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Pemberton J, Collins L, Drummond L, Dias RP, Krone R, Kershaw M, Uday S. Enhancing equity in access to automated insulin delivery systems in an ethnically and socioeconomically diverse group of children with type 1 diabetes. BMJ Open Diabetes Res Care 2024; 12:e004045. [PMID: 38749509 PMCID: PMC11097826 DOI: 10.1136/bmjdrc-2024-004045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/20/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Manufacturer-supported didactic teaching programmes offer effective automated insulin delivery (AID) systems onboarding in children and young people (CYP) with type 1 diabetes (T1D). However, this approach has limited flexibility to accommodate the needs of families requiring additional support. RESEARCH DESIGN AND METHODS Evaluate the efficacy of an inperson manufacturer-supported didactic teaching programme (Group A), in comparison to a flexible flipped learning approach delivered virtually or inperson (Group B). Retrospective analysis of CYP with T1D using continuous glucose monitoring (CGM), who were initiated on AID systems between 2021 and 2023. Compare CGM metrics from baseline to 90 days for both groups A and B. Additionally, compare the two groups for change in CGM metrics over the 90-day period (∆), patient demographics and onboarding time. RESULTS Group A consisted of 74 CYP (53% male) with median age of 13.9 years and Group B 91 CYP (54% male) with median age of 12.7 years. From baseline to 90 days, Group A lowered mean (±SD) time above range (TAR, >10.0 mmol/L) from 47.6% (±15.0) to 33.2% (±15.0) (p<0.001), increased time in range (TIR, 3.9-10.0 mmol/L) from 50.4% (±14.0) to 64.7% (±10.2) (p<0.001). From baseline to 90 days, Group B lowered TAR from 51.3% (±15.1) to 34.5% (±11.3) (p<0.001) and increased TIR from 46.5% (±14.5) to 63.7% (±11.0) (p<0.001). There was no difference from baseline to 90 days for time below range (TBR, <3.9 mmol/L) for Group A and Group B. ∆ TAR, TIR and TBR for both groups were comparable. Group B consisted of CYP with higher socioeconomic deprivation, greater ethnic diversity and lower carer education achievement (p<0.05). The majority of Group B (n=79, 87%) chose virtual flipped learning, halving diabetes educator time and increasing onboarding cadence by fivefold. CONCLUSIONS A flexible virtual flipped learning programme increases onboarding cadence and capacity to offer equitable AID system onboarding.
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Affiliation(s)
- John Pemberton
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Louise Collins
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Lesley Drummond
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Renuka P Dias
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
- University of Birmingham Institute of Cancer and Genomic Sciences, Birmingham, UK
| | - Ruth Krone
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Melanie Kershaw
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Suma Uday
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
- University of Birmingham Institute of Metabolism and Systems Research, Birmingham, UK
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Parent C, Lespagnol E, Berthoin S, Tagougui S, Stuckens C, Tonoli C, Dupire M, Dewaele A, Dereumetz J, Dewast C, Gueorgieva I, Rabasa-Lhoret R, Heyman E. Continuous moderate and intermittent high-intensity exercise in youth with type 1 diabetes: Which protection for dysglycemia? Diabetes Res Clin Pract 2024; 210:111631. [PMID: 38513989 DOI: 10.1016/j.diabres.2024.111631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/05/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
AIM From an early age, exercise is key to managing type 1 diabetes (T1D). However, hypoglycemia around aerobic exercise is a major barrier to physical activity in children. We explore whether intermittent high-intensity aerobic exercise (IHE), designed to mimic spontaneous childhood physical activity patterns, offers better protection against glycemic drop than continuous moderate-intensity exercise (CME). METHODS Five boys and 7 girls with T1D (9.8 ± 1.4y) performed ergo cycle-based randomized CME and IHE of identical duration and total mechanical load [50 %PWC170vs. 15sec(150 %PWC170)/30 sec passive recovery; both during two 10-min sets, 5 min in-between]. Capillary glycemia during exercise and interstitial glucose during recovery were compared between exercises and an inactive condition, controlling for baseline glycemia, carbohydrate and insulin. RESULTS The exercise-induced decrease in capillary glycemia was attenuated by 1.47 mmol·L-1 for IHE vs. CME (P < 0.05). No symptomatic hypoglycemic episodes occurred during exercises. Post-exercise time in hypoglycemia did not differ between conditions. During early recovery, CME reduced time spent > 16.7 mmol·L-1 compared with inactive days (P < 0.05; CME: 0 %; IHE: 16,7 %; INACTIVE: 41,7 %). CONCLUSION IHE appeared to limit the glycemic drop compared to CME. Performing 20-min CME or IHE was not associated with increased hypoglycemic risk compared to being inactive. CME appeared even transiently protective against serious hyperglycemia.
