Emphasis on Carbohydrates May Negatively Influence Dietary Patterns in Youth With Type 1 Diabetes

This is an uncopyedited electronic version of an article accepted for publication in Diabetes Care. The American Diabetes Association, publisher of Diabetes Care, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version will be available in a future issue of Diabetes Care in print and online a

In search of quality evidence for lifestyle management and glycemic control in children and adolescents with type 2 diabetes: A systematic review

<p>Abstract</p> <p>Background</p> <p>Our purpose was to evaluate the impact of lifestyle behavior modification on glycemic control among children and youth with clinically defined Type 2 Diabetes (T2D).</p> <p>Methods</p> <p>We conducted a systematic review of studies (randomized trials, quasi-experimental studies) evaluating lifestyle (diet and/or physical activity) modification and glycemic control (HbA1c). Our data sources included bibliographic databases (EMBASE, CINAHL^®, Cochrane Library, Medline^®, PASCAL, PsycINFO^®, and Sociological Abstracts), manual reference search, and contact with study authors. Two reviewers independently selected studies that included any intervention targeting diet and/or physical activity alone or in combination as a means to reduce HbA1c in children and youth under the age of 18 with T2D.</p> <p>Results</p> <p>Our search strategy generated 4,572 citations. The majority of citations were not relevant to the study objective. One study met inclusion criteria. In this retrospective study, morbidly obese youth with T2D were treated with a very low carbohydrate diet. This single study received a quality index score of < 11, indicating poor study quality and thus limiting confidence in the study's conclusions.</p> <p>Conclusions</p> <p>There is no high quality evidence to suggest lifestyle modification improves either short- or long-term glycemic control in children and youth with T2D. Additional research is clearly warranted to define optimal lifestyle behaviour strategies for young people with T2D.</p

A Social Robot to Deliver an 8-Week Intervention for Diabetes Management : Initial Test of Feasibility in a Hospital Clinic

Social robots show significant potential as a healthcare coach for chronic life-long conditions and within medical settings. This 8-week feasibility trial explored a robot-delivered talk-based program for adolescents with Type 1 Diabetes to coach diabetes management with a focus on healthy eating habits. Trial objectives were to assess initial recruitment uptake, treatment effects, and evaluations of the program before a larger deployment. A NAO robot delivered two 60-minute coaching sessions and two 15-minute videos over an 8-week period. Initial findings revealed the robot program had a 44% uptake rate (n = 4). The robot program helped two participants achieve a 70% reduction in their high-sugar food and drink consumption, including increased motivation and self-efficacy scores. Program evaluation found the robot-delivered content did elicit discussion around personal incentives, goals, strategies, goal planning and consideration to improve diabetes management. Robot evaluation scores increased over time for improved likability, helpfulness, trust, and capacity to help change behavior. Qualitative evaluation found sessions were rated as interactive, supportive, and helpful for their self-management. Results found preliminary support for a robot-delivered program to be offered in conjunction with a hospital outpatient clinic, but more recruitment to increase sample size is needed. The next stage involves technical refinement, better integration into an existing service, and trial extension or replication in a larger sample to further substantiate these findings.</p