In this sixth article in our ‘Test Tips’ series, Dr Souha El‐Abd and Dr Ruth Poole examine the benefits and limitations of traditional capillary blood glucose testing and the more technologically advanced continuous glucose monitoring in the management of glycaemic control.
在我们“测试提示”系列的第六篇文章中,Souha El - Abd博士和Ruth Poole博士研究了传统毛细血管血糖测试和技术更先进的连续血糖监测在血糖控制管理中的优点和局限性。
{"title":"The accuracy of capillary blood glucose testing versus real time and intermittently scanned continuous glucose monitoring","authors":"Souha El‐Abd, Ruth Poole","doi":"10.1002/pdi.2479","DOIUrl":"https://doi.org/10.1002/pdi.2479","url":null,"abstract":"In this sixth article in our ‘Test Tips’ series, Dr Souha El‐Abd and Dr Ruth Poole examine the benefits and limitations of traditional capillary blood glucose testing and the more technologically advanced continuous glucose monitoring in the management of glycaemic control.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Data driven technologies have revolutionised the management of diabetes allowing people to take a greater role in their care; however, use of such systems creates tremendous quantities of data. We have become accustomed to the sharing of data within the health care professional relationship. For example, someone with type 1 diabetes who experiences hypoglycaemia may explore their glucose profile with their diabetes specialist team. This is acceptable to both parties as there is an implicit trust underpinned by confidentiality and a shared goal. What happens when a third party with their own business interest is introduced to that relationship? Who owns that data? There is an increasingly insistent call for people to take control of ‘their’ data framed as the right of ownership with quotes such as ‘Who owns the data owns the future’ becoming well-worn clichés where the alternatives include the risk of exploitation by ‘surveillance capitalism’.1 Health data is far more than that held in clinical records with collective health data being greater than the sum of its parts. All data can be seen as health data with an estimated 80–90% generated outside of the clinical setting.2 From grocery shopping to sleep habits, walking speed to typing speed, patient-generated health data (PGHD) combines all factors that can reflect an individual's health. Despite the concept of personal ownership of one's data coming into the public awareness following the Cambridge Analytica scandal,3 there has been a proliferation and ubiquity in data intensive software generating PGHD such as health and wellness apps, heart rate wrist monitors and nutrition programmes. This ‘self- tracking’ is marketed as a means to gain self-awareness and improved wellbeing.4 It has been shown that motion data from a smartphone can predict behaviour and mental state of the user,5 so how much more might the tremendous volume of data from continuous glucose monitoring, bolus advisors and insulin requirements in a hybrid closed-loop system predict? Cross reference this with an online calendar, geolocation, spending patterns, sleep and menstrual cycle and you gain an in-depth understanding into someone's life beyond the remit of their diabetes care. Ensuring that the collection, use and access of these data meets the expectations of the public is essential to maintain the professional relationship.6 From the perspective of UK law, health data does not have an extensive system of specific rules like those that govern intellectual property. Arguably, even if this were developed, the advantages of a property framework to govern health information may be limited. The monetary value of one person's data points is likely to be insignificant as value lies in collective data from a population. It is also unclear whether legal ownership would provide patients access to the data economy. Perhaps more pertinently from a health perspective is whether legal ownership of health data would enhance self-care and
{"title":"Who owns health data anyway?","authors":"Louise R Curtis","doi":"10.1002/pdi.2472","DOIUrl":"https://doi.org/10.1002/pdi.2472","url":null,"abstract":"Data driven technologies have revolutionised the management of diabetes allowing people to take a greater role in their care; however, use of such systems creates tremendous quantities of data. We have become accustomed to the sharing of data within the health care professional relationship. For example, someone with type 1 diabetes who experiences hypoglycaemia may explore their glucose profile with their diabetes specialist team. This is acceptable to both parties as there is an implicit trust underpinned by confidentiality and a shared goal. What happens when a third party with their own business interest is introduced to that