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Affiliation(s)
- Cassandra Parent
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 413 avenue Eugène Avinée 59120 LOOS, F-59000 Lille, France; Institut de Recherches Cliniques de Montréal, 110 Av. des Pins, Montréal, QC H2W 1R7, Canada
| | - Elodie Lespagnol
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 413 avenue Eugène Avinée 59120 LOOS, F-59000 Lille, France
| | - Serge Berthoin
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 413 avenue Eugène Avinée 59120 LOOS, F-59000 Lille, France
| | - Sémah Tagougui
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 413 avenue Eugène Avinée 59120 LOOS, F-59000 Lille, France
| | - Chantal Stuckens
- Department of Pediatrics, Lille University Hospital, 2 avenue Oscar Lambret, 59000 Lille, France
| | - Cajsa Tonoli
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 413 avenue Eugène Avinée 59120 LOOS, F-59000 Lille, France; Human Physiology Research Group, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Michelle Dupire
- Santélys Association, 351 Rue Ambroise Paré, 59120 Loos, France
| | - Aline Dewaele
- Santélys Association, 351 Rue Ambroise Paré, 59120 Loos, France
| | - Julie Dereumetz
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 413 avenue Eugène Avinée 59120 LOOS, F-59000 Lille, France
| | - Chloé Dewast
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 413 avenue Eugène Avinée 59120 LOOS, F-59000 Lille, France
| | - Iva Gueorgieva
- Department of Pediatrics, Lille University Hospital, 2 avenue Oscar Lambret, 59000 Lille, France
| | - Rémi Rabasa-Lhoret
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 413 avenue Eugène Avinée 59120 LOOS, F-59000 Lille, France; Institut de Recherches Cliniques de Montréal, 110 Av. des Pins, Montréal, QC H2W 1R7, Canada; Department of Nutrition, Université de Montréal, 3e étage, local 3208 du Pavillon Liliane-de-Stewart, 2405 chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada
| | - Elsa Heyman
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, 413 avenue Eugène Avinée 59120 LOOS, F-59000 Lille, France; Institut Universitaire de France, Paris, France.
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Penfornis A, Down S, Seignez A, Vives A, Bonnemaire M, Kulzer B. European Survey on Adult People With Type 1 Diabetes and Their Caregivers: Insights Into Perceptions of Technology. J Diabetes Sci Technol 2023:19322968231208690. [PMID: 37937589 DOI: 10.1177/19322968231208690] [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] [Indexed: 11/09/2023]
Abstract
BACKGROUND Type 1 diabetes (T1D) is a complex condition requiring constant monitoring and self-management. The landscape of diabetes management is evolving with the development of new technologies. This survey aimed to gain insight into the perceptions and experiences of people with T1D (PWD) and their caregivers on the use of technology in diabetes care, and identify future needs for T1D management. METHODS PWD and caregivers (≥18 years) living in five European countries (France, Germany, Italy, Spain, and the United Kingdom) completed an online survey. Data were collected during July and August 2021. RESULTS Responders included 458 PWD and 54 caregivers. More than 60% of PWD perceived devices/digital tools for diabetes management as useful and 63% reported that access to monitoring device data made their life easier. Nearly half of participants hoped for new devices and/or digital tools. While approximately one-third of all PWD had used teleconsultation, perceptions and usage varied significantly between countries and by age (both P < .0001), with the lowest use in Germany (20%) and the highest in Spain (48%). The proportions of PWD contributing to diabetes care costs varied by device and were highest for smart insulin pen users at 83% compared with 44% for insulin pen users and 37% for insulin pump users. One-quarter (24%) of PWD and 15% of caregivers felt they lacked knowledge about devices/digital tools for T1D. CONCLUSIONS Most PWD and caregivers had positive perceptions and experiences of new technologies/digital solutions for diabetes management, although improved support and structured education for devices/digital tools are still required.
