1
|
Moon JS, Kang S, Choi JH, Lee KA, Moon JH, Chon S, Kim DJ, Kim HJ, Seo JA, Kim MK, Lim JH, Song YJ, Yang YS, Kim JH, Lee YB, Noh J, Hur KY, Park JS, Rhee SY, Kim HJ, Kim HM, Ko JH, Kim NH, Kim CH, Ahn J, Oh TJ, Kim SK, Kim J, Han E, Jin SM, Bae J, Jeon E, Kim JM, Kang SM, Park JH, Yun JS, Cha BS, Moon MK, Lee BW. 2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association. Diabetes Metab J 2024; 48:546-708. [PMID: 39091005 PMCID: PMC11307112 DOI: 10.4093/dmj.2024.0249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/20/2024] [Indexed: 08/04/2024] Open
Affiliation(s)
- Jun Sung Moon
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Shinae Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Han Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Kyung Ae Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Joon Ho Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Jin Kim
- Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Hyun Lim
- Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea
| | - Yoon Ju Song
- Department of Food Science and Nutrition, The Catholic University of Korea, Bucheon, Korea
| | - Ye Seul Yang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Junghyun Noh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Suk Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hae Jin Kim
- Department of Endocrinology and Metabolism, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Min Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jung Hae Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chong Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Jeeyun Ahn
- Department of Ophthalmology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Soo-Kyung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jaehyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Eugene Han
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jaehyun Bae
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Eonju Jeon
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Ji Min Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Seon Mee Kang
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jung Hwan Park
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Bong-Soo Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Byung-Wan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
2
|
Calmarza P, Pérez-Ajami RI, Prieto-López C, Gallego-Royo A, García-Carro C, Lou-Francés GM. Glycemic control and study of lipid and bone metabolism in type 1 diabetic children. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2024; 44:171-181. [PMID: 39079139 PMCID: PMC11361410 DOI: 10.7705/biomedica.7132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 05/15/2024] [Indexed: 08/04/2024]
Abstract
Introduction. Type 1 diabetes mellitus is considered one of the most common chronic diseases of childhood. It is a high-risk factor for developing early cardiovascular disease and it also affects bone health. Objective. To describe demographic characteristics and biochemical parameters of a population of children with type 1 diabetes, evaluated in the pediatric diabetes unit of a tertiary Spanish hospital. Materials and methods. In this retrospective study, we determined metabolic, lipid, and bone parameters in 124 children with type 1 diabetes who were monitored in the pediatric diabetes unit of the Hospital Universitario Miguel Servet in Zaragoza (Spain) from May 2020 to July 2021. Results. Children with type 1 diabetes have worse metabolic control of the disease at puberty, but their lipid control is considered acceptable. We found an inverse correlation between bone formation markers and disease duration, as well as with metabolic control. Conclusion. Bone formation markers are inversely correlated with the percentage of glycated hemoglobin and diabetes evolution time. Patients’ lipid and bone profiles are more favorable when metabolic control of the disease is achieved.
Collapse
Affiliation(s)
- Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, EspañaHospital Universitario Miguel ServetHospital Universitario Miguel ServetZaragozaSpain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, EspañaUniversidad de ZaragozaUniversidad de ZaragozaZaragozaSpain
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, EspañaInstituto de Salud Carlos IIIInstituto de Salud Carlos IIIMadridSpain
| | - Rasha Isabel Pérez-Ajami
- Servicio de Pediatría, Hospital Universitario Miguel Servet, Zaragoza, EspañaHospital Universitario Miguel ServetHospital Universitario Miguel ServetZaragozaSpain
| | - Carlos Prieto-López
- Servicio de Bioquímica Clínica, Hospital de Alcañiz, Alcañiz, EspañaHospital de AlcañizHospital de AlcañizAlcañizSpain
| | - Alba Gallego-Royo
- Servicio de Medicina Preventiva, Hospital Universitario Miguel Servet, Zaragoza, EspañaHospital Universitario Miguel ServetHospital Universitario Miguel ServetZaragozaSpain
| | - Celia García-Carro
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, EspañaHospital Universitario Miguel ServetHospital Universitario Miguel ServetZaragozaSpain
| | - Graciela María Lou-Francés
- Centro de Salud de Barbastro, Barbastro, EspañaCentro de Salud de BarbastroCentro de Salud de BarbastroBarbastroSpain
| |
Collapse
|
3
|
Wu V, Choleva L, Wilkes M. Optimizing Glycemic Outcomes for Children with Type 1 Diabetes. Endocrinol Metab Clin North Am 2024; 53:27-38. [PMID: 38272596 DOI: 10.1016/j.ecl.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Changes in physical growth, neurocognitive development, and pubertal maturation are some of the challenges to achieving blood glucose targets in children with type 1 diabetes mellitus. To optimize glycemic outcomes, a comprehensive approach is crucial to address psychosocial needs, expand the use of diabetes technology, and diminish health inequities.
Collapse
Affiliation(s)
- Vickie Wu
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, Box #1616, Annenberg Building, 4th Floor, New York, NY 10029, USA
| | - Lauryn Choleva
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, Box #1616, Annenberg Building, 4th Floor, New York, NY 10029, USA
| | - Meredith Wilkes
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, Box #1616, Annenberg Building, 4th Floor, New York, NY 10029, USA.
| |
Collapse
|
4
|
Shimelash RA, Belay GM, Aknaw W, Shibabaw AT, Adebabay AA, Gedefaw GD, Kassie TD, Zemariam AB. Incidence and predictors of mortality in children with diabetic ketoacidosis in the comprehensive specialized referral hospitals of West Amhara Region, Northwest Ethiopia: a retrospective follow-up study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1204133. [PMID: 37719988 PMCID: PMC10502163 DOI: 10.3389/fcdhc.2023.1204133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/20/2023] [Indexed: 09/19/2023]
Abstract
Background Diabetic ketoacidosis is one of the major life-threatening conditions associated with acute metabolic complications. It remains a major public health problem in developing countries such as Ethiopia. Objective To assess the incidence and prediction of mortality in children with diabetic ketoacidosis in West Amhara Region Comprehensive Specialized Referral Hospitals, Northwest Ethiopia, in 2022. Methods An institution-based retrospective follow-up study was conducted among 423 study participants with a confirmed diagnosis of diabetic ketoacidosis from 01/01/2017 to 31/12/2021. Data were entered, coded, cleaned, and checked using Epi-Data version 4.6 and exported to Stata version 14 for data analysis. Results A total of 401 child records were included in the final analysis and were followed for 3781 days during the study period. The overall mortality of children with diabetic ketoacidosis was 10.6 per 1000 person-days observed (95% CI: 7.8-14.4) during the entire follow-up period. Hypoglycemia (AHR=4.6; 95% CI: 2.13-10.1), rural residence (AHR=2.9; 95% CI=1.01-8.11), age younger than five (AHR=4.4; 95% CI=1.4-13.7) or between five and 10 (AHR=3.1; 95% CI=1.1-8.8), and female gender (AHR=2.6; 95% CI=1.1-5.8) were significant predictors of mortality. Conclusions The incidence rate of mortality in children with diabetic ketoacidosis was relatively high. Age, rural residence, female gender, and hypoglycemia were significantly predictive of mortality. Community education or mass campaigns about the signs and symptoms of diabetic ketoacidosis may reduce the mortality rate in children.
Collapse
Affiliation(s)
- Rahel Asres Shimelash
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getaneh Mulualem Belay
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Worknesh Aknaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aster Tadesse Shibabaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Aderajew Agmas Adebabay
- Department of Biomedical Science, School of Medicine, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Gezahagn Demsu Gedefaw
- Department of Neonatal Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Referral Hospital, Gondar, Ethiopia
| | - Tadele Derbew Kassie
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| |
Collapse
|
5
|
Ispriantari A, Agustina R, Konlan KD, Lee H. Family-centered interventions for children and adolescents with type 1 diabetes mellitus: an integrative review. CHILD HEALTH NURSING RESEARCH 2023; 29:7-23. [PMID: 36760109 PMCID: PMC9925297 DOI: 10.4094/chnr.2023.29.1.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/26/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate the effect of family-centered interventions on improving health outcomes in children and adolescents with type 1 diabetes mellitus (T1DM). METHODS A literature search was conducted according to the PRISMA guidelines, using six electronic databases: EMBASE, CINAHL, Medline, CENTRAL, Scopus, and Web of Science. The inclusion criteria encompassed studies with populations of children and adolescents (age <18 years) and at least one parent/caregiver, or only parents/caregivers if the children were very young, and studies that investigated the health outcomes of children and parents/caregivers diagnosed with T1DM. RESULTS From 2,746 published studies, only nine studies met the inclusion criteria. The key interventions were non-technology-based interventions (n=4), technology-based interventions (n=2), and combined technology- and non-technologybased interventions (n=3). The interventions had effects on glycated hemoglobin, adherence to diabetes management, diabetes self-management behaviors, and parentchild teamwork in diabetes management. Other essential effects were children's quality of life, children's problem-solving skills, parents' quality of life, and parents' coping and depression. CONCLUSION Family-centered interventions can effectively improve health outcomes in children and adolescents with T1DM. In the future, family-centered interventions integrated with other approaches, theories, and models should be developed to achieve the best possible outcomes.
