RESUMO
Continuous Glucose Monitoring (CGM) is rapidly becoming a standard of care in the management of Type 1 diabetes (T1D). Today's devices are nearly as accurate as home glucose meters. They provide glucose data every 5 minutes, alert to high and low blood glucose levels, and allow for remote monitoring of a user's glucose data and patterns. Use of CGM has many benefits including support for tighter glycemic control without increasing the risk for hypoglycemia. There is however emerging evidence of some negative aspects associated with using CGM, which may result in decreased utilization of the device as well as a decline in quality of life, especially in the pediatric population. This article explores some of the challenges to successful CGM use and offers guidelines for helping patients/families minimize the negative impact of these revolutionary devices.
Assuntos
Glicemia/análise , Diabetes Mellitus Tipo 1/sangue , Adolescente , Automonitorização da Glicemia/efeitos adversos , Automonitorização da Glicemia/normas , Automonitorização da Glicemia/estatística & dados numéricos , Criança , Pré-Escolar , Humanos , Sistemas de Infusão de Insulina/efeitos adversos , Sistemas de Infusão de Insulina/estatística & dados numéricos , Padrões de Prática Médica , Qualidade de Vida , Medição de RiscoAssuntos
Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/epidemiologia , Programas de Rastreamento/métodos , Adolescente , Adulto , Distribuição por Idade , Criança , Neuropatias Diabéticas/terapia , Feminino , Humanos , Masculino , Condução Nervosa/fisiologia , Prevalência , Prognóstico , Índice de Gravidade de Doença , Distribuição por Sexo , Resultado do Tratamento , Adulto JovemRESUMO
Of 151 youth with type 1 diabetes who were screened for peripheral neuropathy, and received nerve conduction studies, 11% were diagnosed with Diabetic Peripheral Neuropathy (DPN). DPN can occur in young children, with short diabetes duration, and good diabetes control. National guidelines for screening children for DPN should be developed.
Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Neuropatias Diabéticas/epidemiologia , Programas de Rastreamento/métodos , Condução Nervosa , Doenças do Sistema Nervoso Periférico/epidemiologia , Adolescente , Idade de Início , Criança , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/fisiopatologia , Neuropatias Diabéticas/etiologia , Neuropatias Diabéticas/fisiopatologia , Feminino , Hemoglobinas Glicadas/metabolismo , Guias como Assunto , Humanos , Masculino , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Philadelphia/epidemiologia , Exame Físico , Prevalência , Fatores de Risco , Sensibilidade e Especificidade , Inquéritos e Questionários , Adulto JovemRESUMO
Disorders of hemolysis reduce the exposure time of hemoglobin to glucose, resulting in a falsely low hemoglobin A1c level. This case report describes the unexpected diagnosis of glucose-6-phosphate dehydrogenase deficiency made during evaluation of discordant HbA1c and blood glucose measurements.
Assuntos
Glicemia/análise , Diabetes Mellitus Tipo 1/complicações , Deficiência de Glucosefosfato Desidrogenase/diagnóstico , Hemoglobinas Glicadas/metabolismo , Adolescente , Diabetes Mellitus Tipo 1/sangue , Diagnóstico Diferencial , Deficiência de Glucosefosfato Desidrogenase/sangue , Deficiência de Glucosefosfato Desidrogenase/complicações , Humanos , MasculinoRESUMO
The purpose of the study was to compare three nursing interventions and their impact on glycemic control among children with type I diabetes. The 75 subjects' mean +/- SD age was 12.5 +/- 3.4 years, 55% were boys, and 55% were White. Subjects were randomly assigned to a standard care (SC), an education (ED), or an education and telephone case management (ED + TCM) group. The primary outcome measure was glycemic control (hemoglobin A1c, or HbA1c). Secondary outcome measures were diabetes knowledge (KNOW), parent-child teamwork (TEAM), and adherence (ADH). After 6 months of follow-up, results demonstrated no significant differences among groups in HbA1c. KNOW and TEAM scores improved slightly in the ED and ED + TCM groups, but no statistically significant differences were found among the three groups. Significant improvement in ADH scores among ED + TCM groups was reported when compared with the ED and SC groups. This change may represent a move toward improved adherence to diabetes care and subsequent improvement in diabetes control. The challenges of recruitment and retention of subjects in this study will also be discussed.
