Publications by authors named "Alisa Boucsein"

Aim: To investigate extension phase outcomes with intermittently scanned continuous glucose monitoring (isCGM 2.0) in children with type 1 diabetes mellitus (T1DM) and elevated HbA (7.5-12.

View Article and Find Full Text PDF

Aims: To identify from a parental perspective facilitators and barriers of effective implementation of advanced hybrid closed-loop (AHCL) therapy in children and adolescents with type 1 diabetes (T1D) with elevated glycaemia.

Methods: Semi-structured interviews were conducted with parents of participants while in a post-trial extension phase of the CO-PILOT randomized controlled trial. The Capability, Opportunity, Motivation, Behaviour Model and Theoretical Domain Framework informed the interviews and framework analysis.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to explore the experiences of adolescents and young adults (ages 13-25) with chronic high glucose levels who switched from multiple daily injections (MDI) to advanced hybrid closed-loop (AHCL) therapy.
  • Researchers conducted semi-structured interviews with 14 participants after three months on the AHCL, identifying three key themes: improved glucose levels enhanced overall health perceptions, AHCL features supported self-management, and insulin delivery automation reduced care burden.
  • The transition to AHCL therapy resulted in positive impacts on physical, mental, and social well-being, although some participants experienced transient pseudo-hypoglycaemia, highlighting the need for individualized support to facilitate uptake.
View Article and Find Full Text PDF

Background: Automated insulin delivery is the treatment of choice in adults with type 1 diabetes. Data are needed on the efficacy and safety of automated insulin delivery for children and youth with diabetes and elevated glycated hemoglobin levels.

Methods: In this multicenter, open-label randomized controlled trial, we assigned patients with type 1 diabetes in a 1:1 ratio either to use an automated insulin delivery system (MiniMed 780G) or to receive usual diabetes care of multiple daily injections or non--automated pump therapy (control).

View Article and Find Full Text PDF

Purpose: Advanced hybrid closed loop (AHCL) systems have the potential to improve glycemia and reduce burden for people with type 1 diabetes (T1D). Children and youth, who are at particular risk for out-of-target glycemia, may have the most to gain from AHCL. However, no randomized controlled trial (RCT) specifically targeting this age group with very high HbA has previously been attempted.

View Article and Find Full Text PDF

Aims: To explore the lived experiences of initiating real-time continuous glucose monitoring (rt-CGM) use in individuals with type 2 diabetes using insulin.

Methods: Twelve semi-structured interviews were conducted amongst individuals with type 2 diabetes taking insulin who were enrolled in the 2GO-CGM randomised controlled trial and had completed 3 months of rtCGM. Interviews were transcribed verbatim and analysed to identify common themes regarding their experiences.

View Article and Find Full Text PDF

Aims: To investigate the impact of real-time continuous glucose monitoring (rtCGM) on glycaemia in a predominantly indigenous (Māori) population of adults with insulin-requiring type 2 diabetes (T2D) in New Zealand.

Methods: Twelve-week, multicentre randomised controlled trial (RCT) of adults with T2D using ≥0.2 units/kg/day of insulin and elevated glycated haemoglobin (HbA1c) ≥64 mmol/mol (8.

View Article and Find Full Text PDF
Article Synopsis
  • The study aims to examine the impact of real-time continuous glucose monitoring (rtCGM) on glycaemic control in adults with type 2 diabetes (T2D) who have poor blood sugar levels, alongside assessing its cost-effectiveness and safety.
  • Conducted across three locations in New Zealand, the trial will involve 80 adults with T2D, who will be split into two groups: one using rtCGM and the other using standard blood glucose monitoring for three months, followed by a crossover phase.
  • The main goal is to measure how long participants maintain their glucose levels within a target range, while also analyzing other health metrics, dietary habits, and overall cost-effectiveness throughout the trial.
View Article and Find Full Text PDF

Aims/hypothesis: Type 1 diabetes is one of the most common chronic diseases of childhood. It is hypothesised that the metabolic and psychosocial consequences of type 1 diabetes may affect educational outcomes; however, existing literature presents conflicting results. This study aimed to assess whether educational outcomes differ for young people with and without type 1 diabetes in Aotearoa/New Zealand (NZ).

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates how young adults with type 1 diabetes experience and manage alcohol consumption, highlighting their social drinking habits along with the associated challenges.
  • Four main themes emerged from interviews: inconsistent understanding of alcohol's effects, difficulties in maintaining glycaemic control while socializing, implementation of harm-reduction strategies when feasible, and the role of modern diabetes tech in improving safety.
  • The findings suggest a need for better education and support regarding safe drinking practices for this group to prevent safety issues, such as hypoglycaemia, while leveraging diabetes technology to facilitate better management.
View Article and Find Full Text PDF

To investigate 12-month glycemic and psychosocial changes following transition from multiple daily injections (MDI) to advanced hybrid closed-loop (AHCL) therapy in youth (aged 13-25 years) with type 1 diabetes and suboptimal glycemia (glycated hemoglobin [HbA] ≥8.5% [69 mmol/mol]). Prospective, single arm, dual-center study in 20 participants.

