Integrating an Automated Diabetes Management System Into the Family Management of Children With Type 1 Diabetes

Abstract

OBJECTIVEThe study objective was to evaluate how the use of a pervasive blood glucose monitoring (BGM) technology relates to glycemic control, report of self-care behavior, and emotional response to BGM of children with type 1 diabetes and their parents.RESEARCH DESIGN AND METHODSForty-eight children aged less than 12 years (mean 8.8 years) with type 1 diabetes were randomly assigned to one of two study groups, a control group (conventional care without technology) or an experimental group (conventional care with technology), and followed for 12 months. Families in the experimental group were given the Automated Diabetes Management System (ADMS), which automatically collects blood glucose (BG) values and sends to parent(s) a 21-day BG trending report via e-mail each night. Measures of glycemic control (HbA1c) were collected at baseline and at quarterly diabetes clinic visits; BGM effect and diabetes self-care behavior measures were obtained at the baseline, 6-month, and 12-month visits.RESULTSChildren in the experimental group had significantly (P = 0.01) lower HbA1c at 12 months (7.44 ± 0.94, −0.35 from baseline) than controls (8.31 ± 1.24, +0.15 from baseline). Improvement in HbA1c was more profound in families using the ADMS more frequently. In addition, in these families, parents showed a significant improvement in BGM effect (P = 0.03) and children became more meticulous in diabetes self-care (P = 0.04). Children in both experimental and control groups experienced no change in their emotional response to BGM.CONCLUSIONSUsing the ADMS 1–3 times/week may help children with type 1 diabetes improve glycemic control and gain diabetes self-management skills, as well as improve the BGM effect of parents.

What We Can Really Expect from Telemedicine in Intensive Diabetes Treatment: 10 Years Later

“…the comparison of results from the ADMS, 23 the Diabeo system, 26 applications of the pioneering system of Albisser et al 16 and the implementation of the TeleMed system 21 the results from the classical way of teletransmitting data, which are characterized by a not-so-frequent assessment of the available patient data and which bring one closer to the usual care systems it is possible to draw the conclusion that the real-time monitoring of the patient's state connected with an automatic feedback messages sent to the patient can give a much better improvement than the classical telematic support. However, can we afford increasing frequency without changing the established model of diabetes treatment?…”

“…It can be realized directly by the healthcare provider or by the automatic data analysis and decision support advisory systems. It was demonstrated in the Albisser et al, 16 TeleMed, 21 ADMS, 23 Diabeo, 26 and WellDoc 24,25 systems that both these solutions can be effective. In future, the automated systems should prevail in within-theday applications because the direct interaction with the healthcare provider is more expensive.…”

“…23 Combination of both systems allows for generation of notifications by the real-time alert in text messages to cell phones and generation of the glycemic trend analysis reports transmitted daily by e-mails to parents.…”

Best intentions

“…Although this study was not designed by the authors (see [18] for more details), it was completed after the interview study, enabling the themes identified to be explored in more detail, in particular, the changes in emotional response to BGM by the participants.…”

A co-regulatory approach to stay safe online: reporting inappropriate content with the MediaKids mobile app

“…Kasesniemi, 2003;Oksman and Rautiainen, 2003;Ito, 2005;Chen and Katz, 2009;Kaare et al, 2007;Plowman et al, 2010;Green et al, 2011Green et al, , 2012Green et al, , 2013Hertlein, 2012;Jackson et al, 2012;Palmer et al, 2012;Plowman and McPake, 2013;McPake et al, 2013;Livingstone et al, 2014b;Livingstone et al, 2015). Other studies address specific groups within these ages, such as children with diabetes (Hirose et al, 2012;Toscos et al, 2012), asthma (Mosnaim et al, 2012) intellectual and developmental disabilities (Palmer et al, 2012;Hwang et al 2014), complex communication needs (Light and McNaughton, 2012) and obesity (Woolford et al, 2012;Sharifi et al, 2013). In Europe, the most comprehensive studies have been produced by the EU projects, "EU Kids Online" 2 and "Net Children Go Mobile", 3 which conducted a panEuropean survey of interviews over 33,000 children (as well as some of their parents and teachers) between 2010-2014.…”