Function and Emotion in Everyday Life with Type 1 Diabetes (FEEL-T1D): A fully remote intensive longitudinal study of blood glucose, function, and emotional well-being in adults with type 1 diabetes (Preprint)

BACKGROUND While short-term blood glucose (BG) levels and variability are thought to underlie diminished function and emotional well-being in people with T1D, these relationships are poorly understood. The Function and Emotion in Everyday Life with T1D (FEEL-T1D) study focuses on investigating these short-term dynamic relationships among BG, function, and emotional well-being in adults with T1D. OBJECTIVE To present the FEEL-T1D study design, methods, and study progress to date, including adaptations necessitated by the COVID-19 pandemic to implement the study fully remotely. METHODS The FEEL-T1D study will recruit 200 adults 18-75 years old with T1D. Data collection includes a comprehensive survey battery, along with 14 days of intensive longitudinal data using blinded continuous glucose monitoring (CGM), ecological momentary assessments (EMA), ambulatory cognitive tasks, and accelerometers. All study procedures are conducted remotely, through mailing study equipment and using videoconferencing for study visits. RESULTS To date, after 12 months of recruitment, 124 participants have enrolled in the FEEL-T1D study. Over 87% of EMA surveys have been completed, with minimal missing data, and about 82% of participants have provided concurrent CGM, EMA, and accelerometer data for at least 10 of the 14 days of data collection. CONCLUSIONS Thus far, our reconfiguration of the FEEL-T1D protocol to be implemented remotely during the COVID-19 pandemic has been a success. The FEEL-T1D study will elucidate the dynamic relationships between blood glucose, emotional well-being, cognitive function and participation in daily activities. In doing so, it will pave the way for innovative just-in-time interventions and produce actionable insights to facilitate tailoring of diabetes treatment to optimize function and well-being among individuals with T1D. CLINICALTRIAL

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Short-term use of continuous glucose monitoring system adds to glycemic control in young type 1 diabetes mellitus patients in the long run: A clinical trial

Vojnosanitetski pregled ◽

10.2298/vsp1108650b ◽

2011 ◽

Vol 68 (8) ◽

pp. 650-654 ◽

Cited By ~ 3

Author(s):

Gordana Bukara-Radujkovic ◽

Dragan Zdravkovic ◽

Sinisa Lakic

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Blood Glucose ◽

Glycemic Control ◽

Type 1 Diabetes Mellitus ◽

Glucose Monitoring ◽

Control Group ◽

Short Term ◽

Experimental Group

Background/Aim. Balancing strict glycemic control with setting realistic goals for each individual child and family can optimize growth, ensure normal pubertal development and emotional maturation, and control long term complications in children with type 1 diabetes (T1DM). The aim of this study was to evaluate the efficacy of short-term continuous glucose monitoring system (CGMS) application in improvement of glycemic control in pediatric type 1 diabetes mellitus (T1DM) patients. Methods. A total of 80 pediatric T1DM patients were randomly assigned into the experimental and the control group. The experimental group wore CGMS sensor for 72 hours at the beginning of the study. Self-monitored blood glucose (SMBG) levels and hemoglobin A1c (HbA1c) levels were obtained for both groups at baseline, and at 3 and 6 months. Results. There was a significant improvement in HbA1c (p < 0.001), in both the experimental and the control group, without a significant difference between the groups. Nevertheless, after 6 months the improvement of mean glycemia was noticed only in the experimental group. This finding was accompanied with a decrease in the number of hyperglycemic events and no increase in the number of hypoglycemic events in the experimental group. Conclusions. The results suggest that the CGMS can be considered as a valuable tool in treating pediatric T1DM patients, however further research is needed to more accurately estimate to what extent, if any, it outperforms intensive self-monitoring of blood glucose.

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A Randomized Clinical Trial Assessing Continuous Glucose Monitoring (CGM) Use With Standardized Education With or Without a Family Behavioral Intervention Compared With Finger-stick Blood Glucose Monitoring in Very Young Children With Type 1 Diabetes

10.2337/figshare.13148741 ◽

2020 ◽

Author(s):

Linda A. DiMeglio ◽

Lauren G. Kanapka ◽

Daniel J. DeSalvo ◽

Marisa E. Hilliard ◽

Lori M. Laffel ◽

...

Keyword(s):

Type 1 Diabetes ◽

Blood Glucose ◽

Young Children ◽

Behavioral Intervention ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Well Being ◽

Blood Glucose Monitoring

Objective: This study evaluated the effects of continuous glucose monitoring (CGM) combined with family behavioral intervention (CGM+FBI) and CGM alone (Standard-CGM) on glycemic outcomes and parental quality of life compared with blood glucose monitoring (BGM) in children ages 2 to <8 years with type 1 diabetes Research Design and Methods: A multicenter (N=14), 6-month, randomized controlled trial including 143 youth 2 to <8 years of age with type 1 diabetes. Primary analysis included treatment group comparisons of percent time in range (TIR, 70-180 mg/dL) across follow-up visits. Results: About 90% of participants in the CGM groups used CGM ≥ 6 days/week at 6-months. Between-group TIR comparisons showed no significant changes: CGM+FBI vs BGM = 3.2% [95% CI -0.5%, 7.0%], Standard-CGM vs BGM = 0.5% [-2.6% to 3.6%], CGM+FBI vs Standard-CGM = 2.7% [-0.6%, 6.1%]. Mean time <70 mg/dL was reduced from baseline to follow-up in the CGM+FBI (from 5.2% to 2.6%) and Standard-CGM (5.8% to 2.5%) groups , compared with 5.4% to 5.8% with BGM (CGM+FBI vs. BGM, p<0.001, Standard-CGM vs BGM p<0.001). No severe hypoglycemic events occurred in the CGM+FBI group, 1 in the Standard-CGM, and 5 in the BGM. CGM+FBI parents reported greater reductions in diabetes burden and fear of hypoglycemia compared with Standard-CGM (p=0.008 and 0.04) and BGM (p=0.02 and 0.002). Conclusions: CGM used consistently over a 6-month period in young children with type 1 diabetes did not improve TIR but did significantly reduce time in hypoglycemia. The FBI benefited parental well-being.