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Affiliation(s)
- Alfred Penfornis
- Diabetology Department, Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France and Université Paris-Saclay, Saclay, France
| | - Su Down
- Somerset NHS Foundation Trust, Somerset, UK
| | | | | | | | - Bernhard Kulzer
- Diabetes Zentrum Mergentheim, Forschungsinstitut der Diabetes-Akademie Bad Mergentheim, Universität Bamberg, Bamberg, Germany
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De Block C, Cheng AYY, Christensen TB, Patted URH, Ginovker A. Healthcare Professionals' Knowledge of and Attitudes Towards the Use of Time in Range in Diabetes Management: Online Survey Across Seven Countries. Diabetes Ther 2023:10.1007/s13300-023-01429-x. [PMID: 37332055 PMCID: PMC10299986 DOI: 10.1007/s13300-023-01429-x] [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: 01/06/2023] [Accepted: 05/31/2023] [Indexed: 06/20/2023] Open
Abstract
INTRODUCTION Time in range (TIR) is a metric of glycaemic target management derived from continuous glucose monitoring (CGM) data. This study aimed to understand knowledge of and attitudes towards use of TIR among healthcare professionals (HCPs), and gain insights into benefits and barriers to its use in clinical practice. METHODS An online survey was disseminated across seven countries. Participants were sampled from online HCP panels and were aware of TIR (defined as amount of time in, below, and above target range). Participants were HCPs classified as specialists (SP), generalists (GP), or allied HCPs (AP; diabetes nurse specialists, diabetes educators, general nurses, nurse practitioners/physician assistants). RESULTS Respondents included 741 SP, 671 GP and 307 AP. Most HCPs (approximately 90%) agreed TIR is likely/somewhat likely to become the standard of diabetes management. Perceived benefits of TIR included helping to optimise medication regimen (SP, 71%; GP, 73%; AP, 74%), giving HCPs the knowledge and insights to make informed clinical decisions (SP, 66%; GP, 61%; AP, 72%), and empowering people with diabetes with information to successfully manage their diabetes (SP, 69%; GP, 77%; AP, 78%). Barriers to wider adoption included limited CGM access (SP, 65%; GP, 74%; AP, 69%) and lack of HCP training/education (SP, 45%; GP, 59%; AP, 51%). Most participants considered integration of TIR into clinical guidelines, recognition of TIR by regulators as a primary clinical endpoint, and recognition of TIR by payers as a parameter for diabetes treatment evaluation as key factors for increased use. CONCLUSIONS Overall, HCPs agreed on the benefits of using TIR for diabetes management. Besides raising awareness among HCPs and people with diabetes, more training and healthcare system updates are needed to facilitate increased TIR use. In addition, integration into clinical guidelines and recognition by regulators and payers are needed.
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Affiliation(s)
- Christophe De Block
- Laboratory of Experimental Medicine and Paediatrics, Member of the Infla-Med Center of Excellence, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
- University Hospital Antwerp, Drie Eikenstraat 655, 2650, Edegem, Belgium.
| | - Alice Y Y Cheng
- Trillium Health Partners and Unity Health, University of Toronto, Toronto, ON, Canada
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Fu VR, Irwine K, Browne-Cooper K, Taplin CE, Jones TW, Davis EA, Abraham MB. Outcomes and experiences of families with children with type 1 diabetes on insulin pumps through subsidised pump access programs in Western Australia. Front Endocrinol (Lausanne) 2023; 14:1173559. [PMID: 37361523 PMCID: PMC10286577 DOI: 10.3389/fendo.2023.1173559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction In Australia, access to insulin pump therapy for children with type 1 diabetes (T1D) is predominantly restricted to families with private health insurance. In an attempt to improve equity, additional subsidised pathways exist which provide pumps to families with reduced financial resources. We aimed to describe the outcomes and experiences of families with children commenced on pumps through these subsidised pathways in Western Australia (WA). Methods Children with T1D in WA who did not have private health insurance and received pumps from the subsidised pump programs between January 2016 and December 2020 were included. Study 1 was designed to review glycaemic outcome. A retrospective analysis of HbA1c was conducted in the whole cohort and in children who commenced pump after the first year of diagnosis to exclude the impact of the partial clinical remission phase following diagnosis. HbA1c at baseline, and six, 12, 18 and 24 months after pump initiation were collected. Study 2 was designed to review experiences of families commenced on pumps through subsidised pathway. A questionnaire designed by the clinical team was distributed to parents via an online secure platform to capture their experiences. Results Of the 61 children with mean (SD) age 9.0 (4.9) years who commenced pump therapy through subsidised pump programs, 34 children commenced pump therapy after one year of diagnosis of T1D. The median (IQR) HbA1c (%) in 34 children at baseline was 8.3 (1.3), with no statistically significant change from baseline at six months [7.9 (1.4)], 12 months [8.0 (1.5)], 18 months [8.0 (1.3)] or 24 months [8.0 (1.3)]. The questionnaire response rate was 56%. 83% reported intention to continue pump therapy, however 58% of these families did not have avenue to acquire private health insurance. Families expressed inability to procure private health insurance due to low income and unreliable employment and remained largely unsure about the pathway to obtain the next pump. Discussion Children with T1D who commenced insulin pump therapy on subsidised pathways maintained glycaemic control for two years, and families favored pumps as a management option. However, financial limitations persist as a significant barrier to procure and continue pump therapy. Pathways for access need to be assessed and advocated.
