Online diabetes education: design and evaluation with prospective diabetes camp counsellors

Effect of Telehealth System on Glycemic Control in Children and Adolescents with Type 1 Diabetes

OBJECTIVE

A close diabetes team-patient relationship is required for establishing satisfactory metabolic control. The purpose of this study was to investigate the effect of a telehealth system on diabetes control.

METHODS

The study was carried out between June 2015 and January 2016 at the Gazi University Faculty of Medicine, Pediatric Endocrinology Department. The telehealth system was developed by the diabetes team. The demographic characteristics, frequency of use and hemoglobin A1c (HbA1c) changes of type 1 diabetic (T1DM) patients using this communication network were analysed.

RESULTS

Eighty two patients [43 (52.4%) females, mean (±standard deviation) age 10.89±4 years] used the telehealth system. Fourteen (17.1%) of the cases were on pump therapy and 59 (72.0%) were counting carbohydrates. The individuals with diabetes or their families preferred WhatsApp communication. Whatsapp provided a means for instant messaging in most instances (57.3%), contact with diabetes education nurse (32.9%) and consultation with the diabetes team about insulin doses and blood glucose regulation (42.7%). HbA1c values after six months were significantly lower in patients/parents calling frequently (p<0.001) compared with HbA1c values recorded at the beginning of the study.

CONCLUSION

Increase in frequency of counselling by the diabetes team led to improved blood glucose control in T1DM patients. A telehealth system is useful for early detection of the need for changes in treatment and for intervention. It also promoted better self care.

Diabetes Camp Counselors: An Exploration of Counselor Characteristics and Quality of Life Outcomes

Purpose The purpose of this study is to investigate the effect of volunteering at a diabetes camp on emerging adults with and without type 1 diabetes mellitus (T1DM). Methods Thirty counselors with and 22 without T1DM (19.07 ± 2.71 years old) volunteered at a 1-week T1DM camp in the northeastern United States. Counselors with T1DM had a range of self-reported A1C scores (5.8% or 39.9 mmol/mol to 14.0% or 129.5 mmol/mol). Self-report measures of quality of life, hope, and well-being were completed pre- and postcamp at 4 time points: 1 month before camp, arrival at camp, final day of camp, and 2 months postcamp. Open-ended questions regarding counselor experiences were analyzed to understand camp effect. Results There were significant differences between counselors' levels of trait hope in comparison to published norms. There were few clear differences in psychosocial outcomes pre- and postcamp; however, some increases in well-being were revealed in anticipation of camp. Major reasons for volunteering included assisting others and reciprocating or continuing a perceived positive experience as a camper. Conclusion No changes in psychosocial outcomes pre- to postcamp were observed. However, measures used in this study may be poorly defined for a counselor population. Further research on the characteristics of emerging adults who choose to be camp counselors is needed. By understanding the demographics of this population, health professionals can help target individuals to become camp counselors as well as enhance the camp experience to fit their developmental needs.

Blood Glucose Control and Related Factors at a Camp for Korean Children and Adolescents with Type 1 Diabetes

Data about Asian children and adolescents with type 1 diabetes are sparse. This study's objectives were to describe blood glucose (BG) levels and related factors at a camp for Korean children and adolescents with type 1 diabetes. This descriptive study was conducted January 8-10, 2015. The participants, 24 children and adolescents, were recruited for a 3-day residential diabetes camp. Data on 24 campers were analyzed. Their mean age was 13.4 (± 1.7) years; 44.4% were boys, and mean HgbA1c was 8.5% (± 1.4%). Results revealed that BG levels were maintained safely: The mean BG level during the 3-day stay was 171.1 (± 33.3) mg/dl. Multiple regression analysis showed that insulin adjustment for hyperglycemia (standardized β = .426; t = 2.431; p = .030) and snacks for hypoglycemia (standardized β = -.719; t = -3.723; p = .003) at the camp were the only independent contributors to mean BG levels during the 3-day study period. No demographic or clinical factor was found to be associated with the mean BG level. This is the first study of its kind to be conducted in an Asian population, presumably because the prevalence of type 1 diabetes in Asia is low and diabetes camps are a novel concept. Further research is recommended to assess the characteristics of campers (e.g., diet, activity levels, and cultural background) and to determine how the health outcomes of children and adolescents with type 1 diabetes are affected by camp programs.

The creation and impact evaluation of "Your guide to diet and diabetes," an interactive web-based diabetes tutorial

BACKGROUND

Millions of Americans turn to the Internet for health information. A need for a comprehensive website that provides information on diet and diabetes management was identified. Therefore, the goal of this study was to develop an easy-to-use website that provided accurate information about diet and diabetes management in an interactive format that was widely accessible.

METHODS

The "Your Guide to Diet and Diabetes" website was developed through issue identification, expert panel review, and face validity phase for content and knowledge/skill assessment surveys. During the first 2 weeks of the website's availability, impact data were collected from website visitors. Responses to demographic questions, knowledge, and skill questions were collected in a database.

RESULTS

Of the 406 individuals who completed a demographic question, a maximum of 104 respondents chose to answer one or more of the interactive knowledge or skills questions.

CONCLUSIONS

"Your Guide to Diet and Diabetes" filled a need for an easy-to-use website that addressed the issues of diet and diabetes. Based on the number of visits to the login page (n = 6,124) and number of individuals who answered demographic questions, the site was well received. While a smaller group of participants elected to complete the interactive knowledge and skills questions, responses to these questions demonstrated that participants obtained knowledge from the website. In particular, participants increased their knowledge of food sources and appropriate serving sizes of carbohydrate. The "making a plate" skill activity was used with much greater frequency than the more conceptually complex carbohydrate counting skill activity.

Victimization of youth with type-1 diabetes by teachers: relations with adherence and metabolic control

This study examined rates of teacher victimization and relationships between teacher victimization, adherence and metabolic control in 167 young people with type-1 diabetes. Questions that assessed diabetes-related victimization from teachers were administered to young people with type-1 diabetes. Metabolic control was measured with HbA1c values and diabetes self-management was assessed using the parent version of the Diabetes Self-Management Profile (DSMP). The results indicated that teacher victimization was associated significantly and negatively with the DSMP Diet Subscale (p = .03), DSMP Insulin Adherence Subscale (p = .00) and overall adherence (p = .01) for younger children (aged 8-11 years), but not for older youth (12-17 years). The implications and recommendations for practitioners are discussed.