View Article and Find Full Text PDF

To investigate whether intermittently scanned continuous glucose monitoring (isCGM) reduced glycated hemoglobin (HbA1c) compared with capillary self-monitored capillary blood glucose (SMBG) in children with type 1 diabetes (T1D) and elevated glycemic control. This multicenter 12-week 1:1 randomized, controlled, parallel-arm trial included 100 participants with established T1D aged 4-13 years (mean 10.9 ± 2.

View Article and Find Full Text PDF

Aims: In many countries, real-time continuous glucose monitoring (rt-CGM) is not funded, and cost presents a barrier to access. A do-it-yourself conversion of intermittently scanned CGM (DIY-CGM) is a cheaper alternative. This qualitative study aimed to explore user experiences with DIY-CGM in people aged 16 to 69 years with type 1 diabetes (T1D).

View Article and Find Full Text PDF

Objective: To evaluate glycemic outcomes in youth (aged 13-25 years) with type 1 diabetes and high-risk glycemic control (HbA1c ≥8.5% [69 mmol/mol]) on multiple daily injection (MDI) therapy after transitioning to advanced hybrid closed loop (AHCL) therapy.

Research Design And Methods: This prospective, 3-month, single-arm, dual-center study enrolled 20 participants, and all completed the study.

View Article and Find Full Text PDF

Purpose: Type 1 diabetes (T1D) management requires regular monitoring of glucose levels and judicious therapeutic administration of insulin to prevent both microvascular and macrovascular complications. Few people with diabetes are able to sustain the self-monitored blood glucose measurements needed for optimal care, and those that do, typically experience significant diabetes-related distress. Both intermittently scanned continuous glucose monitoring (isCGM) and continuous glucose monitoring (CGM) offer alternatives to reduce the overall burden, but both still have limitations.

View Article and Find Full Text PDF

Purpose: Frequent glucose monitoring is necessary for optimal glycaemic control. Second-generation intermittently scanned glucose monitoring (isCGM) systems inform users of out-of-target glucose levels and may reduce monitoring burden. We aim to compare FreeStyle Libre 2 (Abbott Diabetes Care, Witney, U.

View Article and Find Full Text PDF
Article Synopsis
  • - Energy homeostasis is regulated by the brain, with hormones like insulin and leptin signaling the body's energy status, influencing food intake, energy use, and glucose metabolism; disruptions can lead to obesity and diabetes.
  • - Leptin not only plays a significant role in glucose regulation but can also lower glucose levels independently of insulin, while insulin remains crucial for long-term blood sugar stability.
  • - The interplay between insulin and leptin involves the WNT/β-catenin pathway, which enhances insulin signaling, and research suggests leptin may have evolved primarily as a hormone for glucose regulation, with its appetite-suppressing function developing later.
View Article and Find Full Text PDF

The importance of fatty acids (FAs) for healthy brain development and function has become more evident in the past decades. However, most studies focus on the hypothalamus as an important FA-sensing brain region involved in energy homeostasis. Less work has been done to evaluate the effects of FAs on brain regions such as the hippocampus or cortex, two important centres of learning, memory formation, and cognition.

View Article and Find Full Text PDF

Synchronization between biologic clocks and metabolism is crucial for most species. Here, we examined the ability of leptin, important in the control of energy metabolism, to induce leptin signaling at the molecular as well as the behavioral level throughout the 24-h day in mice fed either a control or a high-fat diet (HFD). Furthermore, we investigated the effects of time-restricted feeding (TRF; a limitation of HFD access to 6 h each day) on energy metabolism during different periods throughout the 24-h day.

View Article and Find Full Text PDF

Metabolic syndrome and Alzheimer's disease (AD) are two major health issues in modern society causing an extraordinary financial burden for the global healthcare systems. A tight link between the pathologies of obesity and type 2 diabetes (T2D), and more recently between T2D and AD, has been discovered. Furthermore, in recent years it has become apparent that the circadian clock has an important function in controlling metabolism.

View Article and Find Full Text PDF

The WNT pathway was shown to play an important role in the adult central nervous system. We previously identified the WNT pathway as a novel integration site of the adipokine leptin in mediating its neuroendocrine control of metabolism in obese mice. Here we investigated the implication of WNT signaling in seasonal body weight regulation exhibited by the Djungarian hamster (Phodopus sungorus), a seasonal mammal that exhibits profound annual changes in leptin sensitivity.

View Article and Find Full Text PDF

Adiponectin, an adipocyte-derived hormone, regulates glucose and lipid metabolism. It is also antiinflammatory. During obesity, adiponectin levels and sensitivity are reduced.

View Article and Find Full Text PDF

The profound seasonal cycle in body weight exhibited by the Djungarian hamster (Phodopus sungorus) is associated with the development of hypothalamic leptin resistance during long day photoperiod (LD, 16:8 h light dark cycle), when body weight is elevated relative to short day photoperiod (SD, 8:16 h light dark cycle). We previously have shown that this seasonal change in physiology is associated with higher levels of mRNA for the potent inhibitor of leptin signaling, suppressor of cytokine signaling-3 (SOCS3), in the arcuate nucleus (ARC) of LD hamsters relative to hamsters in SD. The alteration in SOCS3 gene expression preceded the body weight change suggesting that SOCS3 might be the molecular switch of seasonal body weight changes.

View Article and Find Full Text PDF