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  • 1
    Online Resource
    Online Resource
    Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice
    The Endocrine Society ; 2023
    In:  Endocrine Reviews Vol. 44, No. 2 ( 2023-03-04), p. 254-280
    Details
    In: Endocrine Reviews, The Endocrine Society, Vol. 44, No. 2 ( 2023-03-04), p. 254-280
    Abstract: The significant and growing global prevalence of diabetes continues to challenge people with diabetes (PwD), healthcare providers, and payers. While maintaining near-normal glucose levels has been shown to prevent or delay the progression of the long-term complications of diabetes, a significant proportion of PwD are not attaining their glycemic goals. During the past 6 years, we have seen tremendous advances in automated insulin delivery (AID) technologies. Numerous randomized controlled trials and real-world studies have shown that the use of AID systems is safe and effective in helping PwD achieve their long-term glycemic goals while reducing hypoglycemia risk. Thus, AID systems have recently become an integral part of diabetes management. However, recommendations for using AID systems in clinical settings have been lacking. Such guided recommendations are critical for AID success and acceptance. All clinicians working with PwD need to become familiar with the available systems in order to eliminate disparities in diabetes quality of care. This report provides much-needed guidance for clinicians who are interested in utilizing AIDs and presents a comprehensive listing of the evidence payers should consider when determining eligibility criteria for AID insurance coverage.
    Type of Medium: Online Resource
    ISSN: 0163-769X , 1945-7189
    URL: Article
    DOI: 10.1210/endrev/bnac022
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2023
    detail.hit.zdb_id: 2011701-2
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  • 2
    Online Resource
    Online Resource
    Who Needs Diabetes Education? A Qualitative Analysis of Emerging Adults With Type 1 Diabetes
    SAGE Publications ; 2021
    In:  The Science of Diabetes Self-Management and Care Vol. 47, No. 6 ( 2021-12), p. 436-446
    Details
    In: The Science of Diabetes Self-Management and Care, SAGE Publications, Vol. 47, No. 6 ( 2021-12), p. 436-446
    Abstract: The purpose of this study is to explore the diabetes self-management education (DSME) needs of emerging adults with type 1 diabetes mellitus (T1DM) because addressing these needs may facilitate optimal glycemic management during this challenging transitional period. Methods A hybrid qualitative design was utilized. Emerging adults and parents of emerging adults were recruited from endocrinology and primary care clinics and through a Utah-specific T1DM online community. Interviews were conducted to asses needs to achieve target A1C. Data were interpreted thematically. Results Emerging adults with T1DM (N = 33) and parents of emerging adults with T1DM (N = 17) were interviewed. Three main themes emerged: (1) mixed desire for personal DSME; (2) I don’t need the education, others do; and (3) health care provider (HCP) attributes that make a difference. Associated subthemes were reported. Conclusions Emerging adults reported that further education for themselves was not needed, although newly diagnosed individuals would benefit from increased training in diabetes management. Although many emerging adults had a supportive social network, they endorsed the need for greater public education to avoid diabetes misinformation. Emerging adults felt more connected with HCPs that had diabetes-specific training (ie, endocrinologist) or those who personally live with T1DM.
    Type of Medium: Online Resource
    ISSN: 2635-0106 , 2635-0114
    URL: Article
    DOI: 10.1177/26350106211051297
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 3062380-7
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  • 3
    Online Resource
    Online Resource
    Mechanism of Acid-Catalyzed Epoxidation of Alkenes with Peroxy Acids
    American Chemical Society (ACS) ; 1997
    In:  The Journal of Organic Chemistry Vol. 62, No. 15 ( 1997-07-01), p. 5191-5197
    Details
    In: The Journal of Organic Chemistry, American Chemical Society (ACS), Vol. 62, No. 15 ( 1997-07-01), p. 5191-5197
    Type of Medium: Online Resource
    ISSN: 0022-3263 , 1520-6904
    URL: Article
    DOI: 10.1021/jo950930e
    RVK:
    VA 5350
    Language: English
    Publisher: American Chemical Society (ACS)
    Publication Date: 1997
    detail.hit.zdb_id: 1472273-2
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  • 4
    Online Resource
    Online Resource
    Financial Barriers in Emerging Adults With Type 1 Diabetes: A Qualitative Analysis
    American Diabetes Association ; 2022
    In:  Diabetes Spectrum Vol. 35, No. 2 ( 2022-05-15), p. 190-197
    Details
    In: Diabetes Spectrum, American Diabetes Association, Vol. 35, No. 2 ( 2022-05-15), p. 190-197
    Abstract: Emerging adulthood is a period fraught with challenging life transitions for many and is especially difficult for individuals with type 1 diabetes, as they encounter more obstacles to independently managing their diabetes. We examined the barriers faced by emerging adults and parents of emerging adults with type 1 diabetes and the impact these barriers had on their lives. Methods Emerging adults and parents of emerging adults with type 1 diabetes were recruited from primary care and specialty clinics and via social media posts. In the parent study, semi-structured interviews were conducted to understand what supported and did not support diabetes self-management. Interviews were transcribed, coded, and analyzed for common themes. This sub-analysis analyzed data related to financial challenges in accessing diabetes management equipment and supplies. Results This study included emerging adults with type 1 diabetes (n = 33; mean age 20 ± 2.9 years) and parents of emerging adults with type 1 diabetes (n = 17; mean age 47.5 ± 6.9 years). The majority of emerging adults used an insulin pump and continuous glucose monitoring system (n = 24 [73%]). Four main themes emerged related to access to care: 1) affordability of diabetes management tools, 2) managing insurance, 3) communication with pharmacies and health care providers, and 4) emotional consequences of financial stress. Conclusion The current health system is challenging for emerging adults with type 1 diabetes and parents and is causing substantial emotional and financial stress. Future research is needed to address interventions for helping emerging adults and their parents navigate the cost of living with diabetes.
