A5091824185- Diabetes Management and Research
- Diabetes Management and Education
- Diabetes and associated disorders
- Pancreatic function and diabetes
- Mobile Health and mHealth Applications
- Diabetes Treatment and Management
- Adolescent and Pediatric Healthcare
- Chronic Disease Management Strategies
- Childhood Cancer Survivors' Quality of Life
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- COVID-19 and Mental Health
- Health and Lifestyle Studies
- Family and Disability Support Research
- Behavioral Health and Interventions
- Digital Mental Health Interventions
- Heart Failure Treatment and Management
- Medication Adherence and Compliance
- Healthcare Technology and Patient Monitoring
- Biochemical Analysis and Sensing Techniques
- Eating Disorders and Behaviors
- Biochemical effects in animals
- Wine Industry and Tourism
- Sleep and related disorders
- Electronic Health Records Systems
- Business Strategy and Innovation
Stanford University
2016-2024
Stanford Medicine
2020-2024
Wellcome/MRC Institute of Metabolic Science
2022
Addenbrooke's Hospital
2022
Alder Hey Children's Hospital
2022
Oxford BioMedica (United Kingdom)
2022
University of Oxford
2022
University of Cambridge
2022
Wellcome Trust
2022
Jaeb Center for Health Research
2022
Diabetes devices (insulin pumps, continuous glucose monitors [CGMs]) are associated with benefits for glycemic control, yet uptake of these continues to be low. Some barriers device may modifiable through psychosocial intervention, but little is known about which and patients target.We surveyed 1,503 adult T1D Exchange participants (mean age 35.3 [SD 14.8] years, mean diagnosis duration 20.4 12.5] years) investigate uptake, understand profiles users versus nonusers, explore differences by...
Background: Adolescents with diabetes have the highest A1cs of all age groups. Diabetes devices (insulin pumps and continuous glucose monitors [CGM]) can improve glycemic outcomes, although uptake has increased, they remain underutilized in this population. This study characterizes adolescent-reported barriers to device use determine targets for clinician intervention. Methods: We surveyed 411 adolescents type 1 (mean 16.30 ± 2.25 years) on use, technology attitudes (general specific),...
Background:Insulin pumps and continuous glucose monitors (CGM) can improve glycemic control for individuals with type 1 diabetes (T1D). Device uptake rates continue to show room improvement, consistent adherence is needed achieve better outcomes. Diabetes health care providers have important roles play in promoting device use adherence. Methods:We surveyed 209 clinicians who treat people examine perceptions of barriers uptake, attitudes toward technology, resources uptake. We compared...
Purpose The first hybrid closed loop (HCL) system, which automates insulin delivery but requires user inputs, was approved for treatment of type 1 diabetes (T1D) by the US Food and Drug Administration in September 2016. purpose this study to explore benefits, expectations, attitudes individuals with T1D following a clinical trial an HCL system. Methods Thirty-two (17 adults, 15 adolescents) participated focus groups after 4 5 days system use. Content analysis generated themes regarding...
Background: Diabetes technology use is associated with favorable type 1 diabetes (T1D) outcomes. American youth public insurance, a proxy for low socioeconomic status, less than those private insurance. We aimed to evaluate the role of insurance-mediated provider implicit bias, defined as systematic discrimination on recommendations T1D in United States. Methods: Multi-disciplinary pediatric providers completed bias assessment comprised clinical vignette and ranking exercises ( n = 39)....
Background: Continuous glucose monitors (CGM) are underutilized by individuals with type 1 diabetes (T1D), particularly during the adolescent years. Little is known about perceptions of CGM benefit and burdens, few tools exist to quantify this information. Methods: Two questionnaires were developed validated—Benefit (BenCGM) Burdens (BurCGM)—in a sample adolescents ages 12-19 years involved in T1D Exchange Registry. We chose start validation process given their low uptake high risk for...
Automated closed loop systems will greatly change type 1 diabetes management; user trust be essential for acceptance of this new technology. This qualitative study explored in 32 individuals following a hybrid trial. Participants described how context-, system-, and person-level factors influenced their the system. attempted to override system when they lacked trust, while trusting decreased self-management burdens stress. Findings highlight considerations fostering systems. Systems may able...
Background: Many people with type 1 diabetes (T1D) report barriers to using continuous glucose monitoring (CGM). Diabetes care providers may have their own promoting CGM uptake. The goal of this study was develop clinician “personas” regard readiness promote Methods: who treat T1D (N = 209) completed a survey on perceived patient device uptake, technology attitudes, and characteristics specific clinical practice. K-means cluster analyses grouped the sample by attitudes. ANOVAs chi-square...
Sugars are major constituents and additives in traditional tobacco products, but little is known about their content or related toxins (formaldehyde, acetaldehyde, acrolein) electronic cigarette (e-cigarette) liquids. This study quantified levels of sugars aldehydes e-cigarette liquids across brands, flavors, nicotine concentrations (n = 66).Unheated were analyzed using liquid chromatography mass spectrometry enzymatic test kits. Generalized linear models, Fisher's exact test, Pearson's...
