Frontiers in clinical diabetes and healthcare最新文献

{"title":"Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus.","authors":"India Dickinson, Ankita Gupta, Gar Mun Lau, Pranav Viswanath Iyer, John Stuart Pemberton, Suma Uday","doi":"10.3389/fcdhc.2024.1417287","DOIUrl":"10.3389/fcdhc.2024.1417287","url":null,"abstract":"<p><strong>Background: </strong>The UK National Paediatric Diabetes Audit (NPDA) data reports disparities in Haemoglobin A1c (HbA1c) levels among children and young people (CYP) with Type 1 Diabetes (T1D), with higher levels in those of Black ethnic background and lower socioeconomic status who have less access to technology. We investigate HbA1c differences in a T1D cohort with higher than national average technology uptake where > 60% come from an ethnic minority and/or socioeconomically deprived population.</p><p><strong>Design & methods: </strong>Retrospective cross-sectional study investigating the influence of demographic factors, technology use, and socioeconomic status (SES) on glycaemic outcomes. The study population was 222 CYP with T1D who attended the diabetes clinic in 2022 at a single tertiary paediatric diabetes centre.</p><p><strong>Results: </strong>Among 222 CYP, 60% were of ethnic minority (Asian, Black, Mixed and Other were 32%, 12%, 6% and 10% respectively) and 40% of white heritage. 94% used Continuous Glucose Monitoring (CGM) and 60% used Continuous Subcutaneous Insulin Infusion (CSII) via open or closed loop. 6% used Self-Monitoring of Blood Glucose (SMBG) and Multiple Daily Injections (MDI), 34% used CGM and MDI, 38% used CGM and CSII and 22% used Hybrid Closed-Loop (HCL) systems. Significant differences in HbA1c across therapy groups (p < 0.001) was noted with lowest HbA1c in HCL group (55 mmol/mol; p <0.001). Despite adjusting for therapy type, the Black group had higher HbA1c than their white and Asian counterparts (p<0.001). CYP from the most deprived tertile had significantly higher HbA1c levels (p < 0.001) but the difference was not sustained after adjusting for therapy type.</p><p><strong>Conclusion: </strong>Advanced diabetes technologies improve glycaemic control. Whilst equalising technology access mitigates socioeconomic disparities in HbA1c, CYP from Black ethnic background continue to display a higher HbA1c. The study underscores the necessity of fair technology distribution and further research into elevated HbA1c levels among Black CYP using advanced diabetes technology.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1417287"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cutting effect of type 2 diabetes on the sensorimotor control of balance.","authors":"Trevor Lopatin, Ben Borngesser, Joshua Haworth","doi":"10.3389/fcdhc.2024.1441947","DOIUrl":"10.3389/fcdhc.2024.1441947","url":null,"abstract":"<p><p>Type 2 Diabetes is a highly prevalent chronic disorder that affects multiple systems through microvascular complications. Complications such as diabetic peripheral neuropathy, diabetic retinopathy, and diabetic vestibular dysfunction (vestibulopathy) all directly interfere with the sensory components of balance and postural stability. The resulting impairments cause increased falls risk and instability, making it difficult to perform daily task or exercise. This commentary will provide clarity on the causes and relationship between the sensory complications of T2D, balance, and excise, while also providing recommendations and precautions for exercising with one of these sensory complications.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1441947"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to facilitate peer support - learnings from the development of a peer support program for people with T2DM via instant messaging service to improve diabetes self-management.","authors":"Ursula Hemetek, Tatjana Aubram, Johanna Grüblbauer, Elisabeth Höld","doi":"10.3389/fcdhc.2024.1491865","DOIUrl":"10.3389/fcdhc.2024.1491865","url":null,"abstract":"<p><p>This study explores the use of Instant Messaging Services (IMS) for peer support among individuals with Type 2 Diabetes Mellitus (T2DM). Leveraging the popularity of IMS within the affected age group, the DiabPeerS study implemented a peer support intervention aimed at improving long-term blood glucose levels (HbA1c) in a randomized controlled trial (RCT). This article describes the development and acceptance of the IMS intervention used in the DiabPeerS study. The intervention included a communication strategy and content designed for lay moderators to facilitate group interaction among people with Type 2 Diabetes mellitus (PWT2D). The intervention's acceptance was determined by conducting participant interviews, moderator meetings, and analysis of IMS chat protocols. Results indicate that the intervention was well-received, with participants engaging in meaningful exchange about diabetes self-management (DSM). However, those less familiar with online communication may benefit from preparational training and initial face-to-face meetings could enhance group cohesion. This research offers insights into the practical application of IMS for diabetes peer support, highlighting both its benefits and room for improvement.