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Affiliation(s)
- Vivian R. Fu
- Medical School, University of Western Australia, Perth, WA, Australia
| | - Kathleen Irwine
- Department of Endocrinology and Diabetes, Perth Children’s Hospital, Perth, WA, Australia
| | - Kirsty Browne-Cooper
- Department of Endocrinology and Diabetes, Perth Children’s Hospital, Perth, WA, Australia
| | - Craig E. Taplin
- Department of Endocrinology and Diabetes, Perth Children’s Hospital, Perth, WA, Australia
- Children’s Diabetes Centre, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Division of Paediatrics, Medical School, University of Western Australia, Perth, WA, Australia
| | - Timothy W. Jones
- Department of Endocrinology and Diabetes, Perth Children’s Hospital, Perth, WA, Australia
- Children’s Diabetes Centre, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Division of Paediatrics, Medical School, University of Western Australia, Perth, WA, Australia
| | - Elizabeth A. Davis
- Department of Endocrinology and Diabetes, Perth Children’s Hospital, Perth, WA, Australia
- Children’s Diabetes Centre, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Division of Paediatrics, Medical School, University of Western Australia, Perth, WA, Australia
| | - Mary B. Abraham
- Department of Endocrinology and Diabetes, Perth Children’s Hospital, Perth, WA, Australia
- Children’s Diabetes Centre, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Division of Paediatrics, Medical School, University of Western Australia, Perth, WA, Australia
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de Vries SAG, Bak JCG, Verheugt CL, Stangenberger VA, Mul D, Wouters MWJM, Nieuwdorp M, Sas TCJ. Healthcare expenditure and technology use in pediatric diabetes care. BMC Endocr Disord 2023; 23:72. [PMID: 37029362 PMCID: PMC10080182 DOI: 10.1186/s12902-023-01316-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/06/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Diabetes mellitus is one of the most common chronic diseases in childhood. With more advanced care options including ever-evolving technology, allocation of resources becomes increasingly important to guarantee equal care for all. Therefore, we investigated healthcare resource utilization, hospital costs, and its determinants in Dutch children with diabetes. METHODS We conducted a retrospective, observational analysis with hospital claims data of 5,474 children with diabetes mellitus treated in 64 hospitals across the Netherlands between 2019-2020. RESULTS Total hospital costs were €33,002,652 per year, and most of these costs were diabetes-associated (€28,151,381; 85.3%). Mean annual diabetes costs were €5,143 per child, and treatment-related costs determined 61.8%. Diabetes technology significantly increased yearly diabetes costs compared to no technology: insulin pumps € 4,759 (28.7% of children), Real-Time Continuous Glucose Monitoring € 7,259 (2.1% of children), and the combination of these treatment modalities € 9,579 (27.3% of children). Technology use increased treatment costs significantly (5.9 - 15.3 times), but lower all-cause hospitalisation rates were observed. In all age groups, diabetes technology use influenced healthcare consumption, yet in adolescence usage decreased and consumption patterns changed. CONCLUSIONS These findings suggest that contemporary hospital costs of children with diabetes of all ages are driven primarily by the treatment of diabetes, with technology use as an important additive factor. The expected rise in technology use in the near future underlines the importance of insight into resource use and cost-effectiveness studies to evaluate if improved outcomes balance out these short-term costs of modern technology.