Background: Diabetes devices such as insulin pumps and continuous glucose monitoring (CGM) are associated with improved health quality of life in adults type 1 diabetes (T1D). However, uptake remains low. The aim this study was to develop different “personas” T1D relation readiness adopt new technology. Methods: Participants were 1498 Exchange participants who completed surveys on barriers uptake, technology attitudes, other psychosocial variables. HbA1c data available from the for 30%...
Hybrid closed loop (HCL) systems are designed to automate insulin delivery improve type 1 diabetes (T1D) outcomes and reduce user burden distress. Because the only some aspects of care, psychosocial human factors remain an important consideration in their use. Thus, we examined whether (i.e., distress related management, fear hypoglycemia, technology attitudes) would (1) change after using system (2) predict glycemic during trial.Fourteen adults 15 adolescents with T1D participated a...
Abstract Aim To examine changes in the lived experience of type 1 diabetes after use hybrid closed loop (CL), including CamAPS FX CL system. Materials and Methods The primary study was conducted as an open‐label, single‐period, randomized, parallel design contrasting versus insulin pump (with or without continuous glucose monitoring). Participants were asked to complete patient‐reported outcomes before starting 3 6 months later. Surveys assessed distress, hypoglycaemia concerns quality life....
This study examined the psychosocial impact of Loop, an open-source automated insulin dosing system that has emerged from diabetes technology "Do-It-Yourself" (DIY) movement.Subsamples 239 adults, 115 children, and 243 parents completed data collection at time Loop initiation 3 6 months later. Surveys collected demographic clinical information, percent time-in-range, HbA1c, validated measures. Analyses included paired t tests McNemar's to compare functioning regression models assess baseline...
Improved insulin infusion set survival and faster action are important issues for pump users the development of an artificial pancreas. The current recommendation is to change sets every 3 days. Our objectives were determine effect lipohypertrophy (LH) on continuous glucose monitoring levels.In this multicenter crossover trial, we recruited 20 subjects (age 28.1 ± 9.0 years) with type 1 diabetes (duration 17.5 8.8 area lipohypertrophied tissue >3 cm. Subjects alternated weekly wearing a...
Background: Loop is an open-source automated insulin delivery (AID) system, used by more than 9,000 people with type 1 diabetes. Understanding the pros and cons of use may help improve disease management support population level innovation. Methods: Focus groups revealed 72 new existing users' perspectives on uptake, use, persistence. A subsample participants from a mixed-methods, observational cohort study shared first-hand accounts their experiences using Loop. Participants were...
Abstract Aims Use of the CamAPS FX hybrid closed loop (CL) system is associated with improved time in range and glycated haemoglobin A1c across age span, but little known about its effects on patient‐reported outcomes (PROs). Methods This open‐label, randomized, multi‐site study compared to sensor‐augmented pump (SAP) a sample older adults (≥60 years) type 1 diabetes (T1D). Thirty‐five completed PROs surveys at start after each period 16 weeks using either CL or SAP. At end study, 19...
Youth with diabetes are at increased risk for depression. However, severity and correlates of depressive symptoms may differ by type.Associations global health, duration, gender were compared between youth type 1 2 diabetes.A sample 149 ages 12 to 21 diagnosed either (n = 122) or 27) screened during routine clinic appointments. Regression models constructed examine differences type.Adolescents had significantly higher symptom scores (4.89 vs 2.99, P .025) than those diabetes. A significant...
DiabetesWise is an unbranded, data-driven online resource that tailors device recommendations based on preferences and priorities of people with insulin-requiring diabetes. The objective this study to examine whether increases uptake diabetes devices, which are empirically supported improve glycemic psychosocial outcomes.The sample included 458 participants (Mage = 37.1, SD 9.73; 66% female; 81% type 1 diabetes) minimal use at enrollment. Participants used completed surveys. Chi-square t...
Background: Loop is an open-source automated insulin dosing system that allows users unrivaled control over settings affect future glucose prediction. Thousands use Loop, but little known about those who discontinue. Methods: In a large observational study, 874 participants completed surveys and provided glycemic data, 46 (5.3%) of self-identified as discontinuing during the observation window, 45 discontinued survey, 22 19 participated in semistructured interviews their discontinuation....
Background: Continuous glucose monitoring (CGM) can improve glycemic control for adults with type 1 diabetes (T1D) but certain barriers interfere consistent use including cost, data overload, alarm fatigue, physical discomfort, and unwanted social attention. This pilot study aimed to examine feasibility acceptability of a behavioral intervention, ONBOARD (Overcoming Barriers Obstacles Adopting Diabetes Devices) support T1D in optimizing CGM use. Methods: Adults (18-50 years) their first year...
This pilot study delivered a comprehensive exercise education intervention to youth with new-onset type 1 diabetes (T1D) and their parents increase knowledge confidence physical activity (PA) shortly after diagnosis.
Background: We tested the safety and performance of “insulin-only” configuration bionic pancreas (BP) closed-loop blood-glucose control system in a home-use setting to assess glycemic outcomes using different static dynamic glucose set-points. Method: This is an open-label non-randomized study with three consecutive intervention periods. Participants had weeks usual care followed by insulin-only BP (1) individualized set-point 115 or 130 mg/dL (2) that automatically varied within 110 mg/dL,...