Faculty of Medicine

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    Item type:Publication,
    A 5-Step Approach Protocol Using CareLink Therapy Software in Type 1 Diabetes Patients
    (SAGE Publications, 2017-11)
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    We have developed a 5-step approach protocol in interpreting SAP using CareLink. The main objective of this pilot study was to assess the usability of the protocol. The main analysis is based on the Therapy Management Dashboard, where five segments are allocated: (1) basic statistics; (2) glucose and insulin overlay; (3) postprandial period; (4) basal/bolus insulin; (5) suspends and sensor. Possible changes are noted on a printed insulin settings page with evaluation of rationale/physiological insulin. Every segment is analyzed with correlation through others with step by step confirmation of possible change. Thirty-four patients (F 18, M 16), age 15.3 ± 7.7 years with total of 128 CareLink downloads were analyzed on monthly basis in a period of 3 months. The patients profile matched our everyday clinical practice, similar to glucose control on patients using insulin pump reported in several studies.3,4 Our data showed increased insulin total daily dose (TDD), due to fine tuning with more bolus dose than the basal rates. The glucose control was improved (as seen in Table 1) with a decreased hyperglycemic and hypoglycemic patterns.A 5-step approach protocol in interpreting SAP using CareLink is simple, convenient, and efficient and should be assessed on the multicenter level and with a wider population.
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    Item type:Publication,
    Social media and diabetes: can Facebook and Skype improve glucose control in patients with type 1 diabetes on pump therapy? One-year experience
    (American Diabetes Association, 2015-04)
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    The aims of the study were to evaluate results from social media (Skype and Facebook) and CareLink software as tools to improve diabetes control in patients with type 1 diabetes using insulin pumps with glucose sensors. To our knowledge, this is the first study where Facebook is used as treatment alternative to regular clinic visits. A total of 56 children and adolescents with type 1 diabetes, ages 14–23, were randomized in two groups: Regular group and Internet group. The Regular group is composed of 29 patients who were treated using standard medical protocol with regular visits at clinic. Data were uploaded at the clinic and interventions (pump settings, basal bolus insulin, and education) were given to the patient by health care professionals. The Internet group was composed of 27 patients who were treated using CareLink software (Medtronic Diabetes). Data were uploaded by the patient at home and interventions (same as Regular group) were given via Facebook (chats) and Skype (sound and video). Both groups had improved A1C at 12 months (Regular group: 7.7 6 1.6% [61 6 17.5 mmol/mol] at baseline vs. 6.6 6 1.5% [49 6 16.4 mmol/mol] at 12 months; Internet group: 7.8 6 1.9% [62 6 20.8 mmol/mol] at baseline vs. 6.4 6 1.6% [46 6 17.5 mmol/mol] at 12 months, P , 0.05 at 12 months) (Table 1). Internet visits were performed with Facebook (54%), Skype (12%), and both Facebook and Skype (34%). Improvement occurred in the first 6 months and was maintained for 6 additional months. There were no differences in acute complications (diabetic ketoacidosis and severe hypoglycemia events), total daily dose of insulin, and weight change in both groups at 12 months. Personalization, presentation, and participation in social media and health care (5) can be tailored to the priorities of the patient Every Internet visit was personalized with patient needs (appointment date and time) and used active patient participation in the decision-making process of diabetes management. We found that social media use allows patients to gain diabetes knowledge and information and interact in their daily insulin adjustments. Moreover, it could help patients cope better with their daily life. This brief trial suggests that patients prefer to communicate with their health care providers using social media. Facebook and Skype can improve diabetes control similar to regular clinic visits.
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    Item type:Publication,