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1491865"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of diabetes mellitus in different regions of KSA and update on its management.","authors":"Mabrouk Al-Rasheedi, Yasir Alhazmi, Lamees Abdullah AlDaiji, Lamya Abdullah AlDaiji, Fatimah Ismail Mobarki, Khuzama Mohammed Almuhaysini, Jawza Salem Alshammari, Nouf Awadh Almistadi, Saeed Adnan Yoldash, Nouf Almaqwashi, Rawabi Saleh Al Abdulgader, Mohammed Yahya Mashyakhi, Sadin Alamro, Ismail A Walbi, Khawaja Husnain Haider","doi":"10.3389/fcdhc.2024.1482090","DOIUrl":"https://doi.org/10.3389/fcdhc.2024.1482090","url":null,"abstract":"<p><strong>Background: </strong>Complications of diabetes and its associated comorbidities can cause rapid progression of type II diabetes mellitus (T2DM). It comes at high costs and affects a patient's quality of life. We aim to assess T2DM in KSA, including the demographics, medications, complications, and comorbidities, as it remains an integral part of Vision 2030.</p><p><strong>Methods: </strong>Observational retrospective study was designed spanning five administrative regions of KSA. A total of 638 patients' records were randomly selected from general hospitals and diabetes centers from 2017 to 2020, and the collected were statistically analyzed.</p><p><strong>Results: </strong>Most (77%) selected patients had uncontrolled diabetes, showing a statistically significant correlation between regions and diabetes control. The Northern, Central, and Southern regions had the highest uncontrolled percentage with less than 20% control, while Western and Eastern regions' control percentages were around 40% of subjects. Eighty percent of the uncontrolled BP patients had uncontrolled diabetes contrasting the 68% of the BP-controlled patients. Biguanides, DPP-4 inhibitors, GLP-1 agonists, Insulin, and SGLT-2 inhibitors are the most common diabetes medications. Metformin was the most prescribed in all regions, followed by DPP4. Results showed that patients used one to four non-diabetes drugs on average. Dispensing of vitamin B complex and statins were higher in diabetes centers than in hospitals. Retinopathy and peripheral neuropathy were the most common complications, while hypertension and ASCVD were the most common comorbidities.</p><p><strong>Conclusion: </strong>Results showed a poor glycemic control situation in the kingdom that necessitates implementing stricter measures to hinder disease progression and reduce complications and comorbidities. Increasing awareness, training, and monitoring programs with larger sample sizes and broader distribution is highly recommended nationally.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1482090"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of fetal sex on antenatal maternal glucose and insulin dynamics.","authors":"Thomas P Mullins, Linda A Gallo, H David McIntyre, Helen L Barrett","doi":"10.3389/fcdhc.2024.1351317","DOIUrl":"10.3389/fcdhc.2024.1351317","url":null,"abstract":"<p><p>The 'Developmental Origins of Health and Disease' (DOHaD) hypothesis postulates that exposures during critical periods of development and growth, including maternal hyperglycemia, can have significant consequences for short- and long-term health in offspring. The influence of fetal status on maternal (patho)physiology is less well understood but gaining attention. Fetal sex specifically may be an independent risk factor for a range of adverse pregnancy outcomes, including increased gestational diabetes mellitus (GDM) frequency with male fetuses in multi-ethnic populations. Fetal sex has been thought to modulate maternal glucose metabolism, including insulin dynamics, through complex genetic and hormonal interactions. Mechanisms have not been fully elucidated, however, but may relate to sexual dimorphism in maternal-fetal-placental interactions. We review current evidence on the potential influence of fetal sex on maternal glucose and insulin dynamics, and fetal outcomes.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1351317"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing glycemic control in type 2 diabetes: the impact of the GLIDE program's personalized digital health intervention.","authors":"Anand Ambesange, Amit Lala Khomane, Jaymin Parikh, Devina Aswal, Mihir Gharia, Prachi Sharma, Vishva Trivedi, Twinkle Maheshwari, Astha Mishra, Bhavan Bhavsar, Vrushali Athavale","doi":"10.3389/fcdhc.2024.1494009","DOIUrl":"10.3389/fcdhc.2024.1494009","url":null,"abstract":"<p><strong>Background: </strong>The integration of digital health applications into type 2 diabetes mellitus (T2DM) management presents promising opportunities for optimizing glycemic control, enhancing adherence, and improving health outcomes. MyTatva's Glycemic Lifestyle Intervention in Diabetes Empowerment (GLIDE) program, which integrates dietary and exercise regimens, cognitive behavioral therapy (CBT), and Internet of Things (IoT) devices, potentiates this approach. This study aimed to evaluate the effectiveness of the GLIDE program's personalized, comprehensive approach in improving glycemic control over 90 days among T2DM patients.</p><p><strong>Methods: </strong>During the study period, 30 diabetic patients completed their GLIDE journey with expert dieticians, physiotherapists, and behavior therapists. Each patient received a personalized root cause analysis based on lifestyle assessment and disease-specific parameters. Statistical analysis was conducted using a paired t-test on the deidentified HbA1c, FBS, and PPBS data at baseline and post-intervention.