen, Scott E Stimpson, Clayton E Mathews
Type 1 diabetes (T1D) has a strong genetic component. The insulin dependent diabetes ( Idd ) 22 locus was identified in crosses of T1D-susceptible NOD mice with the strongly T1D-resistant ALR strain. The NODcALR-( D8Mit293-D8Mit137 )/Mx (NOD- Idd22 ) recombinant congenic mouse strain was generated in which NOD mice carry the full Idd22 confidence interval. NOD- Idd22 mice exhibit almost complete protection from spontaneous T1D and a significant reduction in insulitis. Our goal was to unravel the mode of Idd22 -based protection using in vivo and in vitro models...
December 15, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
Eduardo García Díaz, Davinia Ramírez Medina, Alba García López, Óscar Mauricio Morera Porras
AIM: To assess glycemic control in diabetic patients, to measure the impact on such control of adherence to hypoglycemic agents and to medical visits, and to explore factors that allow for predicting adherence. METHODS: Study of historical cohorts of diabetic patients. The proportion of patients who achieved the target HbA1c levels was estimated. Adherence was assessed using the Haynes-Sackett test. Change in HbA1c from the first to the last visit, adherence, and attendance to visits were analyzed according to comorbidities, cardiovascular risk factors, and treatments used...
December 2017: Endocrinología, Diabetes y Nutrición
Ranee Chatterjee, Cris Slentz, Clemontina A Davenport, Johanna Johnson, Pao-Hwa Lin, Michael Muehlbauer, David D'Alessio, Laura P Svetkey, David Edelman
Background: Low potassium has been identified both as a risk factor for type 2 diabetes and as a mediator of the racial disparity in diabetes risk. Low potassium could be a potentially modifiable risk factor, particularly for African Americans. Objective: We sought to determine the effects of potassium chloride (KCl) supplements, at a commonly prescribed dose, on measures of potassium and glucose metabolism. Design: Among African-American adults with prediabetes, we conducted a double-blinded pilot randomized controlled trial that compared the effects of 40 mEq K/d as KCl supplements with a matching placebo, taken for 3 mo, on measures of potassium and glucose metabolism, with measures collected from frequently sampled oral-glucose-tolerance tests (OGTTs)...
December 2017: American Journal of Clinical Nutrition
Francesco Baratta, Daniele Pastori, Licia Polimeni, Tommaso Bucci, Fabrizio Ceci, Cinzia Calabrese, Ilaria Ernesti, Gaetano Pannitteri, Francesco Violi, Francesco Angelico, Maria Del Ben
OBJECTIVES: The prevalence of cardiometabolic disorders, including non-alcoholic fatty liver disease (NAFLD), is increasing in western countries, because of changes in lifestyle and dietary habits. Mediterranean Diet (Med-Diet) is effective for cardiovascular prevention, but its relationship with NAFLD has been scarcely investigated. METHODS: We included 584 consecutive outpatients presenting with one or more cardiovascular risk factor such as type 2 diabetes mellitus (T2DM), arterial hypertension, overweight/obesity, and dyslipidemia...
December 2017: American Journal of Gastroenterology
Nicolaas C Schaper, Annie Nikolajsen, Anna Sandberg, Sarah Buchs, Mette Bøgelund
INTRODUCTION: We investigated the association of bolus insulin dose timing with demographics, adherence, diabetes education program participation, experience with hypoglycemic events, glycemic control, and patient preference among respondents with type 2 diabetes. METHODS: Adults with type 2 diabetes from 12 countries were recruited to a Web-based self-reported patient preference survey. Adherence was measured using an adapted Morisky Medication Adherence Scale questionnaire...
December 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Jemma J A Anderson, Jennifer J Couper, Lynne C Giles, Catherine E Leggett, Roger Gent, Brian Coppin, Alexia S Peña
Context: Children with type 1 diabetes have vascular dysfunction preceding atherosclerosis. Early interventions are needed to reduce cardiovascular disease. Objective: To evaluate the effect of metformin on vascular function in children with type 1 diabetes. Design: Twelve-month double-blind, randomized, placebo-controlled trial. Setting: Tertiary pediatric diabetes clinic. Participants: Ninety children (8 to 18 years of age), >50th percentile body mass index (BMI), with type 1 diabetes...
December 1, 2017: Journal of Clinical Endocrinology and Metabolism
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