    Type of Medium: Online Resource
    ISSN: 1040-9165 , 1944-7353
    URL: Article
    DOI: 10.2337/ds21-0038
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 2043905-2
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  • 5
    Online Resource
    Online Resource
    Economic Impact and Health Care Utilization Outcomes of Diabetes Self-Management Education and Support Interventions for Persons With Diabetes: A Systematic Review and Recommendations for Future Research
    SAGE Publications ; 2021
    In:  The Science of Diabetes Self-Management and Care Vol. 47, No. 6 ( 2021-12), p. 457-481
    Details
    In: The Science of Diabetes Self-Management and Care, SAGE Publications, Vol. 47, No. 6 ( 2021-12), p. 457-481
    Abstract: Value-driven outcomes are important because health systems determine sustainability of diabetes self-management education and support (DSMES) programming. Health care utilization and clinical outcomes are critical factors when considering the impact of DSMES programs. Objective The aim of this systematic review was to describe studies that report on the economic and health care utilization outcomes of diabetes self-management programs. Methods A systematic literature review was performed in multiple databases. Studies reporting economic and health care utilization outcomes related to DSMES and including 1 or more of the ADCES7 Self-Care BehaviorsTM from January 2006 to May 2020 were included. Eligible articles needed to compare the intervention and comparison group and report on economic impact. The methodological quality was assessed with the Joanna Briggs Institute Critical Appraisal Checklist specific to each individual study design. Results A total of 22 of 14 556 articles published between 2007 and 2020 were included. Cost benefits varied, and there were considerable methodological heterogeneity among design, economic measures, population, perspective, intervention, and biophysical outcomes. Conclusion DSMES interventions may positively impact economic outcomes and/or health care utilization, although not all studies showed consistent benefit. This review highlights an evidence gap, and future health economic evaluations are warranted.
    Type of Medium: Online Resource
    ISSN: 2635-0106 , 2635-0114
    URL: Article
    DOI: 10.1177/26350106211047565
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 6
    Online Resource
    Online Resource
    650-P: Qualitative Findings from D-COPES Emerging Adult Peer Connectors Pilot Study
    American Diabetes Association ; 2023
    In:  Diabetes Vol. 72, No. Supplement_1 ( 2023-06-20)
    Details
    In: Diabetes, American Diabetes Association, Vol. 72, No. Supplement_1 ( 2023-06-20)
    Abstract: Background: Emerging adults with Type 1 Diabetes (T1D) undergo transitions that necessitate a strong social support system. The Diabetes Connecting Online Peers To Enhance Support (D-COPES) pilot intervention was designed by a multidisciplinary group of researchers and people with T1D to engage emerging adults in small-group discourse with “peer connectors” through virtual biweekly sessions and in-between text communication. The purpose of this study was to determine the peer connector's acceptability of the D-COPES intervention. Methods: Five peer connectors with T1D (age 18-30) were trained to deliver D-COPES via 6 biweekly 1-hour group sessions, with text messaging between. Peer connector guides (n=24) included topic-specific discussion questions and resources. Topics addressed included disclosing T1D to others, diabetes burnout, and relationships with food. Semi-structured interviews with peer connectors were conducted at the end of the 12-week pilot study to learn about the acceptability of training, group dynamics, resources, and any areas for improvement. Data were transcribed and analyzed using a qualitative descriptive approach. Results: Key themes included 1) benefits of training, suggestion to include 1 additional training meeting; 2) variety of peer connector guides, suggestion for additional topics (e.g., menstruation, intimate relationships); 3) positive group dynamics resulting from group matching and desire to stay connected after the intervention, though group size could be increased; and 4) peer connector benefits of increased knowledge, social support and opportunity to pay it forward. Conclusion: D-COPES pilot was acceptable and will be revised (e.g., increased training and materials, larger groups) to be evaluated in a fully powered trial. Disclosure N.A.Allen: Consultant; Diathrive Health, Dexcom, Inc. J.E.Blanchette: Advisory Panel; LifeScan Diabetes Institute, Cardinal Health/Edgepark, Provention Bio, Inc., Board Member; JDRF, Consultant; WellDoc, Other Relationship; Tandem Diabetes Care, Inc., Research Support; Association of Diabetes Care & Education Specialists, Speaker's Bureau; Insulet Corporation. N.Shah: None. B.Gonzales: None. A.Moraitis: None. M.E.Hilliard: None. M.L.Litchman: None. Funding Franklin S. Ivory and Rachael C. Ivory Foundation