Collapse
Affiliation(s)
- Aloysia Ispriantari
- Graduate Student, College of Nursing ․ Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea ․ Assistant Professor, Department of Nursing, Institute of Technology and Health Science, Malang, Indonesia
| | - Rismia Agustina
- Graduate Student, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan ․ Assistant Professor, School of Nursing, Faculty of Medicine, Lambung Mangkurat University, Banjarbaru, Indonesia
| | - Kennedy Diema Konlan
- Graduate Student, College of Nursing ․ Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea ․ Lecturer, Department of Public Health Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Hyejung Lee
- Associate Professor, College of Nursing ․ Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea,Corresponding author Hyejung Lee College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea TEL: +82-2-2228-3345 FAX: +82-2-392-5440 E-MAIL:
| |
Collapse
|
6
|
ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Gabbay RA, on behalf of the American Diabetes Association. 14. Children and Adolescents: Standards of Care in Diabetes-2023. Diabetes Care 2023; 46:S230-S253. [PMID: 36507640 PMCID: PMC9810473 DOI: 10.2337/dc23-s014] [Citation(s) in RCA: 81] [Impact Index Per Article: 81.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
7
|
ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Murdock L, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Woodward CC, Gabbay RA, on behalf of the American Diabetes Association. 17. Diabetes Advocacy: Standards of Care in Diabetes-2023. Diabetes Care 2023; 46:S279-S280. [PMID: 36507643 PMCID: PMC9810458 DOI: 10.2337/dc23-s017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
8
|
Matsuzawa Y, Azuma K, Sawa T, Ono Y, Hamada Y, Matsuba I, Kanamori A. A survey of clinical physician's perceptions of stigma and advocacy in patients with type 2 diabetes in Kanagawa, Japan. J Diabetes Investig 2022; 13:2073-2080. [PMID: 35980305 PMCID: PMC9720217 DOI: 10.1111/jdi.13891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 07/15/2022] [Accepted: 08/02/2022] [Indexed: 11/27/2022] Open
Abstract
AIMS/INTRODUCTION To investigate the recognition status of stigma/advocacy in patients with type 2 diabetes in clinical practice settings. METHOD A questionnaire survey on stigma/advocacy of patients with diabetes was carried out for members of the Kanagawa Physicians Association in July 2021. RESULTS The respondents consisted of 33 (16.6%) physicians specializing in diabetes (the D group) and 166 (83.4%) non-specialists (the ND group). 100% of the D group and 48.8% of the ND group knew that patients may be prejudiced or discriminated against because of diabetes. In the question of whether they know the terms 'stigma' and 'advocacy', 'know' was 97.0% and 94.0% in the D group, compared with 45.8% and 36.7% in the ND group, respectively. 97.0% of the D group and 19.9% of the ND group know the advocacy activities of the Japanese Diabetes Society (JDS) and the Japan Association for Diabetes Education (JADEC). The specific contents of the stigma were often unknown or never experienced in the ND group. A free description of the strategy for reducing or eliminating stigma was analyzed by text mining. 'Giving consideration to the patients' feelings', 'Commitment to the problem', and 'Dialogue' were frequent, and there was no significant difference between the two groups. CONCLUSIONS The clinician's understanding of stigma/advocacy associated with having diabetes was insufficient, and activities that alert clinicians to stigma/advocacy, especially those in the ND group, was a theme to be addressed. More awareness-raising activities for stigma/advocacy will lead to better treatment and a better quality of life for patients with diabetes.
Collapse
Affiliation(s)
- Yoko Matsuzawa
- The Study Group of the Medical Communication CommitteeKanagawa Physicians AssociationYokoyama CityJapan
- The Study Group of the Diabetes CommitteeKanagawa Physicians AssociationYokoyama CityJapan
| | - Kosuke Azuma
- The Study Group of the Medical Communication CommitteeKanagawa Physicians AssociationYokoyama CityJapan
- The Study Group of the Diabetes CommitteeKanagawa Physicians AssociationYokoyama CityJapan
| | - Tasuku Sawa
- The Study Group of the Medical Communication CommitteeKanagawa Physicians AssociationYokoyama CityJapan
| | - Yoshiaki Ono
- The Study Group of the Medical Communication CommitteeKanagawa Physicians AssociationYokoyama CityJapan
| | - Yoshiro Hamada
- The Study Group of the Medical Communication CommitteeKanagawa Physicians AssociationYokoyama CityJapan
| | - Ikuro Matsuba
- The Study Group of the Medical Communication CommitteeKanagawa Physicians AssociationYokoyama CityJapan
- The Study Group of the Diabetes CommitteeKanagawa Physicians AssociationYokoyama CityJapan
| | - Akira Kanamori
- The Study Group of the Medical Communication CommitteeKanagawa Physicians AssociationYokoyama CityJapan
- The Study Group of the Diabetes CommitteeKanagawa Physicians AssociationYokoyama CityJapan
| |
Collapse
|
9
|
Zimmerman CF, Bowater KL, Revels MR, Sanchez JE, Gordon VI, Adams JG, Oyetoro RO, Albanese-O'Neill A. Videoconference based training on diabetes technology for school nurses and staff: Pilot study. J Pediatr Nurs 2022; 67:77-82. [PMID: 36030600 DOI: 10.1016/j.pedn.2022.07.024] [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: 12/13/2021] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE Children with diabetes spend a significant portion of time at school and in school-related activities and rely on school nurses for diabetes management support. Diabetes technologies are rapidly evolving, and there are no standardized competencies or training programs for school personnel providing diabetes care. DESIGN AND METHODS A virtual diabetes education program was provided to school nurses and staff in 3 Florida school districts. Program feasibility was measured by attendance; acceptability was measured with a usability survey; and efficacy was measured by participants' improvements in scores on pre- and post-training knowledge assessments. Descriptive statistics were generated and improvements in knowledge were evaluated via t-test. P-values <0.05 were considered significant. RESULTS Pilot survey data (n = 91) revealed high demand for diabetes technology and basic management education among school nurses and staff. Eighty-eight school personnel from 64 schools attended the training, with 67 participants completing the demographic survey and at least one of the pre- and post-training assessments. Post-test scores demonstrated mean + 10.6% absolute improvement on the diabetes technology subscale, +11.5% on the basic management subscale, and + 10.9% on the ketone management subscale, all p < 0.001. Fifty-three participants completed the usability survey with 92% reporting they benefitted from training. CONCLUSIONS Virtual training is feasible and acceptable for delivering diabetes technology education to large numbers of school personnel. Study results demonstrate improved diabetes knowledge. PRACTICE IMPLICATIONS Establishing a standardized training program on diabetes technology for school personnel can optimize diabetes care in the school setting.
Collapse
Affiliation(s)
| | - Katelin L Bowater
- Northeast Florida Pediatric Diabetes Center at Wolfson Children's Hospital, USA
| | - Maureen R Revels
- Northeast Florida Pediatric Diabetes Center at Wolfson Children's Hospital, USA
| | | | | | - Janey G Adams
- University of Florida, Division of Pediatric Endocrinology, USA
| | | | | |
Collapse
|
10
|
An R, Li D, Cole M, Park K, Lyon AR, White NH. Implementation of School Diabetes Care in the United States: A Scoping Review. J Sch Nurs 2022; 38:61-73. [PMID: 34184953 PMCID: PMC9924139 DOI: 10.1177/10598405211026328] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Diabetes management at school demands close collaboration of multiple stakeholders, including students with diabetes and parents, school nurses, teachers/staff, and local health care providers. This scoping review identified and synthesized evidence concerning factors that contributed to the quality and effectiveness of diabetes care implementation in U.S. K-12 schools. Forty-six studies met the eligibility criteria and were included. Five common factors emerged surrounding training and experiences, communications, parent engagement, resource allocations, and school environment. Complex interactions between multiple stakeholders jointly determined the quality of school diabetes care. A conceptual model was established to elucidate the complex interactions between multiple stakeholders and the relevant facilitators and barriers. Future research should improve sample representativeness, contrast school diabetes care practices to the national guidelines, and assess the impact of the social, economic, and political environment at federal, state, local/district levels on school diabetes care implementation.