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A Randomized Clinical Trial Assessing Continuous Glucose Monitoring (CGM) Use With Standardized Education With or Without a Family Behavioral Intervention Compared With Finger-stick Blood Glucose Monitoring in Very Young Children With Type 1 Diabetes

10.2337/figshare.13148741.v1 ◽

2020 ◽

Author(s):

Linda A. DiMeglio ◽

Lauren G. Kanapka ◽

Daniel J. DeSalvo ◽

Marisa E. Hilliard ◽

Lori M. Laffel ◽

...

Keyword(s):

Type 1 Diabetes ◽

Blood Glucose ◽

Young Children ◽

Behavioral Intervention ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Well Being ◽

Blood Glucose Monitoring

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Function and Emotion in Everyday Life with Type 1 Diabetes (FEEL-T1D): A fully remote intensive longitudinal study of blood glucose, function, and emotional well-being in adults with type 1 diabetes (Preprint)

JMIR Research Protocols ◽

10.2196/30901 ◽

2021 ◽

Author(s):

Elizabeth Ann Pyatak ◽

Raymond Hernandez ◽

Loree Pham ◽

Khatira Mehdiyeva ◽

Stefan Schneider ◽

...

Keyword(s):

Type 1 Diabetes ◽

Longitudinal Study ◽

Blood Glucose ◽

Everyday Life ◽

Well Being

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Contested Daily Routines, Contested Care. Children with Type 1 Diabetes in Covid-19 Times

Childhood Vulnerability Journal ◽

10.1007/s41255-021-00017-0 ◽

2021 ◽

Author(s):

Melike Şahinol ◽

Gülşah Başkavak

Keyword(s):

Type 1 Diabetes ◽

Continuous Glucose Monitoring ◽

Conventional Treatment ◽

Glucose Monitoring ◽

Well Being ◽

Monitoring Systems ◽

Solvable Problem ◽

Daily Routines ◽

Depth Interviews

AbstractThe conventional treatment of Type 1 Diabetes (T1D) is especially demanding for children, both physically and psychologically (Iversen et al. Int J Qual Stud Health Well-being,13(1), 1487758, 2018). Continuous Glucose Monitoring Systems (CGM) are an important aid for children and their families in dealing with the disease. In their work, however, Şahinol and Başkavak (2020) point out that CGM carry the risk of viewing T1D as a technologically solvable problem instead of considering the disease as a whole. This is mainly creating confidence in technology due to CGM experiences while neglecting significant dietary measures and exercises needed to be integrated into daily routines. During the current pandemic, this problem seems to take on a whole new level. Based on two periods of in-depth interviews and observations conducted with 8 families with T1D children aged 6 to 14 living in Istanbul and Ankara (Turkey) from May to November 2019 and again from May to June 2020, we compare and focus on the experiences prior to and during the pandemic time. We argue that despite the possibility of technological regulation of the disease, the vulnerability of children is increased and, more than ever, depends on socio-bio-technical entanglements.

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Anxiety, depression, and glycemic control during Covid-19 pandemic in youths with type 1 diabetes

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0153 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Maria Cusinato ◽

Mariangela Martino ◽

Alex Sartori ◽

Claudia Gabrielli ◽

Laura Tassara ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Psychological Impact ◽

Glucose Monitoring ◽

Severe Hypoglycemia ◽

Well Being ◽

Glucose Variability ◽

Threshold Score ◽

The Impact

Abstract Objectives Our study aims to assess the impact of lockdown during the coronavirus disease 2019 pandemic on glycemic control and psychological well-being in youths with type 1 diabetes. Methods We compared glycemic metrics during lockdown with the same period of 2019. The psychological impact was evaluated with the Test of Anxiety and Depression. Results We analyzed metrics of 117 adolescents (87% on Multiple Daily Injections and 100% were flash glucose monitoring/continuous glucose monitoring users). During the lockdown, we observed an increase of the percentage of time in range (TIR) (p<0.001), with a significant reduction of time in moderate (p=0.002), and severe hypoglycemia (p=0.001), as well as the percentage of time in hyperglycemia (p<0.001). Glucose variability did not differ (p=0.863). The glucose management indicator was lower (p=0.001). 7% of youths reached the threshold-score (≥115) for anxiety and 16% for depression. A higher score was associated with lower TIR [p=0.028, p=0.012]. Conclusions Glycemic control improved during the first lockdown period with respect to the previous year. Symptoms of depression and anxiety were associated with worse glycemic control; future researches are necessary to establish if this improvement is transient and if psychological difficulties will increase during the prolonged pandemic situation.

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