    Type of Medium: Online Resource
    ISSN: 0012-1797
    URL: Article
    DOI: 10.2337/db23-650-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2023
    detail.hit.zdb_id: 1501252-9
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  • 7
    Online Resource
    Online Resource
    817-P: Financial Stress Factors, Psychological Factors, and Self-Management Outcomes in Emerging Adults with Type 1 Diabetes
    American Diabetes Association ; 2020
    In:  Diabetes Vol. 69, No. Supplement_1 ( 2020-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 69, No. Supplement_1 ( 2020-06-01)
    Abstract: Emerging adults, ages 18-25, with type 1 diabetes (T1D) may be vulnerable to financial and psychological barriers to self-management as they grapple with the developmental milestones of financial and self-management independence. This correlational, cross-sectional study described the relationships among financial stress factors (perceived stress, financial stress, and financial independence) and psychological factors (depressive symptoms, trait anxiety, and diabetes distress) on self-management outcomes (HbA1c and diabetes-related quality of life [DQoL]) in emerging adults with T1D. Data from 413 emerging adults recruited from the T1D Exchange (mean age 22.1±1.83 years; 62% female; 80.4% white; 37.3% private high-deductible insurance; T1D duration 13.2±4.41 years; 8.0±1.6 HbA1c) were analyzed. The Perceived Stress Scale, Personal Financial Well-Being Scale, Willingness to Pay Scale, Financial Independence Visual Analog Scale, Center for Epidemiological Studies-Depression Inventory, State-Trait Anxiety Inventory, Diabetes Distress Scale and DQoL Measure were completed via REDCap surveys. Hierarchical Multiple Regression analyses revealed that 20.6% of variance in HbA1c (F=15.555, p & lt;.001) was explained by greater financial stress (β=-.197, p & lt;.001) and diabetes distress (β=.181, p & lt;.001); 64.5% of the variance in DQoL (F=148.469, p & lt;.001) was explained by greater financial stress (β=-.112, p = .002), diabetes distress (β=.512, p & lt;.001), trait anxiety (β=.183, p=.001) and depressive symptoms (β=.162, p=.001). Greater financial stress and psychological factors have detrimental impacts on self-management outcomes during emerging adulthood. Future interventions should assess and address these self-management barriers in practice. Disclosure J.E. Blanchette: Other Relationship; Self; Tandem Diabetes Care. V.B. Toly: None. J.R. Wood: Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc. Speaker’s Bureau; Self; Xeris Pharmaceuticals, Inc. C.M. Musil: None. D.L. Morris: None. M.E. Votruba: None. Funding Frances Payne Bolton School of Nursing; Sigma Theta Tau International
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db20-817-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2020
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  • 8
    Online Resource
    Online Resource
    23-LB: Economic Outcomes and Health Care Utilization of DSMES Interventions: A Systematic Review and Recommendations for Research
    American Diabetes Association ; 2021
    In:  Diabetes Vol. 70, No. Supplement_1 ( 2021-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 70, No. Supplement_1 ( 2021-06-01)
    Abstract: Value-driven outcomes are important, especially when health systems are determining sustainability of Diabetes Self-Management Education & Support (DSMES). We conducted a systematic review to synthesize existing research of the economic outcomes and healthcare utilization for interventions that incorporate DSMES in the US. Seven databases were searched for relevant published studies that included of at least one component of the Association of Diabetes Care and Education Specialists 7 Self-Care Behaviors (ADCES7). Reviewers independently selected articles, extracted data and assessed the methodological quality of included studies. In total, 14,804 records were identified, 25 articles met the inclusion criteria. Three articles were determined to have poor quality and were not included in the final analysis. Our findings are based on a total of 22 articles describing 21 studies. DSMES interventions varied widely, including face-to-face education, group classes, home visits with community health workers, telemedicine visits, education modules, and/or visits with registered dietitians, nurses and/or pharmacists. A majority of the studies were not specifically designed for health economic evaluation. Seven studies reported a statistically significant decrease in either total health care costs, hospital or emergency utilization, outpatient medical costs, and/or medication