Improving the school experience of children with diabetes: Evaluation of the KiDS project.

Background: The International Diabetes Federation (IDF) launched the Kids and Diabetes in School (KiDS) project in collaboration with the International Society for Paediatric and Adolescent Diabetes (ISPAD) and Sanofi Diabetes to inform and teach school staff, children and parents on the management of diabetes in school. Brazil and India were chosen as pilot countries.

Methods: The evaluation was conducted using a qualitative methodology using semi-structured face to face in-depth interviews.

Intensive structured education for type 1 diabetes management using BERTIE: Long-term follow-up to assess impact on glycaemic control and quality of life indices.

Aims: Bournemouth Type 1 Intensive Education (BERTIE) is a structured education course delivered 1 day a week for 4 weeks for self-management of type 1 diabetes. BERTIE outcomes were analysed to assess long-term effectiveness: primary outcome assessed impact of BERTIE on glycaemic control, secondary outcomes assessed impact on Problem Area in Diabetes (PAID) scale, severe hypoglycaemia and diabetic ketoacidosis incidence (DKA).

Methods: Prospectively collected outcome data from attendees included glycated haemoglobin (HbA1c), PAID, severe hypoglycaemia and DKA incidence recorded pre-course, 6 months and 1 year post-attendance, with HbA1c assessed annually at subsequent clinic visits.

Global perspectives on the provision of diabetic retinopathy screening and treatment: Survey of health care professionals in 41 countries.

Aim: To assess the level of awareness and provision of screening and treatment for Diabetic Eye Disease (DED) comprising Diabetic Retinopathy (DR) and Diabetic Macular Edema (DME) among health care professionals.

Methods: The study was conducted in two phases. The first phase consisted of a qualitative study, based on semi-structured face-to-face and telephone interviews in 8 countries.

Sustaining diabetes prevention and care interventions: A multiple case study of translational research projects.

Background: This study identifies the barriers and enablers for sustainability of interventions in primary and secondary prevention of diabetes. In the context of translational research, sustainability is defined as the continued use of program components and activities for the continued achievement of desirable program and population outcomes.

Methods: In this study, eleven translational research projects, supported by the BRIDGES program of the International Diabetes Federation, were investigated.

The Diabetic Retinopathy Barometer Study: Global perspectives on access to and experiences of diabetic retinopathy screening and treatment.

Aim: To assess the level of awareness, prevention and treatment of Diabetic Eye Disease (DED) comprising Diabetic Retinopathy (DR) and Diabetic Macula Edema (DME) retinopathy among adults with diabetes and health professionals.

Methods: The Diabetic Retinopathy Barometer Study consisted of a qualitative study, which consisted of semi-structured interviews, and a quantitative study using online surveys for adults with diabetes and for health professionals.

Results: A total of 4340 adults with diabetes and 2329 health professionals participated in the surveys.

IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040.

Aim: To produce current estimates of the national, regional and global impact of diabetes for 2015 and 2040.

Methods: A systematic literature review was conducted to identify data sources on the prevalence of diabetes from studies conducted in the period from 1990 to 2015. An analytic hierarchy process was used to select the most appropriate studies for each country, and estimates for countries without data were modelled using extrapolation from similar countries that had available data.

IDF Diabetes Atlas estimates of 2014 global health expenditures on diabetes.

Aims: To estimate health expenditures due to diabetes in 2014 for the world and its regions.

Methods: Diabetes-attributable health expenditures were estimated using an attributable fraction method. Data were sourced from International Diabetes Federation (IDF) estimates of diabetes prevalence, UN population projections, WHO annual health expenditure reports, and estimates of the cost ratio of people with and without diabetes.

Use of an insulin bolus advisor facilitates earlier and more frequent changes in insulin therapy parameters in suboptimally controlled patients with diabetes treated with multiple daily insulin injection therapy: results of the ABACUS trial.

Background: We assessed the impact of using an automated bolus advisor integrated into a blood glucose meter on the timing and frequency of adjusting insulin therapy parameter settings and whether the availability of this technology would increase blood glucose test strip utilization in diabetes patients treated with multiple daily insulin injection (MDI) therapy.

Subjects And Methods: The Automated Bolus Advisor Control and Usability Study (ABACUS) trial, a 26-week, prospective, randomized, controlled, multinational study that enrolled 218 type 1 and type 2 diabetes patients, demonstrated that use of an automated insulin bolus advisor helps improve glycemic control in suboptimally controlled, MDI-treated patients. Patient data were assessed to determine when and how often changes in insulin parameter settings occurred during the study.

Use of an insulin bolus advisor improves glycemic control in multiple daily insulin injection (MDI) therapy patients with suboptimal glycemic control: first results from the ABACUS trial.

Objective: Use of automated bolus advisors is associated with improved glycemic control in patients treated with insulin pump therapy. We conducted a study to assess the impact of using an insulin bolus advisor embedded in a blood glucose (BG) meter on glycemic control and treatment satisfaction in patients treated with multiple daily insulin injection (MDI) therapy. The study goal was to achieve >0.