Collapse
Affiliation(s)
- Ruopeng An
- Brown School, 7548Washington University, St. Louis, MO, USA
| | - Danyi Li
- Brown School, 7548Washington University, St. Louis, MO, USA
| | - Marjorie Cole
- Missouri Department of Health & Senior Services, Jefferson City, MO, USA
| | | | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, 7284University of Washington, Seattle, WA, USA
| | - Neil H White
- School of Medicine, Washington University, St. Louis, MO, USA
| |
Collapse
|
11
|
Adolfsson P, Björnsson V, Hartvig NV, Kaas A, Møller JB, Ogionwo Lange E. Improved Glycemic Control Observed in Children with Type 1 Diabetes Following the Introduction of Smart Insulin Pens: A Real-World Study. Diabetes Ther 2022; 13:43-56. [PMID: 34748170 PMCID: PMC8776949 DOI: 10.1007/s13300-021-01177-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Many challenges are associated with optimizing glycemic control in pediatric patients with type 1 diabetes (T1D); combining data from smart insulin pens and continuous glucose monitoring (CGM) could mitigate some of these obstacles. METHODS This one-arm, prospective, observational study investigated the effects of introducing a smart pen on glycemic control in pediatric patients with T1D who were using CGM. Children and adolescents with T1D who had been prescribed a smart pen for basal and/or bolus insulin injections were enrolled from three clinics in Sweden. Outcomes compared between baseline and follow-up (≥ 12 months) included: mean numbers of daily (over 24 h) and nocturnal hypoglycemic or hyperglycemic events; time above range (TAR; > 180 mg/dL); time below range (TBR; level 1: 54 to < 70 mg/dL; level 2: < 54 mg/dL); time in range (TIR; 70-180 mg/dL); and missed bolus-dose (MBD) meals. RESULTS Overall, 39 patients were included. Mean numbers of daily hypoglycemic events (- 31.4%; p = 0.00035) and nocturnal hypoglycemic events (- 24.4%; p = 0.043) were significantly reduced from baseline to follow-up. Mean daily TBR level 2 was reduced from 2.82% at baseline to 2.18% at follow-up (- 0.64 percentage points; p = 0.025). There were no statistically significant changes in number of daily hyperglycemic events, MBD meals, TIR, TAR, or TBR level 1. CONCLUSIONS Introducing smart insulin pens was associated with a reduced number of hypoglycemic events and decreases in TBR level 2, demonstrating a potential benefit for glycemic control in pediatric patients.
Collapse
Affiliation(s)
- Peter Adolfsson
- Department of Pediatrics, The Hospital of Halland, Kungsbacka, Tölövägen 5, 43480, Kungsbacka, Sweden.
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Viktor Björnsson
- Department of Pediatrics, The Hospital of Halland, Kungsbacka, Tölövägen 5, 43480, Kungsbacka, Sweden
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Anne Kaas
- Medical & Science, Novo Nordisk A/S, Søborg, Denmark
| | | | - Elsa Ogionwo Lange
- Department of Pediatrics, The Hospital of Halland, Kungsbacka, Tölövägen 5, 43480, Kungsbacka, Sweden
| |
Collapse
|
12
|
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
13
|
Vasireddy D, Sehgal M, Amritphale A. Risk Factors, Trends, and Preventive Measures for 30-Day Unplanned Diabetic Ketoacidosis Readmissions in the Pediatric Population. Cureus 2021; 13:e19205. [PMID: 34873537 PMCID: PMC8638216 DOI: 10.7759/cureus.19205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 11/11/2022] Open
Abstract
Background There has been a steady rise in types 1 and 2 diabetes mellitus among the youth in the USA from 2001 to 2017. Diabetic ketoacidosis (DKA) is a common and preventable presentation of both types of diabetes mellitus. According to the Centers for Disease Control and Prevention's (CDC) United States Diabetes Surveillance System, during 2004-2019 an increase in DKA hospitalization rates by 59.4% was noted, with people aged less than 45 years having the highest rates. Readmissions reflect the quality of disease management, which is integrally tied to care coordination and communication with the patient and their families. This study analyzes the trends and risk factors contributing to 30-day unplanned DKA readmissions in the pediatric age group and looks into possible preventive measures to decrease them. Methods A retrospective study was performed using the National Readmission Database (NRD) from January 1, 2017, to December 1, 2017. Pediatric patients aged 18 years and younger with the primary diagnosis of DKA were included using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code E10.10. All statistical analysis was performed using IBM SPSS Statistics for Windows, version 1.0.0.1327 (IBM Corp., Armonk, NY, USA). Pearson's chi-square test was used for categorical variables and Mann-Whitney U test was used for continuous variables. To independently determine the predictors of readmission within each clinical variable, multiple logistic regressions with values presented as odds ratios (OR) with 95% confidence intervals (CI) were performed. Results A weighted total of 19,519 DKA-related pediatric index admissions were identified from the 2017 NRD. Of these pediatric patients, 831 (4.3%) had 30-day DKA readmission. The median age of a child for readmission was 16 years with an interquartile range of 0 to 18 years. A sharp rise in 30-day DKA readmissions was noted for ages 16 years and over. Females in the 0-25th percentile median household income category, with Medicaid covered, large metropolitan areas with at least 1 million residents, and metropolitan teaching hospitals were found to have a statistically significant higher percentage of readmissions. The mean length of stay for those who had a DKA readmission was 2.06 days, with a standard deviation of 1.84 days. The mean hospital charges for those who had a DKA readmission were $ 20,339.70. The 30-day DKA readmission odds were seen to be increased for female patients, Medicaid-insured patients, admissions at metropolitan non-teaching hospitals, and children from 0-25th percentile median household income category. Conclusion There has not been much of a change in the trend and risk factors contributing to the 30-day unplanned DKA readmissions over the years despite the steady rise in cases of diabetes mellitus. The length of stay for those who did not get readmitted within 30 days was longer than for those who did. This could reflect more comprehensive care and discharge planning that may have prevented them from readmission. Diabetes mellitus is a chronic disease that demands a team effort from the patient, family, healthcare personnel, insurance companies, and lawmakers. There is scope for a lot of improvement with the way our patients are being managed, and a more holistic approach needs to be devised.
Collapse
Affiliation(s)
| | - Mukul Sehgal
- Critical Care Medicine, University of South Alabama, Mobile, USA
| | - Amod Amritphale
- Medicine/Cardiovascular Disease, University of South Alabama College of Medicine, Mobile, USA
| |
Collapse
|
14
|
An RP, Li DY, Xiang XL. Role of theories in school-based diabetes care interventions: A critical review. World J Clin Cases 2021; 9:4709-4720. [PMID: 34222437 PMCID: PMC8223856 DOI: 10.12998/wjcc.v9.i18.4709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/05/2021] [Accepted: 05/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diabetes is one of the most common chronic diseases of childhood. School plays an essential role in the management of student diabetes, which reduces the risk of short- and long-term diabetes complications and ensures that students are well-positioned for optimal academic performance and growth.
AIM The aim of this review was to systematically identify and synthesize the literature concerning theory-based diabetes care interventions in K-12 schools in the United States. It critically assessed the specific role of theories and associated essential constructs in intervention design, implementation, outcome measurement, and evaluation.
METHODS Relevant literature was identified by keyword searches of the Cochrane Library, PubMed, and Web of Science.
RESULTS Four interventions met the eligibility criteria and were included in the review. Of those, two evaluated online diabetes education programs for school personnel and the other two assessed in-person interventions. Three studies adopted a one-group pre-post study design, and the remaining one adopted a one-shot case-study design. Three of the interventions adopted social cognitive theory, and the remaining one was guided by the diffusion of innovations theory. Three studies identified core constructs of a theory as predictors of behavioral change. Two used theory to select or develop intervention techniques. Two studies used theory to customize participant intervention techniques. Two studies discussed their findings in the context of theory. No study used theory to select potential intervention participants.
CONCLUSION In conclusion, despite the value of theory in intervention design and evaluation, theory-based diabetes interventions at school remain scarce. Future research may seek ways to better integrate theory and empirical research.