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Affiliation(s)
- Silvia A G de Vries
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
- Dutch Institute for Clinical Auditing, Leiden, The Netherlands.
| | - Jessica C G Bak
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Dutch Institute for Clinical Auditing, Leiden, The Netherlands
| | - Carianne L Verheugt
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Dick Mul
- Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, The Netherlands
| | - Michel W J M Wouters
- Dutch Institute for Clinical Auditing, Leiden, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Max Nieuwdorp
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Theo C J Sas
- Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Pediatric Endocrinology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
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Chen L, Liu X, Lin Q, Dai H, Zhao Y, Shi Z, Wu L. Status of continuous glucose monitoring use and management in tertiary hospitals of China: a cross-sectional study. BMJ Open 2023; 13:e066801. [PMID: 36737090 PMCID: PMC9900061 DOI: 10.1136/bmjopen-2022-066801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE This study aims to reveal the use and management status of continuous glucose monitoring (CGM) in tertiary hospitals in China and to determine the potential factors affecting the application of CGM, based on which more effective solutions would be produced and implemented. DESIGN An online, cross-sectional study was conducted from October 2021 to December 2021. SETTING Eighty-three tertiary hospitals in China were involved. PARTICIPANTS Eighty-three head nurses and 281 clinical nurses were obtained. OUTCOME Current condition of CGM use and management, the factors that hinder the use and management of CGM, scores of current CGM use and management, as well as their influencing factors, were collected. RESULTS Among the 83 hospitals surveyed, 57 (68.7%) hospitals used CGM for no more than 10 patients per month. Seventy-three (88.0%) hospitals had developed CGM standard operating procedures, but only 29 (34.9%) hospitals devised emergency plans to deal with adverse effects related to CGM. Comparably, maternal and children's hospitals were more likely to have a dedicated person to assign install CGM than general hospitals (52.2% vs 26.7%). As for the potential causes that hinder the use and management of CGM, head nurses' and nurses' perceptions differed. Head nurses perceived patients' limited knowledge about CGM (60.2%), the high costs of CGM and inaccessibility to medical insurance (59.0%), and imperfect CGM management systems (44.6%) as the top three factors. Different from head nurses, CGM operation nurses considered the age of CGM operators, the type of hospital nurses worked in, the number of patients using CGM per month and the number of CGM training sessions as potential factors (p<0.05). CONCLUSIONS The study provides a broad view of the development status of CGM in China. Generally speaking, the use and management of CGM in China are not yet satisfactory, and more efforts are wanted for improvement.
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Affiliation(s)
- Liping Chen
- Department of Endocrinology, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
| | - Xiaoqin Liu
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
- Department of Nursing, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
| | - Qin Lin
- Department of Endocrinology, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
| | - Hongmei Dai
- Department of Endocrinology, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, Chongqing, China
| | - Zumin Shi
- Human Nutrition Department, Qatar University, Doha, Ad Dawhah, Qatar
| | - Liping Wu
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
- Department of Nursing, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
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Fontecha J, González I, Barragán A, Lim T. Use and Trends of Diabetes Self-Management Technologies: A Correlation-Based Study. J Diabetes Res 2022; 2022:5962001. [PMID: 35712029 PMCID: PMC9197631 DOI: 10.1155/2022/5962001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/28/2022] [Accepted: 05/14/2022] [Indexed: 11/24/2022] Open
Abstract
Applications and systems for diabetes self-management are growing and involve a vast majority of factors to consider. This study was aimed at examining the integration of portable technologies for diabetes self-management, as well as benefits and issues arising of its use. From a web-based study on several groups of people with diabetes, most of them accustomed to the daily use of devices and applications for self-control, a deeper analysis based on correlations and inference was conducted considering information about the disease, technology knowledge and devices handling, use of technologies for diabetes control and management, and training with devices from a clinical and educational viewpoint. In this study, more than 70% of participants use Continuous Glucose Systems and additional devices (41.85% also use insulin pumps) which impacts positively on the knowledge of incoming technologies. The "easy to use" factor of current apps for diabetes self-management is the most valuable feature. Also, 88.98% of participants did not use gamification-based methods during the initial training sessions, although gamification is a useful technique in learning stages. An inference analysis shows how specific characteristics of diabetes devices and apps should improve. On the basis of the results, we discuss about benefits, shortcomings, and the state of these technologies and patient needs for the future.
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Affiliation(s)
- Jesús Fontecha
- MAmI Research Lab. University of Castilla-La Mancha, Ciudad Real, Spain
| | - Iván González
- MAmI Research Lab. University of Castilla-La Mancha, Ciudad Real, Spain
| | - Alfonso Barragán
- MAmI Research Lab. University of Castilla-La Mancha, Ciudad Real, Spain
| | - Theodore Lim
- School of Engineering & Physical Sciences, Heriot-Watt University, Edinburgh, UK
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