Automated bolus advisor control and usability study (ABACUS): does use of an insulin bolus advisor improve glycaemic control in patients failing multiple daily insulin injection (MDI) therapy? [NCT01460446].

Background: People with T1DM and insulin-treated T2DM often do not follow and/or adjust their insulin regimens as needed. Key contributors to treatment non-adherence are fear of hypoglycaemia, difficulty and lack of self-efficacy associated with insulin dose determination. Because manual calculation of insulin boluses is both complex and time consuming, people may rely on empirical estimates, which can result in persistent hypoglycaemia and/or hyperglycaemia.

Hypoglycemia impairs quality of blood glucose simulation in a clinical decision support system.

Background: Clinical decision support systems allow for decisions based on blood glucose simulations. The DiasNet simulation tool is based on accepted principles of physiology and simulates blood glucose concentrations accurately in type 1 diabetes mellitus (T1DM) patients during periods without hypoglycemia, but deviations appear after hypoglycemia, possibly because of the long-term glucose counter-regulation to hypoglycemia. The purpose of this study was to evaluate the impact of hypoglycemia on blood glucose simulations.

The relationship between generic and diabetes specific psychological factors and glycaemic control in adults with type 1 diabetes.

259 adults with type 1 diabetes completed measure of anxiety, depression and diabetes specific distress, HbA1c from medical records. Anxiety not depression predicted HbA1c, this association was mediated by illness specific cognitions. Targeting illness specific cognitions may be more productive than treatment of general dysphoria in type 1 diabetes.

The prevalence of depression and anxiety in adults with Type 1 diabetes.

Aim: The aim of the present study was to determine the prevalence of anxiety and depression in a large UK group of people with Type 1 diabetes.

Methods: Patients aged 16-60 years were invited to complete self-report questionnaires when they attended outpatient clinic appointments. HbA(1c) was recorded from the clinic database.

Modelling the effect of alcohol in Type 1 diabetes.

We have recently shown, in studies with patients with Type 1 (insulin dependent) diabetes, that alcohol intake at 2100 hrs significantly reduced blood glucose values after 10-12 hours, compared with control studies with no alcohol. We hypothesised that this was due to the following effects of alcohol: 1. Alcohol metabolism increases NADH, leading to a reduction in hepatic gluconeogenesis; and 2.

Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial.

Objective: To determine if a school based educational programme aimed at reducing consumption of carbonated drinks can prevent excessive weight gain in children.

Design: Cluster randomised controlled trial.

Setting: Six primary schools in southwest England.

Influence of alcohol on cognitive performance during mild hypoglycaemia; implications for Type 1 diabetes.

Aims: Alcohol and hypoglycaemia independently affect cognitive function. This may be relevant for insulin-treated diabetic patients who drive motor vehicles. The aim of this study was to examine the effect of mild hypoglycaemia (2.

Use of the Internet to optimize self-management of type 1 diabetes: preliminary experience with DiasNet.

Six patients with type 1 diabetes participated in a pilot trial. Their median age was 36 years (range 29-61) and the median duration of diabetes was 10 years (range 3-29). They were asked to enter, from their home or work PC, blood glucose values, insulin doses and a food diary.

Copability, coping, and learning as focal concepts in the evaluation of computerised diabetes disease management.

Introduction: Within diabetes care, the majority of health decisions are in the hands of the patient. Therefore, the concepts of disease management and self-care represent inescapable challenges for both patient and healthcare professionals, entailing a considerable amount of learning. Thus, a computerised diabetes disease management systems (CDDM) is to be seen not merely as tools for the medical treatment, but also as pedagogical tools to enhance patient competence.

The effect of alcohol on blood glucose in Type 1 diabetes--metabolic modelling and integration in a decision support system.

Introduction: We have recently shown, in studies with patients with Type 1 (insulin dependent) diabetes, that alcohol intake at 21:00 h significantly reduced blood glucose values after 10-12 h, compared with control studies with no alcohol.

Hypothesis: We hypothesised that this was due to the following effects of alcohol: (1) alcohol metabolism increases NADH, leading to a reduction in hepatic gluconeogenesis; (2) increased glycogen phosphorylase activity depletes hepatic glycogen stores; (3) after the alcohol is metabolised, hepatic insulin sensitivity is increased, leading to the restoration of glycogen stores and reduction in blood glucose levels; and (4) consequently, after several hours, glycogen stores and insulin sensitivity return to normal.

Results: A model describing these changes (DiasNet-Alcohol) was implemented into the DiasNet model of human glucose metabolism.

Preventing glycaemic excursions in diabetic patients requiring percutaneous endoscopic gastrostomy (PEG) feeding after a stroke.

Aims And Methods: Enteral feeding for diabetic patients with a stroke is often associated with hyperglycaemia and/or hypoglycaemia, which can adversely influence neurological recovery. We have developed a structured enteral feeding programme aimed at establishing 'normal' feeding patterns and avoiding marked glycaemic excursions.

Results: Of 332 consecutive patients admitted to an acute stroke unit, 20 of 41 diabetic patients required PEG feeding.