Collapse
Affiliation(s)
- Ruo-Peng An
- Brown School, Washington University in St. Louis, Saint Louis, MO 63130, United States
| | - Dan-Yi Li
- Brown School, Washington University in St. Louis, Saint Louis, MO 63130, United States
| | - Xiao-Ling Xiang
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, United States
| |
Collapse
|
15
|
Grudziąż-Sękowska J, Zamarlik M, Sękowski K. Assessment of Selected Aspects of the Quality of Life of Children with Type 1 Diabetes Mellitus in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042107. [PMID: 33671503 PMCID: PMC7926510 DOI: 10.3390/ijerph18042107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 12/18/2022]
Abstract
Type 1 diabetes mellitus (T1D) is, next to obesity and asthma, the most common chronic disease in children in Poland. T1D is not only a medical challenge, but it also affects all areas of a sick child's life and family functionality. New forms of therapy facilitate the daily management of the disease, but their availability is limited and partly dependent on socioeconomic status. This study aimed to assess the incidence and interrelationships between the child's health condition and the applied therapy model, and selected aspects of the child's family functionality and access to health and care services. The survey involved 206 child and youth caregivers with T1D who are members of Facebook support groups. The analysis of the obtained results revealed the existence of links between family income level and the type of insulin therapy applied. Children from families with a better financial situation (subjective and objective) were more likely to have additional medical consultations and make more frequent control visits. In families with a higher level of income, the T1D-induced restriction of child activity was less frequent. Living outside of urban centers was associated with a reduced availability of care or educational facilities adapted to take care of a child with T1D. No statistically significant correlations were observed between demographic and economic factors and the child's health status expressed by the occurrence of complications. The incidence of the latter, however, affected the child's family situation.
Collapse
Affiliation(s)
- Justyna Grudziąż-Sękowska
- Centre of Postgraduate Medical Education, School of Public Health, 01-813 Warsaw, Poland
- Correspondence: ; Tel.: +48-225-601-150
| | - Monika Zamarlik
- Faculty of Health Sciences, Institute of Public Health, Jagiellonian University, 31-007 Kraków, Poland;
| | - Kuba Sękowski
- Doctoral School, Law College, Kozminski University, 03-301 Warsaw, Poland;
| |
Collapse
|
16
|
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc21-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc21-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
17
|
Demiral M, Demirbilek H, Çelik K, Okur N, Hussain K, Ozbek MN. Neonatal diabetes due to homozygous INS gene promoter mutations: Highly variable phenotype, remission and early relapse during the first 3 years of life. Pediatr Diabetes 2020; 21:1169-1175. [PMID: 32656923 DOI: 10.1111/pedi.13079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 05/03/2020] [Accepted: 06/30/2020] [Indexed: 02/02/2023] Open
Abstract
Neonatal diabetes mellitus (NDM) is a rare form of monogenic diabetes presenting within the first 6 months of life. INS gene promoter mutations have been shown to cause both remitting/relapsing and permanent NDM. We, herein, present three interesting patients with INS gene promoter mutations. Two cousins with an identical homozygous c.-331C > G mutation presented with NDM. The first cousin had nonremitting diabetes and still requires multidose insulin injections at the current age of 6.1 years. However, the other cousin's diabetes remitted at the age of 9 months, and she is still in remission at the age of 3 years with no medication or dietary intervention required (latest HbA1c was 4.9%). The third patient had NDM also due to a homozygous INS promoter c.-331C>A mutation. Her diabetes remitted at the age of 2 months and relapsed at the age of 2.6 years with severe diabetic ketoacidosis (DKA). Distinct clinical phenotype and relapse with severe DKA in one of the three cases suggest that INS promotor mutations can cause a heterogeneous phenotype and even cases exhibiting remission can relapse unpredictably. Therefore, as the age of relapse is unpredictable, close follow-up and family education on diabetes symptoms are essential for cases with remitting/relapsing diabetes due to INS gene mutations.
Collapse
Affiliation(s)
- Meliha Demiral
- Gazi Yaşargil Research and Training Hospital, Pediatric Endocrinology, Diyarbakır, Turkey
| | - Huseyin Demirbilek
- Hacettepe University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Kıymet Çelik
- Gazi Yaşargil Research and Training Hospital, Neonatology, Diyarbakır, Turkey
| | - Nilufer Okur
- Gazi Yaşargil Research and Training Hospital, Neonatology, Diyarbakır, Turkey
| | - Khalid Hussain
- Department of Pediatrics, Division of Endocrinology, Sidra Medicine, Doha, Qatar
| | - Mehmet Nuri Ozbek
- Gazi Yaşargil Research and Training Hospital, Pediatric Endocrinology, Diyarbakır, Turkey
| |
Collapse
|
18
|
Effect of Lactobacillus brevis CD2 containing lozenges and plaque pH and cariogenic bacteria in diabetic children: a randomised clinical trial. Clin Oral Investig 2020; 25:115-123. [PMID: 33083852 PMCID: PMC7785539 DOI: 10.1007/s00784-020-03342-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/12/2020] [Indexed: 12/25/2022]
Abstract
Objective The short-term effect (60 days) of Lactobacillus brevis CD2 lozenges vs placebo on variables related to caries and gingivitis in type 1 diabetic children was evaluated. Material and methods Eight diabetics (4–14 years old) were assigned to two groups (n = 34 subjects each), probiotic lozenges and placebo. Stimulated saliva for microbiological analysis and plaque pH were assessed at baseline (t0), 30 days (t1), 60 days (t2) and in the follow-up period (90 days from baseline, t3). Gingival status was assessed at t0, t2 and t3. Two-way ANOVA assessed differences between groups. Results In the probiotic group, Streptococcus mutans bacterial density mean scores dropped from 3.11 ± 1.13 at baseline to 1.82 ± 0.72 (t2) and to 2.06 ± 0.56 (t3), while in the placebo group, the scores were 3.09 ± 0.8 (t0), 2.82 ± 0.47 (t2) and 3.11 ± 0.43 (t3) (p < 0.01). Lowest and maximum pH fall increased in the probiotic group, from 5.37 ± 0.41 at baseline to 5.49 ± 0.24 at t3 (p < 0.01) and from 1.20 ± 0.46 to 0.98 ± 0.29 (p = 0.02). Bleeding score decreased significantly in both groups, showing a statistically significant lower bleeding score at t2 in the probiotic group (25.6%, 95% CI 21.5–32.7 vs 29.5%, 95% CI 25.2–34.9, p = 0.02). Conclusions Lactobacillus brevis CD2 has shown to improve caries-related risk factors and gingival health in diabetic children. Clinical relevance Lactobacillus brevis CD2 might contribute to improved oral health in type 1 diabetic children. Electronic supplementary material The online version of this article (10.1007/s00784-020-03342-0) contains supplementary material, which is available to authorized users.
Collapse
|
19
|
Commissariat PV, Harrington KR, Whitehouse AL, Miller KM, Hilliard ME, Name MV, DeSalvo DJ, Tamborlane WV, Anderson BJ, DiMeglio LA, Laffel LM. "I'm essentially his pancreas": Parent perceptions of diabetes burden and opportunities to reduce burden in the care of children <8 years old with type 1 diabetes. Pediatr Diabetes 2020; 21:377-383. [PMID: 31808586 PMCID: PMC7830825 DOI: 10.1111/pedi.12956] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/29/2019] [Accepted: 12/02/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Across all age groups, management of type 1 diabetes (T1D) places substantial responsibility and emotional burden upon families. This study explored parent perceptions of the burdens of caring for very young children with T1D. METHODS Semi-structured qualitative interviews were conducted with parents (85% mothers) of 79 children with T1D, aged 1 to <8 years old, from four diverse pediatric diabetes clinical centers. Interviews were transcribed, coded, and analyzed using hybrid thematic analysis to derive central themes. RESULTS Youth (77% White) had T1D for ≥6 months: age (M ± SD) 5.2 ± 1.5 years, diabetes duration 2.4 ± 1.3 years, and A1c 63 ± 10 mmol/mol (7.9 ± 0.9%); 66% used an insulin pump and 61% used CGM. Three major themes emerged related to diabetes burdens: (a) the emotional burden of diabetes on themselves and their children, (b) the burden of finding, training, and trusting effective secondary caregivers to manage the child's diabetes, and (c) suggestions for how more comprehensive, personalized diabetes education from healthcare providers for parents and secondary caregivers could help reduce parent burden and worry. CONCLUSIONS In families with very young children with T1D, parental perceptions of the burden of managing diabetes are common and could be mitigated by tailored education programs that increase parent knowledge, bolster parents' confidence in themselves, and increase trust in their secondary caregivers to manage diabetes. Reduced parental burden and increased caregiver knowledge may positively impact child's glycemic control, as well as improve parent and child quality of life.
