A Quantitative Framework for Evaluating the Performance of Algorithm-Directed Whole-Population Remote Patient Monitoring for Type 1 Diabetes Care.

Clinics continue to adopt remote patient monitoring for type 1 diabetes (T1D) and care models shaped by algorithmic CGM data analysis. No clinic-facing quantitative framework currently exists to track the impact of such algorithm-directed care on patient outcomes and clinical workload. The Teamwork, Targets, Technology, and Tight Control (4T) Study provides precision, whole-population care enabled by algorithms that use continuous glucose monitoring (CGM) data to direct clinician attention to patients with deteriorating glucose management.

Project ECHO Diabetes Trial Improves Outcomes for Medically Underserved People.

Objective: The Project Extension for Community Healthcare Outcomes (ECHO) model is used in 180 countries to address chronic disease care through a provider empowerment, tele-education approach. Few studies have rigorously evaluated the impact of the program on patient outcomes using randomized designs.

Research Design And Methods: Implementation of an ECHO Diabetes program was evaluated using a stepped-wedge design with recruitment of 20 federally qualified health centers (FQHCs) across California and Florida with randomized, phased-in intervention entry.

Bis(azido-κ )bis-(2,2'-di-pyridyl-amine-κ , )iron(II) monohydrate.

In the hydrated title complex, [Fe(dpa)(N)]·HO (dpa is 2,2'-di-pyridyl-amine, CHN), the Fe ion is coordinated in a distorted octa-hedral manner by two neutral, chelating dpa ligands and two anionic, monodentate azide (N ) ions in a -configuration. Distortion results from different Fe-N bond lengths [2.1397 (13)-2.

Psychosocial outcomes in a diverse sample of youth and their families who initiated continuous glucose monitoring within the first year of type 1 diabetes diagnosis.

Aims: Psychosocial impacts of early continuous glucose monitoring (CGM) initiation in youth soon after type 1 diabetes diagnosis are underexplored. We report parent/guardian and youth patient-reported outcomes (PROs) that measure psychosocial states for families in 4T Study 1.

Materials And Methods: Of the 133 families in the 4T Study 1, 132 parent/guardian and 66 youth (≥11 years) were eligible to complete PROs.

The Impact of Public Policy on Equitable Access to Technology for Children and Youth Living with Type 1 Diabetes in British Columbia, Canada.

Structural inequities impede technology uptake in marginalized populations living with type 1 diabetes (T1D). Our objective was to describe hemoglobin A1c (HbA), time in range (TIR), and pump use to evaluate the impact of a universal funding policy for continuous glucose monitoring (CGM) across levels of deprivation in children with T1D in the Canadian province of British Columbia (BC). Patients with T1D and at least one outpatient visit after June 10, 2020 (1-year before universal CGM funding) who were enrolled in the BC Pediatric Diabetes Registry were included ( = 477).

The Role of Whole Food Plant-Based Food Intake on Postprandial Glycemia in Type 1 Diabetes.

Background: Whole food plant-based diet (WFPBD), minimally processed foods with limited consumption of animal products, is associated with improved health outcomes. The benefits of WFPBD are underexplored in individuals with type 1 diabetes (T1D). The primary objective of this analysis is to evaluate the association between WFPBD on glycemia in individuals with T1D.

-Poly[[(8-amino-quinoline)-cobalt(II)]-di-μ-azido].

The title coordination polymer, [Co(N)(CHN)] , was synthesized solvothermally. The Co atom exhibits a distorted octa-hedral [CoN] coordination geometry with a bidentate 8-amino-quinoline ligand and four azide ligands. Bridging azide ligands result in chains extending along [100].

Di-μ-adipato-κ , : , -bis-[(2,2'-di-pyridyl-amine-κ ,')zinc(II)] trihydrate.

The title compound, [Zn(CHO)(CHN)]·3HO or {Zn[(CHN)NH][μ-(CH)(COO)]}·3HO, was separ-ated from the solvothermal reaction of zinc(II) sulfate hepta-hydrate, 2,2'-di-pyridyl-amine and sodium adipate. The dinuclear metal complex has a centrosymmetric structure, with the Zn atom adopting a highly distorted octa-hedral coordination sphere composed of four oxygen atoms from bridging adipato ligands and two pyridine nitro-gen atoms. In the crystal, the title compound aggregates into a tri-periodic supra-molecular structure through inter-molecular hydrogen-bonding networks of the form O-H⋯O and N-H⋯O.

