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Effect of a Hybrid Closed-Loop System on Glycemic and Psychosocial Outcomes in Children and Adolescents with Type 1 Diabetes: A Randomized Clinical TrialHybrid closed-loop (HCL) therapy has improved glycemic control in children and adolescents with type 1 diabetes; however, the efficacy of HCL on glycemic and psychosocial outcomes has not yet been established in a long-term randomized clinical trial.
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Continuous Glucose Monitoring Improves Glycemic Outcomes in Children With Type 1 Diabetes: Real-World Data From a Population-Based ClinicAlthough recent clinical trials of continuous glucose monitoring (CGM) use have shown positive glycemic benefit, outcomes outside the research setting may differ and real-world studies over a long time period are limited. In April 2017, CGM was fully subsidized in Australia for people living with type 1 diabetes (T1D) <21 years. Perth Children’s Hospital is the sole pediatric diabetes center in Western Australia and is where almost all patients <18 years of age are seen.
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Acute hyperglycaemia does not have a consistent adverse effect on exercise performance in recreationally active young people with type 1 diabetes: a randomised crossover in-clinic studyIn individuals with type 1 diabetes, chronic hyperglycaemia impairs aerobic fitness. However, the effect of acute marked hyperglycaemia on aerobic fitness is unclear, and the impact of insulin level has not been examined. In this study, we explored if acute hyperglycaemia with higher or low insulin levels affects [Formula: see text] and other exercise performance indicators in individuals with type 1 diabetes.
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Variation in nutrition education practices in SWEET pediatric diabetes centers-an international comparisonNutrition education is central to pediatric type 1 diabetes management. Dietary management guidelines for type 1 diabetes are evidence based, but implementation may be challenging and inconsistent.
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Less Nocturnal Hypoglycemia but Equivalent Time in Range among Adults with Type 1 Diabetes Using Insulin Pumps Versus Multiple Daily InjectionsThis prerandomization analysis from the Australian HCL-Adult trial (registration number: ACTRN12617000520336) compared masked continuous glucose monitoring (CGM) metrics among adults using insulin pumps versus multiple daily injections (MDIs), who were all self-monitoring blood glucose (SMBG).
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Lower HbA1c targets are associated with better metabolic controlPrevious studies have suggested that clear HbA1c target setting by the diabetes team is associated with HbA1c outcomes in adolescents. The aim of this study was to evaluate whether this finding is consistent in a larger cohort of children from centers participating in the SWEET international diabetes registry. A questionnaire was sent out to 76 SWEET centers, of which responses from 53 pediatric centers were included (70%). Descriptive outcomes were presented as median with lower and upper quartile.
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Effects of Dietary Fat and Protein on Glucoregulatory Hormones in Adolescents and Young Adults With Type 1 DiabetesDietary fat and protein impact postprandial hyperglycemia in people with type 1 diabetes, but the underlying mechanisms are poorly understood. Glucoregulatory hormones are also known to modulate gastric emptying and may contribute to this effect.
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Nationally Subsidized Continuous Glucose Monitoring: A Cost-effectiveness AnalysisThe Continuous Glucose Monitoring (CGM) Initiative recently introduced universal subsidized CGM funding for people with type 1 diabetes under 21 years of age in Australia. We thus aimed to evaluate the cost-effectiveness of this CGM Initiative based on national implementation data and project the economic impact of extending the subsidy to all age-groups.
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Glycemia, Treatment Satisfaction, Cognition, and Sleep Quality in Adults and Adolescents with Type 1 Diabetes When Using a Closed-Loop SystemAndroid-HCLS in both adults and adolescents reduced nocturnal hypoglycemia and, in adults, improved overnight time in target range and treatment satisfaction
Research
Glucose Concentrations of Less Than 3.0 mmol/L (54 mg/dL) Should Be Reported in Clinical Trials: A Joint Position Statement of the American Diabetes Association and the European Association for the Study of DiabetesThe IHSG recommends that the frequency of detection of a glucose concentration <3.0mmol/L, to be included in clinical trial reports of glucose lowering drugs.