costs. Four of the seven studies utilized all components of the ADCES7. Clinical impact across studies varied. Studies that measured HbA1c found a decrease over their study time frame. The methodological heterogeneity among studies was considerable; therefore, a meta-analysis was not conducted. Our review highlights DSMES interventions may positively impact economic outcomes and/or healthcare utilization, though not all studies showed consistent benefit. This review highlights an evidence gap and future full health economic evaluations are warranted. Disclosure C. Whitehouse: None. A. Bzowyckyj: None. S. B. Srivastava: None. A. I. Kauwe tuitama: None. J. E. Blanchette: Board Member; Self; JDRF, Consultant; Self; Insulet Corporation, Other Relationship; Self; Insulet Corporation, Tandem Diabetes Care, Research Support; Self; Association of Diabetes Care and Education Specialists. S. A. Haydon-greatting: None. V. J. Brady: None. T. Smith: None. M. L. Litchman: Research Support; Self; Abbott Diabetes. K. E. Yehl: None.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db21-23-LB
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2021
    detail.hit.zdb_id: 1501252-9
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  • 9
    Online Resource
    Online Resource
    556-P: Codesigning a Diabetes Online Community Intervention for Adults with Type 1 and Type 2 Diabetes
    American Diabetes Association ; 2021
    In:  Diabetes Vol. 70, No. Supplement_1 ( 2021-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 70, No. Supplement_1 ( 2021-06-01)
    Abstract: Engagement in Diabetes Online Communities (DOCs) and diabetes online resources have proven benefits, including improved psychosocial, behavioral and clinical outcomes. However, patients report that finding credible and relevant information can be daunting. The aim of this study was to co-design an intervention with people with diabetes (PWD) to train “Peer Connectors” to help adults with type 1 and type 2 diabetes navigate DOCs and diabetes online resources to improve social support. A community advisory board (CAB) of 11 diverse (race, ethnicity, age, diabetes type, diabetes duration) PWD who were active in a variety of DOCs convened over four 2-hour meetings to discuss and prioritize intervention components and outcome measures. Field notes and audio recordings were analyzed to guide development of the D-COPES (Diabetes - Connecting Online Peers to Enhance Support) intervention. The CAB recommended three intervention components: 1) pairing participants to trained Peer Connectors based on matching characteristics/interests, (2) Peer Connectors delivering a small group intervention to orient participants to DOCs and online resources, and (3) Intervention content that includes tailoring to participants’ individual needs and how to identify misinformation. Recommended outcome measures focused on psychosocial (diabetes distress, empowerment), behavioral (self-efficacy, self-care), and clinical outcomes (A1C as secondary outcome), as well as usage of DOCs and online resources. The co-design process centered the D-COPES intervention on avoidance of misinformation and provided strategies to expand the benefits of DOCs to PWD who might not otherwise have the knowledge and skills to engage most effectively. Co-design also served as a form of social validation, ensuring the intervention itself would be of interest and socially relevant to PWD. The D-COPES intervention will be iteratively piloted with 12 participants over 12 weeks. Disclosure M. L. Litchman: Research Support; Self; Abbott Diabetes. T. Oser: Advisory Panel; Self; Cecelia Health, Dexcom, Inc., Advisory Panel; Spouse/Partner; Cecelia Health, Dexcom, Inc. C. Shockley: None. E. Grigorian: None. H. R. Walker: None. E. Wilson: None. A. Thompson: None. J. E. Blanchette: Board Member; Self; JDRF, Consultant; Self; Insulet Corporation, Other Relationship; Self; Insulet Corporation, Tandem Diabetes Care, Research Support; Self; Association of Diabetes Care and Education Specialists. C. Rice: None. M. E. Hilliard: None. Funding Dick and Timmy Burton Foundation
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db21-556-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2021
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  • 10
    Online Resource
    Online Resource
    Mothers caring for technology-dependent children at home: What is most helpful and least helpful?
    Elsevier BV ; 2019
    In:  Applied Nursing Research Vol. 46 ( 2019-04), p. 24-27
    Details
    In: Applied Nursing Research, Elsevier BV, Vol. 46 ( 2019-04), p. 24-27
    Type of Medium: Online Resource
    ISSN: 0897-1897
    URL: Article
    DOI: 10.1016/j.apnr.2019.02.001
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2048908-0
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