Strategies for Equitable Recruitment to Engage Underrepresented Youth and Their Families into Clinical Research: Findings from the BEAD-T1D Pilot Study.

Introduction: To address disparities in clinical research, we present strategies to optimize recruitment of underrepresented families into the Building the Evidence to Address Disparities in Type 1 Diabetes (BEAD-T1D) study.

Methods: A bilingual/bicultural Latino research assistant (RA) was hired to facilitate culturally congruent recruitment for pediatric type 1 diabetes families. The RA screened, approached, and consented families using their preferred language, time of contact, and answered personal concerns around research.

Discordance Between Clinician and Person-With-Diabetes Perceptions Regarding Technology Barriers and Benefits.

The quality of clinician-patient relationship is integral to patient health and well-being. This article is a narrative review of published literature on concordance between clinician and patient perspectives on barriers to diabetes technology use. The goals of this manuscript were to review published literature on concordance and to provide practical recommendations for clinicians and researchers.

Not all healthcare inequities in diabetes are equal: a comparison of two medically underserved cohorts.

Introduction: Diabetes disparities exist based on socioeconomic status, race, and ethnicity. The aim of this study is to compare two cohorts with diabetes from California and Florida to better elucidate how health outcomes are stratified within underserved communities according to state location, race, and ethnicity.

Research Design And Methods: Two cohorts were recruited for comparison from 20 Federally Qualified Health Centers as part of a larger ECHO Diabetes program.

Project Extension for Community Healthcare Outcomes Intervention Evaluations: A Scoping Review of Research Methods.

Introduction: Since its inception in 2003, the Project Extension for Community Healthcare Outcomes (ECHO) tele-education model has reached and improved outcomes for patients, providers, and health centers through interventions in >180 countries. Utilization of this model has recently increased due to the COVID-19 pandemic and a higher demand for remote education. However, limited research has examined the methodologies used to evaluate Project ECHO interventions.

'We're taught green is good': Perspectives on time in range and time in tight range from youth with type 1 diabetes, and parents of youth with type 1 diabetes.

Aims: Continuous glucose monitoring (CGM) systems are standard of care for youth with type 1 diabetes with the goal of spending >70% time in range (TIR; 70-180 mg/dL, 3.9-10 mmol/L). We aimed to understand paediatric CGM user experiences with TIR metrics considering recent discussion of shifting to time in tight range (TITR; >50% time between 70 and 140 mg/dL, 3.

Consensus Guidance for Monitoring Individuals With Islet Autoantibody-Positive Pre-Stage 3 Type 1 Diabetes.

Given the proven benefits of screening to reduce diabetic ketoacidosis (DKA) likelihood at the time of stage 3 type 1 diabetes diagnosis, and emerging availability of therapy to delay disease progression, type 1 diabetes screening programs are being increasingly emphasized. Once broadly implemented, screening initiatives will identify significant numbers of islet autoantibody-positive (IAb+) children and adults who are at risk for (confirmed single IAb+) or living with (multiple IAb+) early-stage (stage 1 and stage 2) type 1 diabetes. These individuals will need monitoring for disease progression; much of this care will happen in nonspecialized settings.

Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes.

Given the proven benefits of screening to reduce diabetic ketoacidosis (DKA) likelihood at the time of stage 3 type 1 diabetes diagnosis, and emerging availability of therapy to delay disease progression, type 1 diabetes screening programmes are being increasingly emphasised. Once broadly implemented, screening initiatives will identify significant numbers of islet autoantibody-positive (IAb) children and adults who are at risk of (confirmed single IAb) or living with (multiple IAb) early-stage (stage 1 and stage 2) type 1 diabetes. These individuals will need monitoring for disease progression; much of this care will happen in non-specialised settings.

COVID-19 impacts and inequities among underserved communities with diabetes.

Background: People with diabetes have higher COVID-19 morbidity and mortality. These risks are amplified for underserved communities including racial/ethnic minorities and people with lower socioeconomic status. However, limited research has examined COVID-19 outcomes specifically affecting underserved communities with diabetes.