</p><p><strong>Results: </strong>Throughout the study, 27 patients actively adhered to the GLIDE program. All the parameters showed statistically significant (p<0.05) changes post-intervention. HbA1c decreased by 11.79% from 8.43% ± 1.32 to 7.44% ± 0.64. Significant reductions were observed in PPBS (47.7%), decreasing from 260.89 mg/dL ± 36.31 to 136.27 mg/dL± 6.36, compared to FBS (31.1%), which decreased from 8.43 mg/dL± 1.32 to 7.44 mg/dL± 0.64.</p><p><strong>Conclusions: </strong>The effectiveness of the GLIDE program is based on a comprehensive root cause analysis approach. The detailed analysis of the patient's clinical journey by health experts at regular intervals enables precise goal management, resulting in expected outcomes for better glycemic control. Therefore, personalized digital health plans are vital for achieving clinically significant changes.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1494009"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of basic diabetes mellitus services among adult patients with diabetes mellitus at Mbarara Regional Referral Hospital diabetes clinic, Uganda: a cross-sectional study.","authors":"Dan Muramuzi, Richard Mugambe, Laban Muteebwa, Ipola Patrick Albert, Lawrence Nduhukyire, Claire Nnannyanzi, Aggrey David Mukose","doi":"10.3389/fcdhc.2024.1290559","DOIUrl":"10.3389/fcdhc.2024.1290559","url":null,"abstract":"<p><strong>Background: </strong>Utilization of diabetic care services remains a challenge among adult patients in low- and middle-income countries. Optimal utilization of diabetic care services could reduce morbidity and mortality and delay the development of long-term complications. This study assessed the utilization of basic diabetic care services and associated factors among diabetes mellitus patients at Mbarara Regional Referral Hospital in Western Uganda.</p><p><strong>Methods: </strong>We enrolled 208 patients with either type 1 or 2 diabetes mellitus in a cross-sectional study between June and August 2022 at Mbarara Regional Referral Hospital, Uganda. Consecutive sampling was used to select patients with diabetes mellitus who attended the diabetes clinic based on their scheduled date of appointment. Optimal utilization of basic diabetic services was defined as receiving at least three of the four core services: health education, assessment of vital signs (blood sugar, blood pressure, and body mass index), assessment of diabetic complications, and diabetic drug refills. Modified Poisson regression analysis was used to assess the determinants of utilization of basic diabetic services in STATA version 14.0.</p><p><strong>Results: </strong>Three-quarters of the study participants were female patients (75.0%), and the median (inter-quartile range, IQR) age was 52 (43, 56). Moreover, 62.0% [95% confidence interval (CI): 55.3-68.7] self-reported to have utilized basic diabetic care services. In the adjusted analysis, waiting longer than 120 min to receive any service [adjusted prevalence ratio (aPR) 0.46, 95% CI 0.27-0.80), being 45-54 years old (aPR 1.48, 95% CI:1.11-1.98), and being 55-60 years old (aPR, 1.38, 95% CI: 1.02 1.86)] were significantly associated with the utilization of basic diabetic care services.</p><p><strong>Conclusion: </strong>Utilization of basic diabetic care services among adult patients remains sub-optimal. Age and waiting time were significantly associated with the utilization of diabetic care services. Interventions should be directed toward shortening the waiting time in service delivery at diabetes clinics.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1290559"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic syndrome among type 2 Diabetes Mellitus patients in Ethiopia: a systematic review and meta-analysis.","authors":"Tesfaye Getachew Charkos, Hunde Lemi, Godana Arero, Menberu Getnet","doi":"10.3389/fcdhc.2024.1437288","DOIUrl":"10.3389/fcdhc.2024.1437288","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of metabolic syndrome among type 2 diabetes mellitus patients was inconsistent in Ethiopia. Therefore, we aimed to pool the prevalence of metabolic syndrome among type 2 diabetes mellitus patients using a systematic review and meta-analysis.</p><p><strong>Methods: </strong>PubMed, EMBASE, and Cochrane Library databases were systematically searched for relevant articles from January 2023 to January 2024. In addition, a manual search was conducted using published articles' reference lists. The random-effects model was used to pool prevalence from individual studies. All analysis was performed using R software.</p><p><strong>Results: </strong>A total of nine articles met the inclusion criteria and were included in the analysis. The participants' average age was 59.8 ± 3.84 years old. The pooled prevalence of MetS in T2DM patients was 53% (95% CI: 47-58). A significant heterogeneity was found across the included studies (P < 0.001, I2 = 92%). Based on diagnostic criteria, the prevalence of MetS in T2DM patients was 49% (95% CI: 43-56), 57% (95% CI: 47-67), 57% (95% CI: 43-77), and 44% (95% CI: 20-58) based on IDF, NCEP-ATP II, 2009 harmonized, and WHO criteria. By gender, the prevalence of MetS in T2DM patients was 48% (95% CI: 28-68) for females and 32% (95% CI: 17-49) for males.