Collapse
Affiliation(s)
| | - Kara R. Harrington
- Joslin Diabetes Center and Harvard Medical School, Boston, Massachusetts
| | | | | | - Marisa E. Hilliard
- Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas
| | | | - Daniel J. DeSalvo
- Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas
| | | | | | | | - Lori M. Laffel
- Joslin Diabetes Center and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
20
|
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc20-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
21
|
Butler SM, Boucher EA, Tobison J, Phan H. Medication Use in Schools: Current Trends, Challenges, and Best Practices. J Pediatr Pharmacol Ther 2020; 25:7-24. [PMID: 31897071 PMCID: PMC6938291 DOI: 10.5863/1551-6776-25.1.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2019] [Indexed: 02/01/2023]
Abstract
There are a significant number of students on maintenance medications for chronic diseases or with diagnoses that may result in medical emergencies requiring administration of medications in school. With passing of legislation in all 50 states allowing self-administration of emergency medications for allergic reactions and asthma, the landscape of medication use in schools is changing. These changes have raised questions about the need for legislation or policy development relating to self-carrying and self-administration of medications for other disease states, undesignated stock of emergency medications, and administration of medications by non-medical personnel. Medication administration in the school setting has become a complex issue, and this review will discuss current legislation related to medication use in schools and provide best practices for administering medications to children and adolescents while at school.
Collapse
|
22
|
Alaqeel AA. Pediatric diabetes in Saudi Arabia: Challenges and potential solutions. A review article. Int J Pediatr Adolesc Med 2019; 6:125-130. [PMID: 31890836 PMCID: PMC6926216 DOI: 10.1016/j.ijpam.2019.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/28/2019] [Indexed: 01/27/2023]
Abstract
Diabetes in children has increased globally, and the World Health Organization ranks Saudi Arabia 7th in prevalence and 5th in incidence of type 1 diabetes (T1D). Type 2 diabetes (T2D) in children and adolescents has been identified in Saudi Arabia but its prevalence is still unknown. Despite advances in diabetes management including new insulins, insulin delivery systems, glucose monitoring and easy access to media for disease awareness, diabetes in children continues to be challenging in many aspects. Problems include delayed diagnosis, suboptimal glycemic control, early and late disease complications, transition from pediatric to adult care and raising of obesity and T2D, poor psychological and school support. This review summarizes the pediatric and adolescent diabetes studies in Saudi Arabia to date and explores the country-specific treatment challenges and potential solutions.
Collapse
|
23
|
Kodama S, Morikawa S, Horikawa C, Ishii D, Fujihara K, Yamamoto M, Osawa T, Kitazawa M, Yamada T, Kato K, Tanaka S, Sone H. Effect of family-oriented diabetes programs on glycemic control: A meta-analysis. Fam Pract 2019; 36:387-394. [PMID: 30423118 DOI: 10.1093/fampra/cmy112] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Efficacy of programs for patients with diabetes mellitus (DM) that have promoted family members to help with patients' self-care activities has been largely inconsistent. This meta-analysis aims to assess the effect of family-oriented diabetes programs for glycemic control (GC). METHODS Electronic literature searches were conducted for clinical trials with a parallel design wherein there were two groups according to whether family members were included (intervention group) or not included (control group) and changes in glycohemoglobin A1C (A1C) were assessed as a study outcome. Each effect size (i.e. difference in A1C change between the intervention and control group) was pooled with a random-effects model. RESULTS There were 31 eligible trials consisting of 1466 and 1415 patients in the intervention and control groups, respectively. Pooled A1C change [95% confidence interval (CI)] was -0.45% (-0.64% to -0.26%). Limiting analyses to 21 trials targeted at patients with type 1 DM or 9 trials targeted at patients with type 2 DM, the pooled A1C changes (95% CI) were -0.35% (-0.55% to -0.14%) and -0.71% (-1.09% to -0.33%), respectively. CONCLUSION This meta-analysis suggests that focusing on the family as well as the individual patient in self-management diabetes programs to improve the performance of self-care activities of patients with DM is effective in terms of proper GC.
Collapse
Affiliation(s)
- Satoru Kodama
- Department of Laboratory Medicine and Clinical Epidemiology for Prevention of Noncommunicable Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata
| | - Sakiko Morikawa
- Department of Food Science and Dietetics, Faculty of Human Life Studies, Takushima Bunri University, Tokushima
| | - Chika Horikawa
- Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, Niigata
| | - Dai Ishii
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Kazuya Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Masahiko Yamamoto
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Taeko Osawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Masaru Kitazawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Takaho Yamada
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| | - Kiminori Kato
- Department of Laboratory Medicine and Clinical Epidemiology for Prevention of Noncommunicable Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata
| | - Shiro Tanaka
- Department of Clinical Trial, Design & Management, Translational Research Center, Kyoto University Hospital, Kyoto, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata
| |
Collapse
|
24
|
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
25
|
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
26
|
Christison AL, Vaidya S, Tinajero-Deck L, Hampl SE. Application of the Medical Neighborhood to Children with Severe Obesity. Child Obes 2018; 14:461-467. [PMID: 30109953 DOI: 10.1089/chi.2017.0342] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Growth in the prevalence of severe pediatric obesity and tertiary care pediatric weight management programs supports the application of chronic disease management models to the care of children with severe obesity. One such model, the medical neighborhood, aims to optimize care coordination between primary and tertiary care by applying principles of the Patient-Centered Medical Home to all providers. METHODS An exploration of the literature was performed describing effective programs, approaches, and coordinated care models applied to pediatric weight management and other chronic conditions. RESULTS Though there was a paucity of literature discovered with applications specific to pediatric weight management, relevant disease management and care coordination approaches were found. Proposed applications to the care of children with severe obesity can be made. CONCLUSION The application of the medical neighborhood framework, with its inclusion of healthcare and community partners, may optimize the management of children with severe obesity.
Collapse
Affiliation(s)
- Amy L Christison
- 1 Department of Pediatrics, University of Illinois College of Medicine at Peoria , Peoria, IL
| | - Susma Vaidya
- 2 Department of Pediatrics, Children's National Medical Center , Washington, DC
| | | | - Sarah E Hampl
- 4 Department of Pediatrics, Children's Mercy Hospital , Kansas City, MO
| |
Collapse
|
27
|
Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, Wolfsdorf JI, Schatz D. Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes Association. Diabetes Care 2018; 41:2026-2044. [PMID: 30093549 PMCID: PMC6105320 DOI: 10.2337/dci18-0023] [Citation(s) in RCA: 246] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Jane L Chiang
- McKinsey & Company and Diasome Pharmaceuticals, Inc., Palo Alto, CA
| | - David M Maahs
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Katharine C Garvey
- Division of Endocrinology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Korey K Hood
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Lori M Laffel
- Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Stuart A Weinzimer
- Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT
| | - Joseph I Wolfsdorf
- Division of Endocrinology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Desmond Schatz
- Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, FL
| |
Collapse
|
28
|
Taha NA, Rahme Z, Mesbah N, Mahmoud F, AlKandari S, Othman N, Sharaikha H, Lari BS, AlBeloushi S, Saad E, Arefanian H, Sukkar FF. Evaluation of the impact of a diabetes education eLearning program for school personnel on diabetes knowledge, knowledge retention and confidence in caring for students with diabetes. Diabetes Res Clin Pract 2018; 139:348-356. [PMID: 29574107 DOI: 10.1016/j.diabres.2018.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 02/05/2018] [Accepted: 03/09/2018] [Indexed: 11/23/2022]
Abstract
AIMS To study the impact of a novel comprehensive eLearning approach in delivering diabetes related education program that includes knowledge and sets of practices to the school personnel in Kuwait to enable them to provide a supportive environment for students with diabetes. METHODS The program was designed with three components namely; knowledge, skills and recommendations. The diabetes knowledge was delivered through an interactive eLearning program, the effectiveness of which was assessed using diabetes knowledge questionnaires which were deployed pre- and post-course delivery. Additionally, the participants' knowledge retention and confidence in caring for a student with diabetes were evaluated at 6 or 12 months post-intervention. RESULTS A total of 124 public schools' personnel participated in the program. Post e-Learning delivery, diabetes knowledge increased significantly from baseline (p < 0.0001) and knowledge was retained over 6 and 12 months. Average of overall confidence scores in caring for students with diabetes was 61.86% in all items of care. CONCLUSIONS Offering eLearning diabetes education for school personnel increases their knowledge which can be retained for up to 12 months and imparts confidence in caring for students with diabetes. This novel approach of delivering diabetes education will help school personnel in managing students with diabetes.
