Predictors of Insulin Regimens and Impact on Outcomes in Youth with Type 1 Diabetes: The SEARCH for Diabetes in Youth Study

Paris, Carolyn A.; Imperatore, Giuseppina; Klingensmith, Georgeanna J.; Petitti, Diana B.; Rodríguez, Beatriz L.; Anderson, Andrea; Schwartz, I. David; Standiford, Debra; Pihoker, Catherine

doi:10.1016/j.jpeds.2009.01.063

Cited by 136 publications

(170 citation statements)

References 17 publications

Supporting

Mentioning

132

Contrasting

Unclassified

Order By: Relevance

“…Modern, physiologic insulin replacement programs using either basal-bolus injection programs or pump therapy may allow for the reestablishment of appetite as well as flexible eating patterns. Insulin pump therapy, in particular, is an increasingly popular treatment option for managing diabetes in youth, 6 and because hunger can be a symptom of hypoglycemia, patients who have difficulty distinguishing between hunger and hypoglycemia may benefit from pump therapy because insulin can be titrated at small doses, which can help avoid hypoglycemia. In addition, pump therapy not only may allow greater awareness of hypoglycemia, but also provides flexibility around eating and exercise so youth can feel more like their peer group.…”

mentioning

confidence: 99%

Disordered Eating Behaviors in Youth with Type 1 Diabetes: Prospective Pilot Assessment Following Initiation of Insulin Pump Therapy

Markowitz

Alleyn²,

Phillips³

et al. 2013

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

Background: There is risk for disordered eating behaviors in type 1 diabetes, especially related to insulin manipulation. Implementation of insulin pump therapy may encourage either normalization of eating behaviors or a greater focus on food intake due to renewed emphasis on carbohydrate counting. There is need for prospective studies to assess disordered eating behaviors upon implementation of pump therapy using diabetes-specific measurement tools. Subjects and Methods: In a multicenter pilot study, 43 youth with type 1 diabetes, 10-17 years old, were assessed prior to pump initiation and after 1 and 6 months of pump therapy. Youth completed the Diabetes-specific Eating Problems SurveyRevised (DEPS-R), a validated measure of risk for both diabetes-specific and general disordered eating behaviors. Results: Youth (45% female), 13.3 years old with diabetes for 2.1 years, had a mean hemoglobin A1c of 8.3 -1.3% (68 -14.5 mmol/mol) at baseline. DEPS-R scores decreased over time (P = 0.01). Overall rate of high risk for eating disorders was low. Overweight/obese youth endorsed more disordered eating behaviors than normal-weight participants. DEPS-R scores were correlated with z-score for body mass index at all three time points and with hemoglobin A1c after 1 and 6 months. Hemoglobin A1c did not change significantly over the 6 months and was higher in overweight/obese compared with normal-weight participants. Conclusions: Initiation of insulin pump therapy was associated with diminished endorsement of disordered eating behaviors in youth with type 1 diabetes. Longer follow-up studies are needed to assess the impact of insulin pump therapy on glycemic control, weight status, and disordered eating behaviors in this vulnerable population.

show abstract

mentioning

confidence: 99%

Disordered Eating Behaviors in Youth with Type 1 Diabetes: Prospective Pilot Assessment Following Initiation of Insulin Pump Therapy

Markowitz

Alleyn²,

Phillips³

et al. 2013

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

show abstract

“…Insulin pump therapy has been shown to reduce the risk of severe hypoglycemia, to improve quality of life, and probably HbA1c values. 8,9 As a general goal, all pediatric patients should have the opportunity to receive optimized therapy. Thereby, it might be useful to improve cultural perspectives of interventions for diabetes in children and adolescents from ethnic minority groups (e.g., by introducing Turkish staff members to diabetes care teams).…”

Section: Discussionmentioning

confidence: 99%

“…During the past few years, insulin pump therapy in pediatric diabetes care has become common, with nowadays 20-35% of patients using insulin pump therapy. 8,9 Differences in the prevalence of pump therapy between population groups may be interpreted as an indicator for differences in usage of, but also in access to, high-quality medical care. Whereas the majority of healthcare services is provided free of charge, insulin pump treatment is not generally reimbursed by the statutory health insurance, but patients have to apply for reimbursement individually.…”

Section: Introductionmentioning

confidence: 99%

Lower Frequency of Insulin Pump Treatment in Children and Adolescents of Turkish Background with Type 1 Diabetes: Analysis of 21,497 Patients in Germany

Icks

Razum

Rosenbauer

et al. 2012

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

Aim: This study investigated insulin pump therapy in pediatric patients with type 1 diabetes and Turkish origin compared with those without migration background in Germany. Subjects and Methods: Using a nationwide documentation program, we estimated the prevalence of insulin pump therapy in patients < 20 years of age with Turkish origin and those without migration background. Logistic regression was used to adjust for age, sex, diabetes duration, body mass index SD score (BMI-SDS), glycated hemoglobin, number of outpatient visits, number of daily blood glucose self-measurements, and area-based socioeconomic conditions. Results: In 1,695 pediatric type 1 diabetes patients with Turkish background and 19,802 patients without migration background (respectively: 51.2% and 53.0% boys; mean age, 12.4 -4.1 and 12.6 -4.2 years; mean diabetes duration, 4.7 -3.9 and 5.3 -4.0 years), fully adjusted prevalences of insulin pump therapy were 18.5% and 30.9%, respectively (odds ratio 0.51, 95% confidence interval 0.43-0.60, P < 0.001). Age, sex, BMI-SDS, outpatient visits, and blood glucose self-control were significantly associated with the prevalence of insulin pump therapy but did not alter the difference substantially. Conclusions: The prevalence of insulin pump therapy is roughly half among pediatric diabetes patients with Turkish background compared with those without migration background. Several covariates could not explain this difference. Individual characteristics or access barriers within the healthcare system may play a role. Further research is needed.

show abstract

“…Insulin pumps allow users to follow a less strict diet than non-pump users. Moreover, insulin pumps administer insulin more accurately than by hand thereby rendering individual insulin injections unnecessary and decreasing the incidence of severe hypoglycemia [71] [72] Compared to those administering multiple daily injections (MDI), youth using a continuous subcutaneous insulin infusion (CSII), more simply known as an insulin pump, have significantly lower A1C levels [73] [73] and reduced daily insulin requirements. [74] Compared to MDI regimens, children using CSII experienced a significant reduction in their glycosylated hemoglobin level.…”

Section: New Technology Influencing Adherence and Glycemic Controlmentioning

confidence: 99%

Contributing Factors to Poor Adherence and Glycemic Control in Pediatric Type 1 Diabetes: Facilitating a Move Toward Telehealth

McNamara¹,

Reid²,

Freedland³

et al. 2011

Type 1 Diabetes - Complications, Pathogenesis, and Alternative Treatments

View full text Add to dashboard Cite

Predictors of Insulin Regimens and Impact on Outcomes in Youth with Type 1 Diabetes: The SEARCH for Diabetes in Youth Study

Cited by 136 publications

References 17 publications

Disordered Eating Behaviors in Youth with Type 1 Diabetes: Prospective Pilot Assessment Following Initiation of Insulin Pump Therapy

Disordered Eating Behaviors in Youth with Type 1 Diabetes: Prospective Pilot Assessment Following Initiation of Insulin Pump Therapy

Lower Frequency of Insulin Pump Treatment in Children and Adolescents of Turkish Background with Type 1 Diabetes: Analysis of 21,497 Patients in Germany

Contributing Factors to Poor Adherence and Glycemic Control in Pediatric Type 1 Diabetes: Facilitating a Move Toward Telehealth

Contact Info

Product

Resources

About