relationship? Who owns that data? There is an increasingly insistent call for people to take control of ‘their’ data framed as the right of ownership with quotes such as ‘Who owns the data owns the future’ becoming well-worn clichés where the alternatives include the risk of exploitation by ‘surveillance capitalism’.1 Health data is far more than that held in clinical records with collective health data being greater than the sum of its parts. All data can be seen as health data with an estimated 80–90% generated outside of the clinical setting.2 From grocery shopping to sleep habits, walking speed to typing speed, patient-generated health data (PGHD) combines all factors that can reflect an individual's health. Despite the concept of personal ownership of one's data coming into the public awareness following the Cambridge Analytica scandal,3 there has been a proliferation and ubiquity in data intensive software generating PGHD such as health and wellness apps, heart rate wrist monitors and nutrition programmes. This ‘self- tracking’ is marketed as a means to gain self-awareness and improved wellbeing.4 It has been shown that motion data from a smartphone can predict behaviour and mental state of the user,5 so how much more might the tremendous volume of data from continuous glucose monitoring, bolus advisors and insulin requirements in a hybrid closed-loop system predict? Cross reference this with an online calendar, geolocation, spending patterns, sleep and menstrual cycle and you gain an in-depth understanding into someone's life beyond the remit of their diabetes care. Ensuring that the collection, use and access of these data meets the expectations of the public is essential to maintain the professional relationship.6 From the perspective of UK law, health data does not have an extensive system of specific rules like those that govern intellectual property. Arguably, even if this were developed, the advantages of a property framework to govern health information may be limited. The monetary value of one person's data points is likely to be insignificant as value lies in collective data from a population. It is also unclear whether legal ownership would provide patients access to the data economy. Perhaps more pertinently from a health perspective is whether legal ownership of health data would enhance self-care and ","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims. The aim of this study was to explore the relationship between health literacy and diabetes self‐management and control among adults living with type 2 diabetes.
目标本研究旨在探讨成人2型糖尿病患者的健康素养与糖尿病自我管理和控制之间的关系。
{"title":"Health literacy, self‐management and glycaemic control in persons living with type 2 diabetes mellitus: a cross‐sectional study","authors":"Tiffany Lori Nugent, A. Galea, R. Sammut","doi":"10.1002/pdi.2467","DOIUrl":"https://doi.org/10.1002/pdi.2467","url":null,"abstract":"Aims. The aim of this study was to explore the relationship between health literacy and diabetes self‐management and control among adults living with type 2 diabetes.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"48 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76911298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Balani, S. Hyer, Antoinette Johnson, H. Shehata
This study aimed to investigate the utility of first trimester HbA1c in predicting gestational diabetes mellitus (GDM) in obese women with Grade II–III obesity. HbA1c was measured during the first trimester in 160 obese women. A 75g oral glucose tolerance test (OGTT) was performed between 24–28 weeks gestation and GDM diagnosed by WHO criteria.
{"title":"Predicting gestational diabetes mellitus by first trimester HbA1c: a retrospective study in women with moderate to severe obesity","authors":"J. Balani, S. Hyer, Antoinette Johnson, H. Shehata","doi":"10.1002/pdi.2466","DOIUrl":"https://doi.org/10.1002/pdi.2466","url":null,"abstract":"This study aimed to investigate the utility of first trimester HbA1c in predicting gestational diabetes mellitus (GDM) in obese women with Grade II–III obesity. HbA1c was measured during the first trimester in 160 obese women. A 75g oral glucose tolerance test (OGTT) was performed between 24–28 weeks gestation and GDM diagnosed by WHO criteria.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"10 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86756060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The onset of diabetes foot complications signals a new stage of diabetes progression. Amputation may be the result of such difficulties and can impact upon all aspects of a person's life such as mobility, independence, relationships, and possible loss of earning potential, all likely triggers of distress.