Collapse
Affiliation(s)
| | | | | | | | | | - Nashwa Othman
- Dasman Diabetes Institute, Kuwait; Faculty of Nursing, Mansoura University, Egypt.
| | | | | | | | | | | | | |
Collapse
|
29
|
Kahkoska AR, Watts ME, Driscoll KA, Bishop FK, Mihas P, Thomas J, Law JR, Jain N, Mayer-Davis EJ. Understanding antagonism and synergism: A qualitative assessment of weight management in youth with Type 1 diabetes mellitus. ACTA ACUST UNITED AC 2018; 9:21-31. [PMID: 29984330 DOI: 10.1016/j.obmed.2017.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Aims No current clinical guidelines focus on weight management in youth with type 1 diabetes mellitus (T1DM). Our aim was to characterize the patient-perceived experience and barriers to weight management in youth with T1DM. Methods Participants were recruited from the University of North Carolina (n = 16, 56% female, 60% White, 50% insulin pump users, mean age 14.8 years, mean HbA1c 8.5% (69 mmol/mol)) and the University of Colorado (n = 18, 50% female, 80% white, 53% pump users, mean age 15.3 years, mean HbA1c 9.3% (78 mmol/mol)). Focus groups were stratified by sex and weight status (BMI cutoff = 25). Discussions were guided by a standardized set of questions, audio-taped, transcribed, and analyzed thematically using inductive qualitative methods. Results Youth with T1DM expressed four interrelated themes of antagonism between type 1 diabetes and weight management: dysregulated appetite, disruption of blood glucose levels associated with changing diet/exercise, hypoglycemia as a barrier to weight loss, and the overwhelming nature of dual management of weight and glycemic control, and two interrelated themes of synergism: improvement in shared, underlying heath behaviors and exercise as a tool for weight and glycemic control. Variation in emphasis of specific thematic elements was greatest across sex. Youth identified five major components of a weight management program for T1DM: intensified glucose management, healthy diet with known carbohydrate content, exercise, individualization and flexibility, and psychosocial and peer support. Conclusions There is critical need for personalized, T1DM-specific weight recommendations to overcome disease-specific barriers to weight management in the context of T1DM.
Collapse
Affiliation(s)
- Anna R Kahkoska
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Madison E Watts
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kimberly A Driscoll
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, USA
| | - Franziska K Bishop
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO, USA
| | - Paul Mihas
- Odum Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joan Thomas
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer R Law
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nina Jain
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
30
|
Carral San Laureano F, Gutiérrez Manzanedo JV, Moreno Vides P, de Castro Maqueda G, Fernández Santos JR, Ponce González JG, Ayala Ortega MDC. Teachers' attitudes and perceptions about preparation of public schools to assist students with type 1 diabetes. ACTA ACUST UNITED AC 2018; 65:213-219. [PMID: 29358047 DOI: 10.1016/j.endinu.2017.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 11/01/2017] [Accepted: 11/08/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess teachers' attitudes and perceptions about preparation of public primary and secondary education schools in the Puerto Real University Hospital (Cádiz, Spain) area to care for students with type 1 diabetes mellitus (T1DM) METHODS: A descriptive observational study where answers to an attitude and perception questionnaire on the preparation of schools to care for pupils with T1DM were analyzed. A total of 765 teachers (mean age, 44.3±8.8 years; 61.7% women) from 44 public schools in the area of the Puerto Real University Hospital were selected by random sampling. RESULTS Overall, 43.2% of teachers surveyed had or had previously had students with T1DM, but only 0.8% had received specific training on diabetes. 18.9% of teachers reported that one of their students with T1DM had experienced at least one episode of hypoglycemia at school, and half of them felt that their school was not prepared to deal with diabetic emergencies. 6.4% stated that their school had glucagon in its first aid kit, and 46.9% would be willing to administer it personally. Women, physical education teachers, and headmasters had a more positive perception of the school than their colleagues. Teachers with a positive perception of school preparation and with a positive attitude to administer glucagon were significantly younger than those with no positive perception and attitude. CONCLUSIONS The study results suggest that teachers of public schools in our health area have not been specifically trained in the care of patients with T1DM and perceive that their educational centers are not qualified to address diabetic emergencies.
Collapse
Affiliation(s)
| | | | - Pablo Moreno Vides
- Facultad de Ciencias de la Educación, Universidad de Cádiz, Puerto Real, Cádiz, España
| | | | | | | | | |
Collapse
|
31
|
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
32
|
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Collapse
|
33
|
Sundberg F, Barnard K, Cato A, de Beaufort C, DiMeglio LA, Dooley G, Hershey T, Hitchcock J, Jain V, Weissberg-Benchell J, Rami-Merhar B, Smart CE, Hanas R. ISPAD Guidelines. Managing diabetes in preschool children. Pediatr Diabetes 2017; 18:499-517. [PMID: 28726299 DOI: 10.1111/pedi.12554] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 05/14/2017] [Accepted: 05/31/2017] [Indexed: 01/09/2023] Open
Affiliation(s)
- Frida Sundberg
- The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Katharine Barnard
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Allison Cato
- Neurology Division, Nemours Children's Health System, Jacksonville, Florida
| | - Carine de Beaufort
- Clinique Pediatrique, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg.,Department of Pediatrics, UZ Brussels, Jette, Belgium
| | - Linda A DiMeglio
- Department of Pediatrics, Section of Pediatric Endocrinology/Diabetology, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Tamara Hershey
- Psychiatry Department, Washington University School of Medicine, St. Louis, Missouri.,Radiology Department, Washington University School of Medicine, St. Louis, Missouri
| | | | - Vandana Jain
- Pediatric Endocrinology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jill Weissberg-Benchell
- Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Birgit Rami-Merhar
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Carmel E Smart
- Department of Endocrinology, John Hunter Children's Hospital and University of Newcastle, Newcastle, Australia
| | - Ragnar Hanas
- Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Department of Pediatrics, NU Hospital Group, Uddevalla, Sweden
| |
Collapse
|
34
|
Zhang J, Chi H, Xiao H, Tian X, Wang Y, Yun X, Xu Y. Interleukin 6 (IL-6) and Tumor Necrosis Factor α (TNF-α) Single Nucleotide Polymorphisms (SNPs), Inflammation and Metabolism in Gestational Diabetes Mellitus in Inner Mongolia. Med Sci Monit 2017; 23:4149-4157. [PMID: 28846666 PMCID: PMC5584822 DOI: 10.12659/msm.903565] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is common all over the world. GDM women are with inflammatory and metabolisms abnormalities. However, few studies have focused on the association of IL-65-72C/G and TNF-α -857C/T single nucleotide polymorphisms (SNPs), inflammatory biomarkers, and metabolic indexes in women with GDM, especially in the Inner Mongolia population. The aim of this study was to investigate the associations of IL-65-72C/G and TNF-α -857C/T SNPs, and inflammation and metabolic biomarkers in women with GDM pregnancies. MATERIAL AND METHODS Blood samples and placentas from 140 women with GDM and 140 women with healthy pregnancies were collected. Matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS) and MassARRAY-IPLEX were performed to analyze IL-65-72C/G and TNF-α -857C/T SNPs. Enzyme linked immunosorbent assay (ELISA) was performed to analyze inflammatory biomarkers and adipokines. RESULTS Distribution frequency of TNF-α -857CT (OR=3.316, 95% CI=1.092-8.304, p=0.025) in women with GDM pregnancies were obviously higher than that in women with healthy pregnancies. Women with GDM were of older maternal age, had higher BMI, were more nulliparous, and had T2DM and GDM history, compared to women with healthy pregnancies (p<0.05). Inflammatory biomarkers in serum (hs-CRP, IL-6, IL-8, IL-6/IL-10 ratio) and placental (NF-κB, IL-6, IL-8, IL-6/IL-10 ratio, IL-1b, TNF-α) were significantly different (p<0.05) between women with GDM and women with healthy pregnancies. Differences were found for serum FBG, FINS, HOMA-IR, and HOMA-β, and placental IRS-1, IRS-2, leptin, adiponectin, visfatin, RBP-4, chemerin, nesfatin-1, FATP-4, EL, LPL, FABP-1, FABP-3, FABP-4, and FABP-5. CONCLUSIONS TNF-α -857C/T SNP, hs-CRP, IL-6, IL-8, and IL-6/IL-10 were associated with GDM in women from Inner Mongolia, as was serious inflammation and disordered lipid and glucose metabolisms.
