Improving Self-Monitoring of Blood Glucose among Adults with Type 1 Diabetes: Results of the Mobile™ Study

Overland, Jane; Abousleiman, Jessie; Chronopoulos, Andriana; Leader, Natasha; Molyneaux, Lynda; Gilfillan, Christopher

doi:10.1007/s13300-014-0092-9

Cited by 11 publications

(10 citation statements)

References 17 publications

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“…Before the introduction of the FGM system, we used 3 high-quality BG meters in our department. The ACM is a user-friendly BG meter using a cassette containing 50 test spots instead of test strips and is very popular in adolescents [30, 31]. The CNL meter communicates with the Paradigm® Veo TM insulin pump and is mainly used by children treated with continuous subcutaneous insulin infusion [32].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

et al. 2018

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Background/Aims: The FreeStyle® Libre Flash Glucose Monitoring System (FGM, Abbott) measures glucose concentrations in the interstitial fluid for up to 14 days. It has been approved for use in children aged > 4 years in January 2016. Experience in children is still limited. We evaluated the accuracy and usability of the FGM in children with type 1 diabetes mellitus (DM). Methods: 67 children with type 1 DM (35 girls), aged 4–18 years, were included. Subjects wore a sensor on the back of their upper arm. For the first 14 days, they regularly measured capillary blood glucose (BG) with their usual BG meter (Accu-Chek® Mobile [ACM], Roche [n = 24]; Contour® Next Link [CNL], Bayer [n = 26]; OneTouch® Verio® IQ [OTV], LifeScan [n = 17]) followed by a sensor glucose (SG) scanning. SG readings were compared to BG measurements by consensus error grid (CEG) analysis; the mean difference (MD), the mean relative difference (MRD), the mean absolute difference (MAD), and the mean absolute relative difference (MARD) were calculated. After 14 days, subjects were asked to fill in a questionnaire on the usability of the FGM. Results: 2,626 SG readings were paired with BG results. FGM readings were highly correlated with BG (r = 0.926, p < 0.001). 80.3% of the data pairs were in zone A (= no effect on clinical action) and 18.4% were in zone B (= altered clinical action with little or no effect on the clinical outcome) of the CEG. Overall MD was +7.5 mg/dL; MD varied with the BG meter: ACM +10.4 mg/dL, CNL +14.2 mg/dL, OTV –3.6 mg/dL (p < 0.001). Overall, MARD was 16.7%. We observed a large interindividual variability in the accuracy parameters. MD and MRD were inversely related to BMI (r = –0.261 [p < 0.05]; r = –0.266 [p < 0.05], respectively). MARD was inversely related to age (r = –0.266 [p < 0.05]). Twenty-nine patients (43.3%) reported sensor problems, mainly early detachment of the sensor. Nonetheless, the usability questionnaire indicated high levels of satisfaction. Conclusions: Our results showed a reasonable agreement between the FGM SG readings and capillary BG measurements in children. There was, however, a large interindividual variability. The wearing of the sensor requires special attention. Further studies in children are imperative in order to document the accuracy and safety of the FGM in the paediatric population.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

et al. 2018

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“…In fact, data are rapidly collected and transferred either to the specialist or the general practitioner (e.g., by email or digital systems), who could consider eventual therapy modifications, as well as deeper diagnostic/therapeutic urgent investigations [ 36 – 38 ]. Many studies have also demonstrated an increased rate of HbA 1c target achievement among users of glycemic monitoring devices rather than controls, with a subsequent reduction also in the risk of complications [ 39 – 42 ].…”

Section: Diabetic Retinopathy Management During Covid-19mentioning

confidence: 99%

The Importance of Telemedicine during COVID-19 Pandemic: A Focus on Diabetic Retinopathy

Galiero

Pafundi

Nevola

et al. 2020

Journal of Diabetes Research

131

101

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Recently, telemedicine has become remarkably important, due to increased deployment and development of digital technologies. National and international guidelines should consider its inclusion in their updates. During the COVID-19 pandemic, mandatory social distancing and the lack of effective treatments has made telemedicine the safest interactive system between patients, both infected and uninfected, and clinicians. A few potential evidence-based scenarios for the application of telemedicine have been hypothesized. In particular, its use in diabetes and complication monitoring has been remarkably increasing, due to the high risk of poor prognosis. New evidence and technological improvements in telemedicine application in diabetic retinopathy (DR) have demonstrated efficacy and usefulness in screening. Moreover, despite an initial increase for devices and training costs, teleophthalmology demonstrated a good cost-to-efficacy ratio; however, no national screening program has yet focused on DR prevention and diagnosis. Lack of data during the COVID-19 pandemic strongly limits the possibility of tracing the real management of the disease, which is only conceivable from past evidence in normal conditions. The pandemic further stressed the importance of remote monitoring. However, the deployment of device and digital application used to increase screening of individuals and monitor progression of retinal disease needs to be easily accessible to general practitioners.

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“…Despite an increase in the use of health-related apps, data is lacking on its benefits and cost-effectiveness. Small studies have shown better glucose control, improved SMBG frequencies, better patient satisfaction, moderate weight loss, and medication adherence with the use of digital tools [ 17 , 20 , 28 , 36 , 41 , 47 ]. A recent review of a major electronic database for clinical trials including 16 randomized controlled trials with 3,578 adult participants with type 2 diabetes mellitus by Pal and colleagues showed small benefits on glycemic control (pooled effect on HbA1c: −0.2 %) with the use of computer-based diabetes self-management interventions.…”

Section: Reviewmentioning

confidence: 99%

Managing diabetes in the digital age

Shah

Garg

2015

Clin Diabetes Endocrinol

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The prevalence of diabetes is rising globally. Poor glucose control results in higher rates of diabetes-related complications and an increase in health care expenditure. Diabetes self-management education (DSME) training has shown to improve glucose control, and thus may reduce long-term complications. Implementation of diabetes self-management education programs may not be feasible for all the institutions or in developing countries due to lack of resources and higher costs associated with DSME training. With the increasing use of smartphones and Internet, there is an opportunity to use digital tools for training people with diabetes to self-manage their disease. A number of mobile applications, Internet portal, and websites are available to help patients to improve their diabetes care. However, the studies are limited to show its effectiveness and cost-benefits in diabetes self-management. In addition, there are many challenges ahead for the digital health industry. In this review, we assess the use of newer technologies and digital health in diabetes self-management with a focus on future directions and potential challenges.

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Improving Self-Monitoring of Blood Glucose among Adults with Type 1 Diabetes: Results of the Mobile™ Study

Cited by 11 publications

References 17 publications

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

The Importance of Telemedicine during COVID-19 Pandemic: A Focus on Diabetic Retinopathy

Managing diabetes in the digital age

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