{"title":"The importance of asking about wellbeing in a diabetes foot clinic","authors":"C. Bewsey","doi":"10.1002/pdi.2465","DOIUrl":"https://doi.org/10.1002/pdi.2465","url":null,"abstract":"The onset of diabetes foot complications signals a new stage of diabetes progression. Amputation may be the result of such difficulties and can impact upon all aspects of a person's life such as mobility, independence, relationships, and possible loss of earning potential, all likely triggers of distress.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"15 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74727899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper aims to describe experiences and challenges when managing diabetes along with dementia from the perspectives of those living with these conditions, their informal carers and health care professionals.
{"title":"Managing diabetes and dementia, a challenging duo: a scoping review","authors":"Florence Sharkey, V. Coates","doi":"10.1002/pdi.2469","DOIUrl":"https://doi.org/10.1002/pdi.2469","url":null,"abstract":"This paper aims to describe experiences and challenges when managing diabetes along with dementia from the perspectives of those living with these conditions, their informal carers and health care professionals.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"98 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78017791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Global incidence and challenges of type 1 diabetes Type 1 diabetes (T1D) is a chronic disease that affects millions of people around the world. The International Diabetes Federation (IDF) reports that the global incidence of T1D is estimated to be around 15 cases per 100,000 population per year.1 There has been a global increase in the incidence of T1D over the past few decades, particularly in children under the age of five. The reasons for this increase in incidence are not well understood, but it is thought to be due to a combination of genetic and environmental factors. In the UK, around 400,000 people are affected by T1D and life expectancy is reduced in people with T1D.2 Diabetes remains a leading cause of blindness in people of working age, the leading cause of renal failure and second most common cause of lower limb amputation. While the condition can be managed with proper treatment and care, those living in low-middle income countries (LMICs) often lack access to the necessary resources, resulting in poor health outcomes for many living with T1D.1 In LMICs, T1D is often diagnosed late due to limited access to health care services and diagnostic tools. This delay in diagnosis can result in high mortality rates from diabetic ketoacidosis (DKA). Once diagnosed, managing T1D in LMICs can be a challenge. The cost of insulin and other medications can be prohibitively expensive, and many people do not have access to blood glucose monitoring devices, blood glucose strips or other essential diabetes supplies. As a result, many people with T1D in these countries must rely on inadequate treatment options putting their health at risk of lifelong complications such as nerve damage, blindness, and kidney failure.3
{"title":"Action4Diabetes: a non‐profit organisation bridging the type 1 diabetes gap in Southeast Asia","authors":"Sze May Ng","doi":"10.1002/pdi.2463","DOIUrl":"https://doi.org/10.1002/pdi.2463","url":null,"abstract":"Global incidence and challenges of type 1 diabetes Type 1 diabetes (T1D) is a chronic disease that affects millions of people around the world. The International Diabetes Federation (IDF) reports that the global incidence of T1D is estimated to be around 15 cases per 100,000 population per year.1 There has been a global increase in the incidence of T1D over the past few decades, particularly in children under the age of five. The reasons for this increase in incidence are not well understood, but it is thought to be due to a combination of genetic and environmental factors. In the UK, around 400,000 people are affected by T1D and life expectancy is reduced in people with T1D.2 Diabetes remains a leading cause of blindness in people of working age, the leading cause of renal failure and second most common cause of lower limb amputation. While the condition can be managed with proper treatment and care, those living in low-middle income countries (LMICs) often lack access to the necessary resources, resulting in poor health outcomes for many living with T1D.1 In LMICs, T1D is often diagnosed late due to limited access to health care services and diagnostic tools. This delay in diagnosis can result in high mortality rates from diabetic ketoacidosis (DKA). Once diagnosed, managing T1D in LMICs can be a challenge. The cost of insulin and other medications can be prohibitively expensive, and many people do not have access to blood glucose monitoring devices, blood glucose strips or other essential diabetes supplies. As a result, many people with T1D in these countries must rely on inadequate treatment options putting their health at risk of lifelong complications such as nerve damage, blindness, and kidney failure.3","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"51 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88962604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}