Collapse
Affiliation(s)
- Jie Zhang
- Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China (mainland)
| | - Haiyi Chi
- Department of Endocrinology, Huhhot 1st Hospital, Huhhot, Inner Mongolia, China (mainland)
| | - Huiying Xiao
- Department of Obstetrics, Huhhot 1st Hospital, Huhhot, Inner Mongolia, China (mainland)
| | - Xiaoyan Tian
- Department of Obstetrics, Huhhot 1st Hospital, Huhhot, Inner Mongolia, China (mainland)
| | - Yilin Wang
- Department of Obstetrics, Inner Mongolia People's Hospital, Huhhot, Inner Mongolia, China (mainland)
| | - Xia Yun
- Department of internal Medicine, Maternal and Child Health Hospital of Inner Mongolia, Huhhot, Inner Mongolia, China (mainland)
| | - Yancheng Xu
- Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China (mainland)
| |
Collapse
|
35
|
Sparapani VDC, Fels S, Nascimento LC. The Value of Children's Voices for a Video Game Development in the Context of Type 1 Diabetes: Focus Group Study. JMIR Diabetes 2017; 2:e17. [PMID: 30291061 PMCID: PMC6238838 DOI: 10.2196/diabetes.7652] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Children with type 1 diabetes mellitus (T1DM) face daily challenges performing self-care tasks, controlling symptoms, and dealing with psychosocial issues. The use of video games to improve health is a successful support for persons with chronic diseases, promoting adequate self-management through simulations of real life. Involving future users in the development of games is essential to generating innovative, creative, and effective programs. OBJECTIVE Our goal is to identify what children with T1DM need to know about their disease and their self-care tasks as well as their preferences in video games. METHODS Children with T1DM provided input about their learning needs, self-care tasks, and preferences in video games. Three categories were identified through qualitative content analysis: dealing with emotions and knowledge, practical skills and awareness, and game preferences. RESULTS Children expressed concerns about the difficulties of self-care, lack of knowledge about diabetes, and lack of awareness about the consequences of behaviors related to self-care, which contribute to inappropriate behaviors and significantly impact self-management of their disease. They expressed enthusiasm for a video game for children with diabetes that considered their needs and preferences. CONCLUSIONS Findings support the potential benefits when children's input is considered in game design. Consideration of customer needs and preferences is a powerful resource in the development of video games with enhanced learning experience.
Collapse
Affiliation(s)
- Valéria de Cássia Sparapani
- Ribeirao Preto College of Nursing, World Health Organization Collaborating Centre for Nursing Research Development, Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Sidney Fels
- Electrical and Computer Engineering, Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, Canada
| | - Lucila Castanheira Nascimento
- Ribeirao Preto College of Nursing, World Health Organization Collaborating Centre for Nursing Research Development, Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| |
Collapse
|
36
|
Commissariat PV, Boyle CT, Miller KM, Mantravadi MG, DeSalvo DJ, Tamborlane WV, Van Name MA, Anderson BJ, DiMeglio LA, Laffel LM. Insulin Pump Use in Young Children with Type 1 Diabetes: Sociodemographic Factors and Parent-Reported Barriers. Diabetes Technol Ther 2017; 19:363-369. [PMID: 28581817 PMCID: PMC6435342 DOI: 10.1089/dia.2016.0375] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Managing type 1 diabetes (T1D) in young children presents challenges to families and caregivers. Pump therapy may reduce challenges and benefit glycemic control. However, pump use is not universal; parent-reported reasons for lack of uptake are not well described. METHODS Parents of children <7, with T1D for ≥1 year, in the T1D Exchange registry completed surveys capturing demographic and clinical characteristics, as well as barriers to pump use. Data from pump users were compared to nonusers, and barriers were analyzed among parents who received pump recommendations, but decided against uptake. RESULTS Young children (N = 515) from 41 sites were identified (mean age 5.2 ± 1.2 years, diabetes duration 2.4 ± 1.0 years, 46% female, and 78% Non-Hispanic White). Overall glycemic control was suboptimal (HbA1c 8.1% ± 1.0%). The majority were pump users (64%, n = 331; nonusers 36%, n = 184). Pump users had longer T1D duration (2.5 ± 1.1 years vs. 2.2 ± 1.0 years, P = 0.001), were more likely to have annual household incomes ≥$75,000 (62% vs. 36%, P < 0.001), have a parent with college education or higher (70% vs. 45%, P < 0.001), perform more frequent blood glucose monitoring (7.5 ± 2.5 times/day vs. 6.5 ± 2.3 times/day, P < 0.001), and use continuous glucose monitoring (CGM) (45% vs. 13%, P < 0.001). Only income, education, frequency of blood glucose monitoring, and CGM use remained significant in a multivariate model including age, sex, ethnicity, and duration of diabetes. Barriers to pump uptake included concerns with physical interference, therapeutic effectiveness, and to a lesser extent, financial burden. CONCLUSIONS These findings provide an opportunity to address potentially modifiable parent-reported barriers to pump uptake through education and behavioral intervention.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lori M. Laffel
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
37
|
DeBoer MD, Breton MD, Wakeman C, Schertz EM, Emory EG, Robic JL, Kollar LL, Kovatchev BP, Cherñavvsky DR. Performance of an Artificial Pancreas System for Young Children with Type 1 Diabetes. Diabetes Technol Ther 2017; 19:293-298. [PMID: 28426239 DOI: 10.1089/dia.2016.0424] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Young children 5-8 years old with type 1 diabetes (T1D) exhibit clear needs for improved glycemic control but may be limited in their ability to safely interact with an artificial pancreas system. Our goal was to evaluate the safety and performance of an artificial pancreas (AP) system among young children with T1D. RESEARCH DESIGN AND METHODS In a randomized, crossover trial, children with T1D age 5-8 years were enrolled to receive on separate study periods (in random order) either the UVa AP using the DiAs Control Platform software with child-resistant lock-out screens (followed as an out-patient admission) or their usual insulin pump+continuous glucose monitor (CGM) care at home. Hypoglycemic events and CGM tracings were compared between the two 68-h study periods. All analyses were adjusted for level of physical activity as tracked using Fitbit devices. RESULTS Twelve participants (median age 7 years, n = 6 males) completed the trial. Compared to home care, the AP admission resulted in increased time with blood glucose (BG) 70-180 mg/dL (73% vs. 47%) and lower mean BG (152 mg/dL vs. 190 mg/dL), both P < 0.001 after adjustment for activity. Occurrence of hypoglycemia was similar between sessions without differences in time <70 mg/dL (AP 1.1% ± 1.1%; home 1.6% ± 1.2%). There were no adverse events during the AP or home study periods. CONCLUSIONS Use of an AP in young children was safe and resulted in improved mean BG without increased hypoglycemia. This suggests that AP use in young children is safe and improves overall diabetes control. ClinicalTrials.gov registration number: NCT02750267.
Collapse
Affiliation(s)
- Mark D DeBoer
- 1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia
- 2 Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia , Charlottesville, Virginia
| | - Marc D Breton
- 1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia
| | - Christian Wakeman
- 1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia
| | - Elaine M Schertz
- 1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia
| | - Emma G Emory
- 1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia
| | - Jessica L Robic
- 1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia
| | - Laura L Kollar
- 1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia
| | - Boris P Kovatchev
- 1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia
| | - Daniel R Cherñavvsky
- 1 Center for Diabetes Technology, University of Virginia , Charlottesville, Virginia
- 3 TypeZero Technologies, Inc., Charlottesville, Virginia
| |
Collapse
|
38
|
|
39
|
|
40
|
Miller JE, Nugent CN, Russell LB. How Much Time Do Families Spend on the Health Care of Children with Diabetes? Diabetes Ther 2016; 7:497-509. [PMID: 27350546 PMCID: PMC5014787 DOI: 10.1007/s13300-016-0181-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Family time caring for children with diabetes is an overlooked component of the overall burden of the condition. We document and analyze risk factors for time family members spend providing health care at home and arranging/coordinating health care for children with diabetes. METHODS Data for 755 diabetic children and 16,161 non-diabetic children whose chronic conditions required only prescription (Rx) medication were from the 2009-2010 United States National Survey of Children with Special Health Care Needs (NS-CSHCN). We used generalized ordered logistic regressions to estimate adjusted odds ratios (AORs) of time burden by diabetes, insulin use, and stability of the child's health care needs, controlling for health and socioeconomic status. RESULTS Nearly one-quarter of diabetic children had family members who spent 11+ h/week providing health care at home, and 8% spent 11+ h/week arranging/coordinating care, compared with 3.3% and 1.9%, respectively, of non-diabetic Rx-only children. Time providing care at home for insulin-using children was concentrated in the higher time categories: AORs for insulin-using diabetic compared to non-diabetic Rx-only children were 4.4 for 1+ h/week compared with <1 h/week, 9.7 for 6+ vs. <6 h, and 12.4 for 11+ vs. <11 h (all P < 0.05); the pattern was less pronounced for non-insulin-using children. AORs for arranging/coordinating care did not vary by time contrast: AOR = 4.2 for insulin-using, 3.0 for non-insulin-using children. CONCLUSION Health care providers, school personnel, and policymakers need to work with family members to improve care coordination and identify other ways to reduce family time burdens caring for children with diabetes.
