Exploring Family Perspectives on a Group-Based Hands-on Advanced Carbohydrate Counting Education Program for Children and Adolescents with Type 1 Diabetes: A Qualitative Study.

The care needs of children and adolescents with type 1 diabetes and their families are frequently approached as if they were identical to those of adults, overlooking the distinct challenges young people may face. It has been stated that children and adolescents often find conventional conversations with diabetes specialists tiresome and unpleasant. The present study focuses on familial experiences of an advanced carbohydrate counting program tailored to children and adolescents. The data encompass semi-structured interviews with families who participated in a group-based child-centered advanced carbohydrate counting program. The analysis revealed five themes: (1) peer-to-peer interaction is an essential determinant of sharing and learning; (2) illness perception significantly influences dietary intake; (3) normalization of diabetes in everyday life eases the disease burden; (4) repetition of dietary knowledge is important for retention; and (5) creating a safe and playful learning environment is crucial to engaging children and adolescents in their own treatment. The present findings suggest that it would be beneficial to explore and consider alternative teaching approaches that are adapted to a more interactive and engaging learning environment that is specifically tailored to children and adolescents. This entails moving away from traditional individual approaches.

Glycemic Effects and Predictors of Increased Time-in-Range After Initiating MiniMed 670G: A 12-Month Observational Study.

We aimed to evaluate the glycemic effect and detect any predictors of improved time-in-range (TIR) in persons with type 1 diabetes after initiating hybrid closed-loop (HCL) treatment with MiniMed 670G in a 12-month retrospective observational study. Before starting HCL treatment, the 62 participants followed a Steno-developed training program; 7 participants (6.5%) discontinued the HCL therapy; the remaining 55 (58% female) had an age (mean ± standard deviation) of 45.6 ± 12.6 years and diabetes duration of 28.2 ± 10.9 years. After 12 months' HCL therapy, glycated hemoglobin A1c decreased from 7.4% +0.7% to 7.1% +0.5%, TIR increased from 59.3% ± 13.5% to 72% ± 9.3%, time in 54-70 mg/dL (3.0-3.9 mM) decreased from 2.4% ± 2.0% to 1.4% ± 1.0%, and time in 180-250 mg/dL (10.0-13.9 mM) decreased from 26.4% ± 8.3% to 20.8% ± 5.5%, all P < 0.001. Improvement in TIR was significantly associated with lower total daily insulin dose, higher amount of total carbohydrate, and more time spent in Auto Mode. Our findings support the promising results on glycemic outcomes seen with HCL treatment.

Dietary habits and adherence to dietary recommendations in patients with type 1 and type 2 diabetes compared with the general population in Denmark.

OBJECTIVES: The aim of the present study was to examine dietary habits and adherence to dietary recommendations in adult patients with type 1 diabetes (T1D) and type 2 diabetes (T2D) compared with the general population in Denmark. METHODS: The study was cross-sectional and included 426 patients with T1D and 348 patients with T2D recruited from an outpatient diabetes clinic in the capital region of Denmark. Dietary habits were assessed by a food frequency questionnaire and compared with dietary data from 2,899 participants without diabetes from the Danish National Survey of Dietary Habits and Physical Activity. RESULTS: Patients with diabetes had a 20-50% lower intake of added sugar and alcohol, and a 10-20% higher intake of fibre and vegetables compared with the general population (p<0.001 for all). Patients with T2D had a 37% lower intake of alcohol compared with T1D (p<0.001). Adherence to dietary recommendations (e.g. fibre, saturated fat, vegetables, fruit and fish) were low in all groups but lowest in the general population. CONCLUSION: The Danish diet is too high in saturated fat and too low in dietary fibre, vegetable, fruit and fish compared to dietary recommendations in both patients with diabetes and the general population. However, our data demonstrate that patients with diabetes consume a healthier diet compared to the general population: Limiting the intake of added sugar and alcohol, and increasing the intake of vegetables and dietary fibre.