1
|
Rawat P, Sehar U, Bisht J, Reddy PH. Support Provided by Caregivers for Community-Dwelling Diabetic Hispanic Adults with Intellectual Disabilities and Comorbid Conditions. Int J Mol Sci 2023; 24:3848. [PMID: 36835260 PMCID: PMC9962604 DOI: 10.3390/ijms24043848] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
Diabetes is an age-related chronic health condition and a major public health concern. Diabetes is one of the significant causes of morbidity and mortality and a major contributing factor to dementia. Recent research reveals that Hispanic Americans are at an increased risk of chronic conditions such as diabetes, dementia, and obesity. Recent research also revealed that diabetes develops at least ten years earlier in Hispanics and Latinos than in neighboring non-Hispanic whites. Furthermore, the management of diabetes and providing necessary/timely support is a challenging task for healthcare professionals. Caregiver support is an emerging area of research for people with diabetes, mainly family caregiver support work for Hispanic and Native Americans. Our article discusses several aspects of diabetes, factors associated with diabetes among Hispanics, its management, and how caregivers can support individuals with diabetes.
Collapse
Affiliation(s)
- Priyanka Rawat
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Jasbir Bisht
- Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Neurology Department, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA
| |
Collapse
|
2
|
Ilkowitz J, Wissing V, Gallagher MP. Pediatric Smart Insulin Pen Use: The Next Best Thing. J Diabetes Sci Technol 2022; 16:635-640. [PMID: 34474591 PMCID: PMC9294571 DOI: 10.1177/19322968211041362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the pediatric population, insulin pump therapy, or CSII, is often considered the gold standard for intensive diabetes management. Insulin pump technology offers families and caregivers many beneficial features including a calculator for insulin dosing and the ability to review diabetes management data to provide data-driven diabetes management. However, for those who find CSII challenging or choose to use multiple daily injections (MDI) there is an option that offers similar features called the Smart Insulin Pen (SIP). Even though SIP technology provides a safe and data-driven diabetes self-management tool for the pediatric population using MDI, there is limited pediatric specific literature. This article will describe current options, data-driven diabetes management, benefits, challenges and clinical use of SIP technology in the pediatric population.
Collapse
Affiliation(s)
- Jeniece Ilkowitz
- The NYU Pediatric Diabetes Center,
Hassenfeld Childrens’ Hospital at NYU Langone, New York, NY, USA
| | - Vanessa Wissing
- The NYU Pediatric Diabetes Center,
Hassenfeld Childrens’ Hospital at NYU Langone, New York, NY, USA
| | - Mary Pat Gallagher
- The NYU Pediatric Diabetes Center,
Hassenfeld Childrens’ Hospital at NYU Langone, New York, NY, USA
| |
Collapse
|
3
|
Delagrange M, Dalla-Vale F, Salet R, Asensio-Weiss V, Moulin P, Cabaret B, Colmel C, Morin C, Talvard M, LeTallec C. Impact of deprivation on glycaemic control in youth with type 1 diabetes in the southwestern region of France. Pediatr Diabetes 2021; 22:796-806. [PMID: 33205845 DOI: 10.1111/pedi.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/09/2020] [Accepted: 11/11/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The objective of this multicenter cross-sectional study was to determine predictors of poor glycaemic control in children with type 1 diabetes mellitus (T1DM), particularly with respect to socioeconomic status (SES). METHODS Our study population consisted of 1154 children who attended T1DM follow-up consultation with a pediatric diabetes specialist. Clinical and demographic data were retrieved retrospectively from patients' records. Individual deprivation was defined by an EPICES (Evaluation of the Deprivation and Inequalities of Health in Healthcare Centers) score ≥ 30. Patients were assigned to quintiles of the European Deprivation Index (EDI) based on their area deprivation scores. We used multivariable linear regression models to detect potential associations between glycaemic control and indicators of low SES. RESULTS In total, 33% (n = 376) of patients had an EPICES score ≥ 30 and 23% (n = 268) were in the 5th EDI quintile. Multivariable linear regression analysis showed that poor glycaemic control was associated with both individual (β 0.38; 95%CI 0.26-0.5; p < 0.001) and area deprivation (β 0.26; 95%CI 0.08-0.43; p = 0.004). Demographic factors, body mass index (BMI) and insulin regimen were also independently associated with poor glycaemic control (p < 0.001). Interestingly, access to diabetes technologies was not related to SES or either glycaemic control. CONCLUSION Low SES is associated with a higher risk of poor glycaemic control, independently of insulin regimen. BMI, age at the time of consultation, duration of diabetes, and insulin regimen. Also have an impact on HbA1c. These parameters need to be considered when developing novel treatment strategies for children with T1DM to better target at-risk patients.
