8 research outputs found
Health Literacy in People with Type 1 Diabetes: A Scoping Review Protocol
This protocol aims to provide the rationale and methodology for conducting a scoping review to understand the extent and type of evidence on Health Literacy (HL) in individuals with Type 1 Diabetes (T1D).</p
Switching from twice-daily glargine or detemir to once-daily degludec improves glucose control in type 1 diabetes. An observational study
Degludec is an ultralong-acting insulin analogue with a flat and reproducible pharmacodynamic profile. As some patients with type 1 diabetes (T1D) fail to achieve 24-h\ua0coverage with glargine or detemir despite twice-daily injections, we studied the effect of switching T1D patients from twice-daily glargine or detemir to degludec
Telemedicine and urban diabetes during COVID-19 pandemic in Milano, Italy during lock-down: epidemiological and sociodemographic picture
Background Since 2010, more than half of World population lives in Urban Environments. Urban Diabetes has arisen as a
novel nosological entity in Medicine. Urbanization leads to the accrual of a number of factors increasing the vulnerability to
diabetes mellitus and related diseases. Herein we report clinical-epidemiological data of the Milano Metropolitan Area in the
contest of the Cities Changing Diabetes Program. Since the epidemiological picture was taken in January 2020, on the edge
of COVID-19 outbreak in the Milano Metropolitan Area, a perspective addressing potential interactions between diabetes
and obesity prevalence and COVID-19 outbreak, morbidity and mortality will be presented. To counteract lock-down isolation and, in general, social distancing a pilot study was conducted to assess the feasibility and efcacy of tele-monitoring
via Flash Glucose control in a cohort of diabetic patients in ASST North Milano.
Methods Data presented derive from 1. ISTAT (National Institute of Statistics of Italy), 2. Milano ATS web site (Health
Agency of Metropolitan Milano Area), which entails fve ASST (Health Agencies in the Territories). A pilot study was
conducted in 65 screened diabetic patients (only 40 were enrolled in the study of those 36 were afected by type 2 diabetes
and 4 were afected by type 1 diabetes) of ASST North Milano utilizing Flash Glucose Monitoring for 3 months (mean
age 65 years, HbA1c 7,9%. Patients were subdivided in 3 groups using glycemic Variability Coefcient (VC): a. High risk,
VC>36, n. 8 patients; Intermediate risk 20<36, n. 26 patients; Low risk VC<20, n. 4 patients. The control group
was constituted by 26 diabetic patients non utilizing Flash Glucose monitoring.
Results In a total population of 3.227.264 (23% is over 65 y) there is an overall prevalence of 5.65% with a signifcant diference between Downtown ASST (5.31%) and peripheral ASST (ASST North Milano, 6.8%). Obesity and overweight account
for a prevalence of 7.8% and 27.7%, respectively, in Milano Metropolitan Area. We found a linear relationship (R=0.36)
between prevalence of diabetes and aging index. Similarly, correlations between diabetes prevalence and both older people
depending index and structural dependence index (R=0.75 and R=0.93, respectively), were found. A positive correlation
(R=0.46) with percent of unoccupied people and diabetes prevalence was also found. A reverse relationship between diabetes
prevalence and University level instruction rate was fnally identifed (R=â0.82). Our preliminary study demonstrated a
reduction of Glycated Hemoglobin (p=0.047) at 3 months follow-up during the lock-down period, indicating Flash Glucose
Monitoring and remote control as a potential methodology for diabetes management during COVID-19 lock-down.
Hypothesis and discussion The increase in diabetes and obesity prevalence in Milano Metropolitan Area, which took place
over 30 years, is related to several environmental factors. We hypothesize that some of those factors may have also determined the high incidence and virulence of COVID-19 in the Milano area. Health Agencies of Milano Metropolitan Area
are presently taking care of diabetic patients facing the new challenge of maintaining sustainable diabetes care costs in
light of an increase in urban population and of the new life-style. The COVID-19 pandemic will modify the management
of diabetic and obese patients permanently, via the implementation of approaches that entail telemedicine technology. The
pilot study conducted during the lock-down period indicates an improvement of glucose control utilizing a remote glucose control system in the Milano Metropolitan Area, suggesting a wider utilization of similar methodologies during the present
âsecond waveâ lock-down
Influence of health locus of control and fear of hypoglycaemia on glycaemic control and treatment satisfaction in people with Type 1 diabetes on insulin pump therapy
To assess the influence of health locus of control and fear of hypoglycaemia on metabolic control and treatment satisfaction in people with Type 1 diabetes mellitus on continuous subcutaneous insulin infusion.
METHODS:
People with Type 1 diabetes on continuous subcutaneous insulin infusion for at least 1 year, sub-classified as an 'acceptable glucose control' group [HbA1c 64 58 mmol/mol (7.5%)] and a 'suboptimum glucose control' group [HbA1c > 58 mmol/mol (7.5%)], were consecutively enrolled in a multicentre cross-sectional study. Questionnaires were administered to assess health locus of control [Multidimensional Health Locus of Control (MHLC) scale, with internal and external subscales], fear of hypoglycaemia [Hypoglycaemia Fear Survey II (HFS-II)] and treatment satisfaction [Diabetes Treatment Satisfaction Questionnaire (DTSQ)].
RESULTS:
We enrolled 214 participants (mean \ub1 sd age 43.4 \ub1 12.1 years). The suboptimum glucose control group (n = 127) had lower mean \ub1 sd internal MHLC and DTSQ scores than the acceptable glucose control group (19.6 \ub1 5.2 vs 21.0 \ub1 5.0, P = 0.04 and 28.8 \ub1 4.8 vs 30.9 \ub1 4.5, P < 0.001). HFS-II scores did not differ between the two groups. Internal MHLC score was negatively associated with HbA1c (r = -0.15, P < 0.05) and positively associated with the number of mild and severe hypoglycaemic episodes (r = 0.16, P < 0.05 and r = 0.18, P < 0.001, respectively) and with DTSQ score (r = 0.17, P < 0.05). HFS-II score was negatively associated with DTSQ score (r = -0.18, P < 0.05) and positively with number of severe hypoglycaemic episodes (r = 0.16, P < 0.5).
CONCLUSIONS:
In adults with Type 1 diabetes receiving continuous subcutaneous insulin infusion, high internal locus represents the most important locus of control pattern for achieving good metabolic control
Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion
The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII)