Injection Technique: Development of a Novel Questionnaire and User Guide
CONCLUSIONThis novel resource is clinically relevant, acceptable, and easy to use as both a clinical tool and a self-assessment tool for people using injectable therapies for diabetes. (Source: Diabetes Spectrum)
Source: Diabetes Spectrum - December 21, 2021 Category: Endocrinology Source Type: research
Parent Perspectives on Educational and Psychosocial Intervention for Recent-Onset Type 1 Diabetes in Their School-Age Child: A Qualitative Study
CONCLUSIONParents endorsed four time points for education and psychosocial services within the first year of a T1D diagnosis. Parents/caregivers may benefit the most from psychosocial interventions 3 –6 months post-diagnosis, once they have had sufficient time to develop basic T1D management skills. These findings support the need for regular parent psychosocial screening and access to scalable psychosocial interventions in the first year post-diagnosis of T1D. (Source: Diabetes Spectrum)
Source: Diabetes Spectrum - December 21, 2021 Category: Endocrinology Source Type: research
Cannabidiol (CBD) Use in Type 2 Diabetes: A Case Report
Cannabidiol (CBD) oil has been gaining popularity as a natural alternative for numerous disease states. CBD is a phytocannabinoid obtained from theCannabis sativa plant. Unlike its relative tetrahydrocannabinol (THC), CBD does not activate CB1 receptors in the brain and therefore lacks psychotropic effects (1). Instead, this substance is thought to work on the G-protein coupled receptor, endothelial cannabinoid receptor, and serotonin-1A receptors, among others. (Source: Diabetes Spectrum)
Source: Diabetes Spectrum - December 21, 2021 Category: Endocrinology Source Type: research
Global Well-Being Is Associated With A1C and Frequency of Self-Monitoring of Blood Glucose in Predominately Latinx Youth and Young Adults With Type 1 Diabetes
Youth and young adults (YYAs) with type 1 diabetes do not consistently meet A1C targets set forth by national and international guidelines (1,2). Diabetes care is further compromised for YYAs because they are at high risk of failure to transition from a pediatric to an adult endocrinologist (1,3). Additionally, people from minority racial/ethnic groups have poorer A1C, increased diabetes complications, and worse diabetes-related outcomes compared with those from nonminority groups (4–6). Youth from lower socioeconomic backgrounds have poorer diabetes-specific outcomes compared with those of higher socioeconomic backgroun...
Source: Diabetes Spectrum - December 21, 2021 Category: Endocrinology Source Type: research
Associations of Time in Range and Other Continuous Glucose Monitoring –Derived Metrics With Well-Being and Patient-Reported Outcomes: Overview and Trends
This article reviews existing evidence on links between times in glycemic ranges and patient-reported outcomes. It also describes a novel research approach of using ecological momentary assessment to analyze on a more granular level in real time possible associations of these parameters of glycemic control and patient-reported outcomes. Such an approach could further our understanding of how glucose and patient-reported outcomes may be interconnected. (Source: Diabetes Spectrum)
Source: Diabetes Spectrum - May 25, 2021 Category: Endocrinology Source Type: research
Time in Range as a Research Outcome Measure
Time in range (TIR) is gaining ground as an outcome measure in type 1 diabetes trials. However, inclusion of TIR raises several issues for trial design. In this article, the authors begin by defining TIR and describing the current international consensus around TIR targets. They then expand on evidence for the validity of TIR as a primary clinical trial outcome before concluding with some practical, ethical, and logistical implications. (Source: Diabetes Spectrum)
Source: Diabetes Spectrum - May 25, 2021 Category: Endocrinology Source Type: research
Time in Range in Pregnancy: Is There a Role?
Continuous glucose monitoring (CGM) is being used with increasing frequency as an adjunct to self-monitoring of blood glucose in pregnancy, and novel targets based on CGM data are becoming standardized. This adoption of CGM is the result of its improving accuracy, patient preference, and evolving data demonstrating associations of novel targets such as time in range (TIR) with pregnancy and neonatal outcomes. A greater understanding of the relationship of various CGM metrics to outcomes in pregnancy complicated by diabetes is needed. It is clear that TIR parameters need to be uniquely lower for pregnant women than for nonp...
Source: Diabetes Spectrum - May 25, 2021 Category: Endocrinology Source Type: research
Clinical Application of Time in Range and Other Metrics
Time in range (TIR) and other continuous glucose monitoring (CGM)-derived metrics have been standardized in international consensus conferences. TIR correlates closely with A1C; a TIR of 70% correlates to an A1C of 6.7 –7%. Evidence is emerging on the association of TIR with long-term diabetes complications, and each 10% increase in TIR shows a substantial decrease in risk for long-term complications. Application of TIR to clinical practice can be easily done with a stepped approach to the analysis and interpret ation of CGM-derived metrics and the ambulatory glucose profile report. Clinician education and partnership wi...
Source: Diabetes Spectrum - May 25, 2021 Category: Endocrinology Source Type: research
Beyond A1C: Time in Range and Other Metrics Preface
Continuous glucose monitoring (CGM) and the metrics surrounding its use have become increasingly integrated into the world of diabetes management. However, these tools require that people have access to the devices and providers who can help interpret them. I remember when I first heard about time in range (TIR) as a concept from Dr. Richard M. Bergenstal. Initially, I was a bit dubious. I was used to looking at my beloved “spaghetti graphs” and viewing the individual colorful linear representations of each day layered on top of each other; I knew how to analyze datamy way. But over time, I became a convert. It was imp...
Source: Diabetes Spectrum - May 25, 2021 Category: Endocrinology Source Type: research
About Anne L. Peters, MD: Guest Editor
(Source: Diabetes Spectrum)
Source: Diabetes Spectrum - May 25, 2021 Category: Endocrinology Source Type: research
Beyond A1C: A Practical Approach to Interpreting and Optimizing Continuous Glucose Data in Youth
Despite significant pharmacological and technological advances in the treatment of type 1 diabetes, the majority of youth in the United States do not meet the American Diabetes Association ’s recommended A1C goal. Understanding and managing glycemic variability is important in children and adolescents. Because A1C provides an incomplete picture of day-to-day glycemic fluctuations, continuous glucose monitoring (CGM)-derived metrics are a promising addition to address glycemic manage ment challenges in youth with diabetes. In this article, we discuss how to develop practical strategies to optimize the use of CGM in the pe...
Source: Diabetes Spectrum - May 25, 2021 Category: Endocrinology Source Type: research
Beyond A1C —Standardization of Continuous Glucose Monitoring Reporting: Why It Is Needed and How It Continues to Evolve
Continuous glucose monitoring (CGM) systems are becoming part of standard care for type 1 diabetes, and their use is increasing for type 2 diabetes. Consensus has been reached on standardized metrics for reporting CGM data, with time in range of 70 –180 mg/dL and time below 54 mg/dL recognized as the key metrics of focus for diabetes management. The ambulatory glucose profile report has emerged as the standard for visualization of CGM data and will continue to evolve to incorporate other elements such as insulin, food, and exercise data to s upport glycemic management. (Source: Diabetes Spectrum)
Source: Diabetes Spectrum - May 25, 2021 Category: Endocrinology Source Type: research
Feasibility of Implementing a Pediatric Diabetes Clinic via Telehealth
CONCLUSIONCOVID-19 presented an opportunity to adopt and test the feasibility of using a telehealth delivery model for routine diabetes care. Yet, to make telehealth a viable treatment delivery alternative will likely involve the uptake of new clinic procedures, investment in institutional infrastructure, and team-based flexibility. (Source: Diabetes Spectrum)
Source: Diabetes Spectrum - March 16, 2021 Category: Endocrinology Source Type: research
Use of Flash Continuous Glucose Monitoring Is Associated With A1C Reduction in People With Type 2 Diabetes Treated With Basal Insulin or Noninsulin Therapy
CONCLUSIONPrescription of the flash CGM system was associated with significant reductions in A1C in patients with type 2 diabetes treated with basal insulin or noninsulin therapy. These findings provide evidence for expanding access to flash CGM within the broader population of people with type 2 diabetes. (Source: Diabetes Spectrum)
Source: Diabetes Spectrum - February 10, 2021 Category: Endocrinology Source Type: research
Exploring Why People With Type 2 Diabetes Do or Do Not Persist With Glucagon-Like Peptide-1 Receptor Agonist Therapy: A Qualitative Study
CONCLUSIONAlthough cost is a major obstacle to treatment continuation, it can only be resolved through changes in ongoing reimbursement coverage and policies. However, many other obstacles could potentially be addressed (e.g., reducing side effects with gradual dosage titration and setting appropriate expectations regarding efficacy) through more collaborative patient-clinician interactions before initiating therapy. (Source: Diabetes Spectrum)
Source: Diabetes Spectrum - February 2, 2021 Category: Endocrinology Source Type: research