Collapse
Affiliation(s)
- Marine Delagrange
- Pediatric Diabetology Unit, Toulouse University Hospital, Toulouse, France
| | - Fabienne Dalla-Vale
- Montpellier University Hospital, Pediatric Diabetology Unit, Arnaud De Villeneuve Hospital, Saint-Pierre Institute, Palavas-les-Flots, France
| | - Randa Salet
- Pediatric Diabetology Unit, Nîmes University Hospital, Nîmes, France
| | | | - Pierre Moulin
- Pediatric Unit, Montauban Hospital, Montauban, France
| | - Blandine Cabaret
- Bigorre Hospital, Boulevard de Lattre de Tassigny, Tarbes, France
| | - Corinne Colmel
- Toulouse, Childhood, Adolescence, Diabetes Association, Association Enfance, Adolescence & Diabète; EAD, Toulouse, France
| | - Carole Morin
- Pediatric Diabetology Unit, Toulouse University Hospital, Toulouse, France
| | - Maeva Talvard
- Pediatric Diabetology Unit, Toulouse University Hospital, Toulouse, France
| | - Claire LeTallec
- Pediatric Diabetology Unit, Toulouse University Hospital, Toulouse, France.,Toulouse, Childhood, Adolescence, Diabetes Association, Association Enfance, Adolescence & Diabète; EAD, Toulouse, France
| |
Collapse
|
4
|
Dave D, Erraguntla M, Lawley M, DeSalvo D, Haridas B, McKay S, Koh C. Improved Low-Glucose Predictive Alerts Based on Sustained Hypoglycemia: Model Development and Validation Study. JMIR Diabetes 2021; 6:e26909. [PMID: 33913816 PMCID: PMC8120423 DOI: 10.2196/26909] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Predictive alerts for impending hypoglycemic events enable persons with type 1 diabetes to take preventive actions and avoid serious consequences. OBJECTIVE This study aimed to develop a prediction model for hypoglycemic events with a low false alert rate, high sensitivity and specificity, and good generalizability to new patients and time periods. METHODS Performance improvement by focusing on sustained hypoglycemic events, defined as glucose values less than 70 mg/dL for at least 15 minutes, was explored. Two different modeling approaches were considered: (1) a classification-based method to directly predict sustained hypoglycemic events, and (2) a regression-based prediction of glucose at multiple time points in the prediction horizon and subsequent inference of sustained hypoglycemia. To address the generalizability and robustness of the model, two different validation mechanisms were considered: (1) patient-based validation (model performance was evaluated on new patients), and (2) time-based validation (model performance was evaluated on new time periods). RESULTS This study utilized data from 110 patients over 30-90 days comprising 1.6 million continuous glucose monitoring values under normal living conditions. The model accurately predicted sustained events with >97% sensitivity and specificity for both 30- and 60-minute prediction horizons. The false alert rate was kept to <25%. The results were consistent across patient- and time-based validation strategies. CONCLUSIONS Providing alerts focused on sustained events instead of all hypoglycemic events reduces the false alert rate and improves sensitivity and specificity. It also results in models that have better generalizability to new patients and time periods.
Collapse
Affiliation(s)
- Darpit Dave
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Madhav Erraguntla
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Mark Lawley
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Daniel DeSalvo
- Department of Pediatrics, Baylor College of Medicine / Texas Children's Hospital, Houston, TX, United States
| | - Balakrishna Haridas
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, United States
| | - Siripoom McKay
- Department of Pediatrics, Baylor College of Medicine / Texas Children's Hospital, Houston, TX, United States
| | - Chester Koh
- Division of Pediatric Urology, Texas Children's Hospital, Houston, TX, United States
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States
| |
Collapse
|
5
|
Deeb A, Muammar T, Alsaffar H, Sedaghat S, Al Hassani N, Odeh R, Alkhayyat H, Al Sinani A, Attia N, Adhami S, Elbarbary N. Use of ambulatory glucose monitoring and analysis of ambulatory glucose profile in clinical practice for diabetes management; a position statement of the Arab Society of Paediatric Endocrinology and diabetes. Diabetes Res Clin Pract 2021; 173:108671. [PMID: 33493578 DOI: 10.1016/j.diabres.2021.108671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/03/2021] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM Diabetes mellitus imposes a significant burden around the world generally and in the Middle East and North Africa specifically. Glucose monitoring is a cornerstone of diabetes management. METHODS Glycated haemoglobin has always been the main metric for assessing glycaemic control, but its use is linked with multiple pitfalls. As an alternative, continuous glucose monitoring is becoming a standard of care in many countries. Intermittent scanning glucose monitoring (isCGM) has acquired a worldwide popularity and has been proven to improve glycaemic control, hypoglycaemia detection and prevention, and quality of life. RESULTS The most recent International Society of Paediatric and Adolescent Diabetes practice. guidelines recommended its use in young people with diabetes observing Ramadan to ensure safe fasting. At a meeting in Abu Dhabi in November 2019, the Arab Society for Paediatric. Endocrinology and Diabetes brought together a number of regional diabetes experts, patient. representatives and international expert advisors to review the evidence for isCGM and propose. guidelines for its use in the Middle East and North Africa region. CONCLUSION In this paper, the authors strongly recommend the use of isCGM for patients in MENA and present general recommendations and compressive specific guidance for physicians and patients, which they believe will also have wider resonance.
Collapse
Affiliation(s)
- Asma Deeb
- Paediatric Endocrinology Department, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Tawfik Muammar
- Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates
| | - Hussain Alsaffar
- Paediatric Endocrine and Diabetics Unit, Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Noura Al Hassani
- Department of Paediatrics, Tawam Hospital and UAE College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rasha Odeh
- Department of Paediatrics, School of Medicine, University of Jordan, Amman, Jordan
| | - Haya Alkhayyat
- Bahrain Defence Force Royal Medical Services Military Hospital, West Riffa, Kingdom of Bahrain, Kingdom of Bahrain, Royal College of Surgeons in Ireland Medical University of Bahrain, Adliya, Bahrain
| | - Aisha Al Sinani
- National Diabetic and Endocrine Center, Royal Hospital, Muscat, Oman
| | - Najya Attia
- King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Sarah Adhami
- Mediclinic City Hospital, Dubai, United Arab Emirates
| | - Nancy Elbarbary
- Diabetes Unit, Department of Pediatrics, Faculty of medicine, Ain Shams University, Cairo, Egypt.
| |
Collapse
|