</p><p><strong>Conclusion: </strong>This study found that over half of type 2 diabetes mellitus patients in Ethiopia are affected by metabolic syndrome, with a higher prevalence observed in females compared to males. The NCEP-ATP II and 2009 harmonized criteria consistently yielded similar prevalence rates of metabolic syndrome. These findings highlight the importance of educating T2DM patients on preventing and managing cardiovascular disease and its related complications.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1437288"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and its associated factors of diabetic retinopathy among type 1 and type 2 diabetic patients at public hospitals in Eastern Ethiopia, 2023: a hospital-based comparative cross-sectional study.","authors":"Feyisa Shasho Bayisa, Teshome Demis Nimani, Samuel Demissie Darcho","doi":"10.3389/fcdhc.2024.1432551","DOIUrl":"10.3389/fcdhc.2024.1432551","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic retinopathy (DR) is a highly prevalent microvascular disease among diabetic patients, resulting in irreversible blindness. However, there is a dearth of evidence on diabetic retinopathy (DR) and its associated factors in eastern Ethiopia. The study aimed to determine the prevalence of diabetic retinopathy (DR) and its associated factors among type 1 and type 2 diabetic patients at public hospitals in eastern Ethiopia.</p><p><strong>Method: </strong>A hospital-based comparative cross-sectional was conducted among 520 diabetic patients. Epidata software was used for data entry, and STATA version 17 was used for statistical analysis. Multivariate binary logistic regression was computed to identify factors associated with DR. The Hosmer and Lemeshow chi-square test assessed goodness of fit.</p><p><strong>Results: </strong>The overall prevalence of DR was 43.5%. The prevalence of diabetic retinopathy among type 1 DM was 38.5%, and the prevalence of DR among type 2 DM was 48.5%. Age >60 [AOR = 4.64 95% CI (1.60, 13.51)], being male [AOR = 4.05 95% CI (1.51, 10.97)], and having complications [AOR = 0.01 95% CI (0.003, 0.04)] were significantly associated with DR among type 1 diabetes. Having a family history of DM [AOR = 1.57 95% CI (1.76, 3.24)], poor glycemic status [AOR = 1.91 95% CI (1.56, 2.83)], and having complications [AOR = 11.07 95% CI (4.89, 25.13)] were significantly associated with DR among type 2 diabetes.</p><p><strong>Conclusions: </strong>In the current study, the prevalence of DR was 43.5%. The prevalence was higher among type 2 diabetes compared to type 1 diabetes. Factors such as poor glycemic control, older age, male sex, a family history of diabetes, and complications related to diabetes were significantly associated with DR. To minimize the impact of diabetics, it requires regular screening programs for diabetic patients, especially those with poor glycemic control and other identified risk factors.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1432551"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The success of insulin pump therapy: importance of education of patients and health professionals.","authors":"Bojana Carić, Saša Marin, Jelena Malinović-Pančić, Gabrijela Malešević, Duška Mirnić","doi":"10.3389/fcdhc.2024.1464365","DOIUrl":"10.3389/fcdhc.2024.1464365","url":null,"abstract":"<p><p>The purpose of the study is to investigate the importance of education and re-education for the proper use of the insulin pump (IP) in order to maintain stable glycemic control over an extended period.</p><p><strong>Methods: </strong>The study was designed as a cross-sectional retrospective study. A total of 168 patients participated in a five-day structured education program in a small group. Following the initial education, 42 patients who met the criteria for continuation of IP treatment continued to be monitored every six months (period I). After six years of follow-up (period II) data from 36 patients were taken and analyzed. The data from the IP were downloaded from the IP Paradigm 754 \"VEO\" (Medtronic Inc., Illinois, USA) on the personal computer via the CareLink Pro software (Medtronic, Inc., Illinois).</p><p><strong>Results: </strong>The number of patients using the bolus calculator (BC+) for at least 50% of all administered boluses remained high in both periods. However, BC+ patients statistically significantly increased their A1C value in period II. The average number of hypoglycemias was statistically significantly increased in the group of BC+ patients in period II compared to period I (p=0.009). The continuous glucose monitors (CGM) were used only in period II, so the number of hypoglycemias in period I were roughly estimated.</p><p><strong>Conclusions: </strong>The long-term success of IP therapy primary depends on the proper use of the device, highlighting the importance of good education and regular re-education for both patients and health professionals. Advanced hybrid technology systems could be particularly in settings with poorly organized healthcare, where re-education is not routinely provided and diabetes control relies heavily on the patient engagement.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"5 ","pages":"1464365"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}