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

The Impact of Frequency and Tone of Parent–Youth Communication on Type 1 Diabetes Management

<p><strong>Article full text</strong></p> <p><br> The full text of this article can be found <a href="https://link.springer.com/article/10.1007/s13300-017-0259-2"><b>here</b>.</a><br> <br> <strong>Provide enhanced digital features for this article</strong><br> If you are an author of this publication and would like to provide additional enhanced digital features for your article then please contact <u>[email protected]</u>.<br> <br> The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.<br> <br> Other enhanced features include, but are not limited to:<br> • Slide decks<br> • Videos and animations<br> • Audio abstracts<br> • Audio slides<u></u></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p

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. The 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 = 0.0001). 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 = 200 euro/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

Artificial Pancreas: First Clinical Trials in Argentina

The first clinical trials using an Artificial Pancreas (AP) in Latin America have been defined in 2 stages. The first stage was carried out in November 2016 with the UVA controller (developed by the Center for Diabetes Technology and already clinically tested), and the second will be performed during the first semester of 2017 with the ARG (Automatic Regulation of Glucose) algorithm (developed by ITBA, UNQ, and UNLP in Argentina). Both tests are based on the DiAs (Diabetes Assistant) from the UVA, and are performed in the HIBA on 5 patients with Type 1 Diabetes Mellitus (T1DM), for 36 hours. For the first stage, Open-Loop (OL) insulin boluses were applied before meals and patient's physical activity was included. On the other hand, for the second stage, patients will not be involved in physical activity, but no OL insulin boluses will be injected before meals. In this work, experimental results from the first stage with the UVA controller, and preliminary results with the ARG control algorithm tested on the UVA/Padova simulator are presented. Due to the final paper deadline, the experimental results from the second stage are not included here, but will be presented at the IFAC World Congress.Fil: Sanchez Peña, Ricardo Salvador. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Tecnológico de Buenos Aires; ArgentinaFil: Colmegna, Patricio Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Quilmes; ArgentinaFil: Grosembacher, L.. Universidad Nacional de Quilmes; ArgentinaFil: Breton, M.. University of Virginia; Estados UnidosFil: de Battista, Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata; ArgentinaFil: Garelli, Fabricio. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata; ArgentinaFil: Belloso, Waldo Horacio. Hospital Italiano; ArgentinaFil: Campos Nánez, E.. University of Virginia; Estados UnidosFil: Simonovich, Ventura. Hospital Italiano; ArgentinaFil: Beruto, V.. Hospital Italiano; ArgentinaFil: Scibona, Paula. Hospital Italiano; ArgentinaFil: Chernavvsky, D.. University of Virginia; Estados Unido

Safety of outpatient closed-loop control: first randomized crossover trials of a wearable artificial pancreas

International audienceOBJECTIVE We estimate the effect size of hypoglycemia risk reduction on closed-loop control (CLC) versus open-loop (OL) sensor-augmented insulin pump therapy in supervised outpatient setting. RESEARCH DESIGN AND METHODS Twenty patients with type 1 diabetes initiated the study at the Universities of Virginia, Padova, and Montpellier and Sansum Diabetes Research Institute; 18 completed the entire protocol. Each patient participated in two 40-h outpatient sessions, CLC versus OL, in randomized order. Sensor (Dexcom G4) and insulin pump (Tandem t:slim) were connected to Diabetes Assistant (DiAs)da smart-phone artificial pancreas platform. The patient operated the system through the DiAs user interface during both CLC and OL; study personnel supervised on site and monitored DiAs remotely. There were no dietary restrictions; 45-min walks in town and restaurant dinners were included in both CLC and OL; alcohol was permitted. RESULTS The primary outcomedreduction in risk for hypoglycemia as measured by the low blood glucose (BG) index (LGBI)dresulted in an effect size of 0.64, P = 0.003, with a twofold reduction of hypoglycemia requiring carbohydrate treatment: 1.2 vs. 2.4 episodes/session on CLC versus OL (P = 0.02). This was accompanied by a slight decrease in percentage of time in the target range of 3.9-10 mmol/L (66.1 vs. 70.7%) and increase in mean BG (8.9 vs. 8.4 mmol/L; P = 0.04) on CLC versus OL. CONCLUSIONS CLC running on a smartphone (DiAs) in outpatient conditions reduced hypoglyce-mia and hypoglycemia treatments when compared with sensor-augmented pump therapy. This was accompanied by marginal increase in average glycemia resulting from a possible overemphasis on hypoglycemia safety

Evaluating the experience of children with type 1 diabetes and their parents taking part in an artificial pancreas clinical trial over multiple days in a diabetes camp setting

OBJECTIVE To explore the experiences of children with type 1 diabetes and their parents taking part in an artificial pancreas (AP) clinical trial during a 7-day summer camp. RESEARCH DESIGN AND METHODS A semistructured interview, composed of 14 questions based on the Technology Acceptance Model, was conducted at the end of the clinical trial. Participants also completed the Diabetes Treatment Satisfaction Questionnaire (DTSQ, parent version) and the AP Acceptance Questionnaire. RESULTS Thirty children, aged 5-9 years, and their parents completed the study. A content analysis of the interviews showed that parents were focused on understanding themechanisms, risks, and benefits of the new device, whereas the children were focused on the novelty of the new system. The parents' main concerns about adopting the new system seemed related to the quality of glucose control. The mean scores of DTSQ subscales indicated general parents' satisfaction (44.24 6 5.99, range 32-53) and trustful views of diabetes control provided by the new system (7.8 6 2.2, range 3-12). The AP Acceptance Questionnaire revealed that most parents considered the AP easy to use (70.5%), intended to use it long term (94.0%), and felt that it was apt to improve glucose control (67.0%). CONCLUSIONS Participants manifested a positive attitude toward the AP. Further studies are required to explore participants' perceptions early in the AP development to individualize the new treatment as much as possible, and to tailor it to respond to their needs and values

THE SOCIAL ACCEPTANCE OF FUTURE ARTIFICIAL PANCREAS TECHNOLOGY: PARENTS' PERCEPTIONS OF PEDARPAN (PEDIATRICS ARTIFICIAL PANCREAS)

none27noneTroncone, A; Bonfanti, R; Iafusco, D; Rabbone, I; Sabbion, A; Schiaffini, R; Galderisi, A; Marigliano, M; Rapini, N; Rigamonti, A; Tinti, D; Vallone, V; Zanfardino, A; Boscari, F; Del Favero, S; Galasso, S; Lanzola, G; Messori, M; Di Palma, F; Visentin, R; Calore, R; Leal, Y; Magni, L; Losiouk, E; Chernavvsky, D; Quaglini, S; Cobelli, C; Bruttomesso, DTroncone, A; Bonfanti, R; Iafusco, D; Rabbone, I; Sabbion, A; Schiaffini, R; Galderisi, Alfonso; Marigliano, M; Rapini, N; Rigamonti, A; Tinti, D; Vallone, Valeria; Zanfardino, A; Boscari, Federico; DEL FAVERO, Simone; Galasso, Silvia; Lanzola, G; Messori, M; Di Palma, F; Visentin, Roberto; Calore, Roberta; Leal, Y; Magni, L; Chernavvsky, D; Quaglini, S; Cobelli, Claudio; Bruttomesso, Daniel