Collapse
Affiliation(s)
- Jane E Miller
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA
- Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA
| | - Colleen N Nugent
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA.
| | - Louise B Russell
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA
- Department of Economics, Rutgers University, New Brunswick, NJ, USA
| |
Collapse
|
41
|
Jackson CC, Albanese-O'Neill A. Supporting the Student's Graduated Independence in Diabetes Care. NASN Sch Nurse 2016; 31:202-4. [PMID: 27260800 DOI: 10.1177/1942602x16651749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The gradual progression to self-management is a critical milestone for children/adolescents with diabetes. This article provides recommendations to facilitate collaboration between the student's family, diabetes healthcare provider, and school nurse to support and implement a plan that enables the child/adolescent to acquire the skills and knowledge necessary to successfully transition to independent management of diabetes.
Collapse
Affiliation(s)
- Crystal C Jackson
- Director, Safe at School Initiative, American Diabetes Association, Alexandria, VA
| | | |
Collapse
|
42
|
Herbert LJ, Wall K, Monaghan M, Streisand R. Parent Employment and School/Daycare Decisions among Parents of Young Children with Type 1 Diabetes. CHILDRENS HEALTH CARE 2016; 46:170-180. [PMID: 30906103 DOI: 10.1080/02739615.2015.1124776] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study explored the employment and school/daycare experiences of parents of young children with type 1 diabetes (T1D). Parents (n=134) of young children with T1D (ages 1-6) responded to open-ended questions. Responses were systematically reviewed to identify themes. Four parent employment themes were identified: work cessation/reduction, employment flexibility, significant career impact, and financial pressure. Three school/daycare attendance themes were identified: school/daycare structure and setting, previous experience with T1D, and school/daycare importance. Insulin regimen, child age, and family income were related to parents' decisions. Parents may benefit from clinical programs that assist them with employment and school/daycare decisions.
Collapse
Affiliation(s)
- Linda J Herbert
- Division of Psychology and Behavioral Health, Center for Translational, Science, Children's National Health System, 111 Michigan Ave NW, Washington, DC 20010,
| | - Katheryne Wall
- Center for Translational Science, Children's National Health System, 111 Michigan Ave NW, Washington, DC 20010,
| | - Maureen Monaghan
- Division of Psychology and Behavioral Health, Center for Translational Science, Children's National Health System, 111 Michigan Ave NW, Washington, DC 20010,
| | - Randi Streisand
- Division of Psychology and Behavioral Health, Center for Translational Science, Children's National Health System, 111 Michigan Ave NW, Washington, DC 20010,
| |
Collapse
|
43
|
|
44
|
|
45
|
Díaz-Cárdenas C, Wong C, Vargas Catalán NA. [Metabolic control in children and adolescents with type 1 diabetes]. ACTA ACUST UNITED AC 2015; 87:43-7. [PMID: 26530408 DOI: 10.1016/j.rchipe.2015.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 08/31/2015] [Accepted: 09/09/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Type 1 diabetes mellitus (T1D) is an important disease in children and adolescent being a major risk factor for early morbidity and mortality. OBJECTIVE To know the degree of metabolic control and prevalence of cardiovascular risk factors in T1D patients. PATIENTS AND METHOD Retrospective study including patients under 19 years of age with T1D controlled at a Chilean hospital in 2011. RESULTS 94 patients were evaluated (average age at diagnosis: 7.3 years; current age: 11,9 years; evolution time: 4.5 years). Seventy-nine percent (79.8%) of patients presented glycated hemoglobin (HbA1c) over the recommended level with an average of 8.9%. The group between 13 and 19 years of age exhibited the worst metabolic control (86% with HbA1c abnormal levels). Overweight or obesity occurred in 26.6% of patients, 20.3% had LDL >100mg/dl and 4.2% had hypertension. CONCLUSIONS Only about twenty percent of patients had adequate metabolic control as measured by HbA1c, although cardiovascular risk profile was acceptable. Therapeutic and educational efforts must be reinforced mainly in adolescents, emphasizing the importance of adequate nutritional management as a primary method to treat this entity.
Collapse
Affiliation(s)
- Claudia Díaz-Cárdenas
- Departamento de Pediatría y Cirugía Infantil, Sede Occidente, Universidad de Chile, Santiago, Chile; Unidad de Diabetes Infantil, Servicio de Pediatría, Hospital San Juan de Dios, Santiago, Chile; Servicio de Pediatría, Hospital de Puerto Montt, Puerto Montt, Chile.
| | - Carolina Wong
- Departamento de Pediatría y Cirugía Infantil, Sede Occidente, Universidad de Chile, Santiago, Chile; Unidad de Diabetes Infantil, Servicio de Pediatría, Hospital San Juan de Dios, Santiago, Chile
| | - Nelson A Vargas Catalán
- Departamento de Pediatría y Cirugía Infantil, Sede Occidente, Universidad de Chile, Santiago, Chile
| |
Collapse
|
46
|
Affiliation(s)
- William T Cefalu
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | | |
Collapse
|
47
|
Jackson CC, Albanese-O'Neill A, Butler KL, Chiang JL, Deeb LC, Hathaway K, Kraus E, Weissberg-Benchell J, Yatvin AL, Siminerio LM. Diabetes care in the school setting: a position statement of the American Diabetes Association. Diabetes Care 2015; 38:1958-63. [PMID: 26404925 DOI: 10.2337/dc15-1418] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
| | | | | | | | - Larry C Deeb
- Florida State University College of Medicine, Tallahassee, FL
| | | | - Ed Kraus
- IIT Chicago-Kent College of Law, Chicago, IL
| | - Jill Weissberg-Benchell
- Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | | | | |
Collapse
|
48
|
Hilliard ME, Oser SM, Close KL, Liu NF, Hood KK, Anderson BJ. From Individuals to International Policy: Achievements and Ongoing Needs in Diabetes Advocacy. Curr Diab Rep 2015; 15:59. [PMID: 26194156 PMCID: PMC4581582 DOI: 10.1007/s11892-015-0636-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Diabetes impacts tens of millions of people in the United States of America and 9 % of the worldwide population. Given the public health implications and economic burden of diabetes, the needs of people with diabetes must be addressed through strategic and effective advocacy efforts. Diabetes advocacy aims to increase public awareness about diabetes, raise funds for research and care, influence policy impacting people with diabetes, and promote optimal individual outcomes. We present a framework for diabetes advocacy activities by individuals and at the community, national, and international levels and identify challenges and gaps in current diabetes advocacy. Various groups have organized successful diabetes advocacy campaigns toward these goals, and lessons for further advancing diabetes advocacy can be learned from other health-related populations. Finally, we discuss the role of healthcare providers and mental/behavioral health professionals in advocacy efforts that can benefit their patients and the broader population of people with diabetes.
Collapse
Affiliation(s)
- Marisa E. Hilliard
- Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA
| | - Sean M. Oser
- Pennsylvania State University College of Medicine, 500 University Drive, HP-21, Hershey, PA 17033, USA
| | - Kelly L. Close
- The diaTribe Foundation, 804 Haight Street, San Francisco, CA 94117, USA
| | - Nancy F. Liu
- The diaTribe Foundation, 804 Haight Street, San Francisco, CA 94117, USA
| | - Korey K. Hood
- Stanford University School of Medicine, 780 Welch Road, MC 5208, Palo Alto, CA 94305-5208, USA
| | - Barbara J. Anderson
- Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA
| |
Collapse
|
49
|
Cefalu WT, Boulton AJ, Tamborlane WV, Moses RG, LeRoith D, Greene EL, Hu FB, Bakris G, Wylie-Rosett J, Rosenstock J, Weinger K, Blonde L, de Groot M, Riddle MC, Henry R, Golden SH, Rich S, Reynolds L. Status of Diabetes Care: New Challenges, New Concepts, New Measures--Focusing on the Future! Diabetes Care 2015; 38:1177-80. [PMID: 26312261 PMCID: PMC5131862 DOI: 10.2337/dc15-0875] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- William T. Cefalu
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | | | | | | | - Derek LeRoith
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Eddie L. Greene
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | - Frank B. Hu
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - George Bakris
- ASH Comprehensive Hypertension Center, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, The University of Chicago Medicine, Chicago, IL
| | - Judith Wylie-Rosett
- Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Julio Rosenstock
- Dallas Diabetes and Endocrine Center at Medical City, Dallas, TX
| | - Katie Weinger
- Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Lawrence Blonde
- Ochsner Diabetes Clinical Research Unit, Frank Riddick Diabetes Institute, Department of Endocrinology, Ochsner Medical Center, New Orleans, LA
| | - Mary de Groot
- Indiana University School of Medicine, Indianapolis, IN
| | - Matthew C. Riddle
- Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, Portland, OR
| | | | - Sherita Hill Golden
- Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stephen Rich
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA
| | | |
Collapse
|
50
|
|