A5069337982- Diabetes Management and Research
- Adolescent and Pediatric Healthcare
- Childhood Cancer Survivors' Quality of Life
- Mobile Health and mHealth Applications
- Diabetes Management and Education
- Diabetes and associated disorders
- Diabetes Treatment and Management
- Chronic Disease Management Strategies
- Pancreatic function and diabetes
- Diet and metabolism studies
- Medication Adherence and Compliance
- Dietary Effects on Health
- Telemedicine and Telehealth Implementation
- LGBTQ Health, Identity, and Policy
- Obesity, Physical Activity, Diet
- Circadian rhythm and melatonin
- Bipolar Disorder and Treatment
- Child and Adolescent Psychosocial and Emotional Development
- Hormonal Regulation and Hypertension
- Adrenal Hormones and Disorders
- Primary Care and Health Outcomes
- Child and Adolescent Health
- Eating Disorders and Behaviors
- Family and Patient Care in Intensive Care Units
- Family Support in Illness
Children's Hospital of Los Angeles
2016-2025
University of Southern California
2018-2025
Keck Hospital of USC
2020-2025
Southern California University for Professional Studies
2023
Dartmouth College
2022
Massachusetts General Hospital
2022
Dartmouth Institute for Health Policy and Clinical Practice
2022
Harvard University
2022
Dartmouth Health
2022
Dartmouth–Hitchcock Medical Center
2022
Abstract Context Minority young adults (YA) currently represent the largest growing population with type 1 diabetes (T1D) and experience very poor outcomes. Modifiable drivers of disparities need to be identified, but are not well-studied. Objective To describe racial-ethnic among YA T1D identify glycemic disparity other than socioeconomic status (SES). Design Cross-sectional multicenter collection patient chart-reported variables, including SES, social determinants health, diabetes-specific...
OBJECTIVE Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. We developed a survey evaluate transition experiences in two groups of young diabetes, before (PEDS) and after (ADULT) care. RESEARCH DESIGN AND METHODS fielded an electronic (18 <30 years) 60 T1D Exchange Clinic Registry centers. RESULTS Surveys were completed by 602 adults, 303 the PEDS group (60% female, age 20 ± 2 299 ADULT (62% 24 3 years). In group, mean...
OBJECTIVE The objective of the study was to report on measurement properties revised and updated Pediatric Quality Life Inventory (PedsQL) 3.2 Diabetes Module for children, adolescents, young adults with type 1 diabetes. RESEARCH DESIGN AND METHODS 33-item PedsQL Generic Core Scales were completed in a 10-site national field test by 656 families patients ages 2–25 years RESULTS 15-item Symptoms Summary Score 18-item Management derived from factor analysis items. Scores evidenced excellent...
OBJECTIVE To evaluate the contemporary prevalence of diabetic peripheral neuropathy (DPN) in participants with type 1 diabetes T1D Exchange Clinic Registry throughout U.S. RESEARCH DESIGN AND METHODS DPN was assessed Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ) adults ≥5 years duration. A score ≥4 defined DPN. Associations demographic, clinical, and laboratory factors were assessed. RESULTS Among 5,936 (mean ± SD age 39 18 years, median duration [interquartile range 11,...
Compared with their peers, historically excluded and marginalized adolescents young adults (AYAs) type 1 diabetes experience more adverse outcomes. CoYoT1 Care (a program offering person-centered care virtual peer groups) provided via telehealth can serve the unique needs of diverse AYAs by increasing engagement reducing A1C physician-related distress.
Young adults with type 1 diabetes (T1D) experience poor glycemic control, disengagement in care, and are often lost to the medical system well into their adult years. Diabetes providers need a new approach working population. The goal of this study was determine whether an innovative shared telemedicine appointment care model (CoYoT1 Clinic [pronounced as "coyote"; Colorado Adults T1D]) for young T1D improves engagement, satisfaction, adherence American Association (ADA) guidelines regarding...
Purpose To assess the impact of a home telemedicine clinic model (CoYoT1 Clinic) on psychosocial and behavioral outcomes designed for young adults (YAs) with type 1 diabetes (T1D). Methods YAs self-selected to participate in CoYoT1 Clinic or serve as usual care control. visits consisted an individual appointment provider group other T1D using telemedicine. Psychosocial functioning was assessed by 4 measures: Diabetes Distress Scale, Self-Efficacy Self-Management Type Adolescence Center...
