Parental evaluation of a telemonitoring service for children with Type 1 Diabetes

Introduction In the past years, we developed a telemonitoring service for young patients affected by Type 1 Diabetes. That service provides data to the clinical staff and offers an important tool to the parents, that are able to oversee in real time their children. The aim of this work was to analyze the parents' perceived usefulness of the service. Methods The service was tested by the parents of 31 children enrolled in a seven-day clinical trial during a summer camp. To study the parents' perception we proposed and analyzed two questionnaires. A baseline questionnaire focused on the daily management and implications of their children's diabetes, while a post-study one measured the perceived benefits of telemonitoring. Questionnaires also included free text comment spaces. Results Analysis of the baseline questionnaires underlined the parents' suffering and fatigue: 51% of total responses showed a negative tendency and the mean value of the perceived quality of life was 64.13 in a 0-100 scale. In the post-study questionnaires about half of the parents believed in a possible improvement adopting telemonitoring. Moreover, the foreseen improvement in quality of life was significant, increasing from 64.13 to 78.39 ( p-value\u2009=\u20090.0001). The analysis of free text comments highlighted an improvement in mood, and parents' commitment was also proved by their willingness to pay for the service (median\u2009=\u2009200\u2009euro/year). Discussion A high number of parents appreciated the telemonitoring service and were confident that it could improve communication with physicians as well as the family's own peace of mind

Day and night closed-loop control in adults with type 1 diabetes: a comparison of two closed-loop algorithms driving continuous subcutaneous insulin infusion versus patient self-management.

OBJECTIVE: To compare two validated closed-loop (CL) algorithms versus patient self-control with CSII in terms of glycemic control. RESEARCH DESIGN AND METHODS: This study was a multicenter, randomized, three-way crossover, open-label trial in 48 patients with type 1 diabetes mellitus for at least 6 months, treated with continuous subcutaneous insulin infusion. Blood glucose was controlled for 23 h by the algorithm of the Universities of Pavia and Padova with a Safety Supervision Module developed at the Universities of Virginia and California at Santa Barbara (international artificial pancreas [iAP]), by the algorithm of University of Cambridge (CAM), or by patients themselves in open loop (OL) during three hospital admissions including meals and exercise. The main analysis was on an intention-to-treat basis. Main outcome measures included time spent in target (glucose levels between 3.9 and 8.0 mmol/L or between 3.9 and 10.0 mmol/L after meals). RESULTS: Time spent in the target range was similar in CL and OL: 62.6% for OL, 59.2% for iAP, and 58.3% for CAM. While mean glucose level was significantly lower in OL (7.19, 8.15, and 8.26 mmol/L, respectively) (overall P = 0.001), percentage of time spent in hypoglycemia (<3.9 mmol/L) was almost threefold reduced during CL (6.4%, 2.1%, and 2.0%) (overall P = 0.001) with less time ≤2.8 mmol/L (overall P = 0.038). There were no significant differences in outcomes between algorithms. CONCLUSIONS: Both CAM and iAP algorithms provide safe glycemic control

Skin temperature and energy expenditure

The value of mean skin temperature as an estimate of energy expenditure was verified in a sample of 10 normal-weight adult male subjects. Measurements were carried out with thermometric probes under conditions of rest and environmental thermoneutrality. Total heat losses were then calculated through a computerized complex mathematical formula. The value for mean energy expenditure obtained in this manner (100.2 +/- 7.02 kcal/h) is extremely close to the value for theoretical metabolism derived from the predictive equations in the literature (95.01 +/- 6.14). This verification of the validity of transforming cutaneous temperature data into energy expenditure, in accurately standardized experimental conditions, confirms the importance that the value of mean skin temperature, in the area of variability among individuals, can have in conditioning the energy balance at different levels, for a given caloric intake and with all other parameters being equal (age, sex, physical activity). In this connection, these results suggest that skin temperature may play a role in the pathogenesis of obesity

Effects of various dietary selenium intakes on the levels of blood glutathione-peroxidase and selenium in long-term fed rats

Female Sprague-Dawley rats were fed a torula diet or wheat diets containing 4 levels of Se partially supplemented (24-402 ppb) for 120 days. Selenium content and glutathione-peroxidase (GSH-Px) activity in plasma and erythrocytes were measured every 20 days. In rats fed torula diet or basal wheat diet, plasma Se (P-Se) increased for up to 60 days, then remained constant, while erythrocytes Se (E-Se) and E-GSH-Px decreased in basal-diet rats during the first 40-60 days, then increased. In rats fed supplemented diets, P-Se and P-GSH-Px increased more rapidly than E-Se and E-GSH-Px, plateauing at 60-80 days. The best correlation was found between P-GSH-Px and dietary Se indicating that this index is the most sensitive for evaluating changes resulting from different Se intakes. In addition, correlations became more significant with time. The results from rats fed a low Se diet suggest the existence of regulatory mechanisms working in different ways and at different times in plasma and erythrocytes

Obesity, diet and body temperature

Studies conducted thus far on the pathogenesis of obesity have not clearly determined the role of body temperature in the energy balance. In an attempt to explore this relationship further, research has been undertaken, a part of which is represented by the present investigation carried out on 22 adult males: 11 having a BMI less than or equal to 25 (group A) and 11 with BMI greater than 25 (group B). Body temperature was measured by mouth and on the skin surface (in 4 points according to Ramanathan) on 2 consecutive days (every 30 min from noon to 6:30 p.m.), the 1st day with the participants fasting and the 2nd day after consumption of a meal whose energy content represented a part (45%) of the 24-hour energy intake of the subjects, as previously ascertained by a survey of their food consumption. The study was carried out under frequently checked microclimatic conditions. During the week prior to the measurements, the alimentary consumption of the subjects was monitored by direct weighing for 5 consecutive days. A significant rise in body temperature, probably due to dietary thermogenesis, was observed in group A (internal temperature: F = 13.05; skin temperature: F = 6.48) as well as in group B (internal temperature: F = 24.88; skin temperature: F = 5.35) after the meal. However in group B the skin temperature showed a smaller increase than in group A (delta t degree 0.31 vs. 0.49) and an earlier trend towards the basal values (nearly 5 vs. 6 h after the meal). In both groups a decrease in the skin delta t degrees is evident at 3 and 3.5 h, respectively, after the meal, followed by a more remarkable increase in this difference between the 4th and the 5th hour. The meaning of this decrease as well as the difference in body temperature versus caloric intake is discussed. Normal weight individuals demonstrated a positive correlation (r = 0.83) between usual caloric intake per square meter of body surface and fasting internal body temperature. This correlation was not observed in subjects with BMI greater than 25