Young adults with type 1 diabetes (T1D) face many challenges in managing their diabetes, resulting suboptimal glycemic control and often loss to follow-up. Comprehensive strategies are needed engage this population care improve outcomes. This pilot study investigated the feasibility acceptability of Colorado Adults Type Diabetes (CoYoT1) Clinic-an innovative clinical model for young T1D, incorporating telemedicine peer interactions.
Diabetes management is well suited to use of telehealth, and recent improvements in both diabetes technology telehealth policy make this an ideal time for providers begin integrating into their practices. This article provides background information, specific recommendations effective implementation, a vision the future landscape within care guide interested practices on topic. Note: was written prior COVID19 pandemic, does not include information about changes that occurred during or as...
The ongoing coronavirus pandemic led to a rapid and dramatic increase in the use of telehealth for diabetes care. In wake this transition, we examine new opportunities challenges using within management, based on data experiences from pre-pandemic time frames.
Purpose The purpose of the study was to evaluate an adult health care program model for emerging adults with type 1 diabetes transitioning from pediatric care. Methods Evaluation Pediatric Adult Diabetes Transition Clinic at University Pennsylvania included a cohort 72 diabetes, ages 18 25 years. Data were extracted transfer summaries and electronic medical record, including sociodemographic, clinical, follow-up characteristics. Pre- postprogram assessment 6 months mean daily blood glucose...
Objective To examine trajectories of two types type 1 diabetes (T1D) specific distress (i.e., daily T1D management and worries about the future long-term complications) moderating role parental depression in parents children newly diagnosed with T1D. Method A total 126 families 5- to 9-year-olds new-onset enrolled study. One-hundred twenty-five completed study measures at baseline, 102 6-month follow-up, 89 12-month follow-up. Parents T1D-specific concerning complications baseline 6-...
Abstract Introduction Multisystem inflammatory syndrome in children (MIS-C) is a unique clinical complication of SARS-CoV-2 infection observed pediatric patients. COVID-19 emerging as potential trigger for the development diabetes children. Here, we report patient presenting with MIS-C and new onset diabetes, discuss implication management these concomitant conditions. Case presentation An eight-year-old female presented hyperglycemia, ketosis metabolic acidosis consistent diabetic...
The purpose of this study was to analyze the impact virtual group appointments (VGA) on self-reported health-related outcomes and care activities for young adults (YA) with type 1 diabetes (T1D).Fifty-three YA (ages 18-25 years) T1D participated in a randomized controlled trial (RCT) Colorado Young Adults (CoYoT1) Clinic intervention, encompassing telehealth (TH) or without VGA. Both new patients (n = 32) those who pilot phase 26) were CoYoT1 (TH+VGA; n 23) TH-only 35) followed year....
Due to its simplicity, time-limited eating (TLE) may represent a more feasible approach for treating adolescents with obesity compared other caloric restriction regimens. This pilot study examines the feasibility and safety of TLE combined continuous glucose monitoring (CGM) in adolescents. Fifty BMI ≥95th percentile were recruited complete 12-week study. All received standard nutritional counseling, wore CGM daily, randomized to: (1) Prolonged window: 12 h eating/12 fasting + blinded CGM;...
Background Randomized controlled trials of time restricted eating (TRE) in adults have demonstrated improvements glucose variability as captured by continuous monitors (CGM). However, little is known about the feasibility CGM use TRE interventions adolescents, or expected changes glycemic profiles response to meal-timing. As part a pilot trial adolescents with obesity, this study aimed 1) assess use, 2) describe baseline without diabetes, and 3) compare difference between groups practicing...
Background Healthcare transition from pediatric to adult care for young adults (YA) with type 1 diabetes (T1D) is associated risk of adverse outcomes. Consensus recommendations exist US professional societies on YA T1D, but it not known whether they have been widely adopted. We describe experiences, barriers, and provider characteristics in a national sample endocrinologists. Methods endocrinologists identified through the American Medical Association Physician Masterfile were sent an...
To describe factors associated with transfer from paediatric to adult care and poor glycaemic control among young adults Type 2 diabetes, using the SEARCH for Diabetes in Youth study.
The primary objective was to investigate the mediating effects of diabetes management in relationship between symptoms and generic health-related quality life (HRQOL) adolescents young adults (AYAs) with type 1 diabetes. secondary explored patient health communication perceived treatment adherence barriers as mediators a serial multiple mediator model.