Ashley N. Shtoyko, Meaghan B. Murphy, Jenna L. Harris, Caitlin Toomey, Elizabeth M. Phillips
{"title":"Characterizing Prescribing Patterns of Diabetes Medications at an Adult Medicine Clinic: A Focus on Glucagon-Like Peptide 1 Receptor Agonists and Sodium–Glucose Cotransporter 2 Inhibitors","authors":"Ashley N. Shtoyko, Meaghan B. Murphy, Jenna L. Harris, Caitlin Toomey, Elizabeth M. Phillips","doi":"10.2337/ds22-0095","DOIUrl":"https://doi.org/10.2337/ds22-0095","url":null,"abstract":"","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"2 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139381158","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}
Pub Date : 2024-01-01Epub Date: 2023-09-08DOI: 10.2337/ds23-0018
Fayo Abadula, Lori C Jordan, Lauren LeStourgeon, Sarah S Jaser
Introduction: Many challenges exist in developing multisite protocols for newly diagnosed children with type 1 diabetes. Our research team engaged community members to increase the likelihood of study success during a planning grant for a longitudinal study aimed at understanding risk and protective factors for neurocognitive function in school-aged children newly diagnosed with type 1 diabetes.
Methods: Two methods were used to obtain caregiver input into study protocol decisions. The first was a survey given to caregivers of children with diabetes (n = 21) about which aspects of the study protocol would make families more or less likely to participate. The second was a Community Engagement (CE) Studio to obtain recommendations from a diverse group of caregivers of children with diabetes (n = 7) on key aspects of recruitment and enrollment.
Results: Results from both the survey and the CE Studio indicated that caregivers were interested and willing to participate in a longitudinal study of this nature. Both methods resulted in similar preferences for the type and amount of compensation, convenient study visits, flexible scheduling options, and receipt of neurocognitive test results. Recommendations from the CE Studio included additional strategies to minimize participant burden and enhance communication around study participation.
Conclusion: Both the feasibility survey and the CE Studio were useful mechanisms to obtain caregiver input during the study's planning and design phase. Uniquely, the CE Studio approach offers researchers the ability to gain valuable community member input with minimal staff effort.
{"title":"Using Community Engagement Methods to Guide Study Protocol Decisions for School-Aged Children With Type 1 Diabetes.","authors":"Fayo Abadula, Lori C Jordan, Lauren LeStourgeon, Sarah S Jaser","doi":"10.2337/ds23-0018","DOIUrl":"10.2337/ds23-0018","url":null,"abstract":"<p><strong>Introduction: </strong>Many challenges exist in developing multisite protocols for newly diagnosed children with type 1 diabetes. Our research team engaged community members to increase the likelihood of study success during a planning grant for a longitudinal study aimed at understanding risk and protective factors for neurocognitive function in school-aged children newly diagnosed with type 1 diabetes.</p><p><strong>Methods: </strong>Two methods were used to obtain caregiver input into study protocol decisions. The first was a survey given to caregivers of children with diabetes (<i>n</i> = 21) about which aspects of the study protocol would make families more or less likely to participate. The second was a Community Engagement (CE) Studio to obtain recommendations from a diverse group of caregivers of children with diabetes (<i>n</i> = 7) on key aspects of recruitment and enrollment.</p><p><strong>Results: </strong>Results from both the survey and the CE Studio indicated that caregivers were interested and willing to participate in a longitudinal study of this nature. Both methods resulted in similar preferences for the type and amount of compensation, convenient study visits, flexible scheduling options, and receipt of neurocognitive test results. Recommendations from the CE Studio included additional strategies to minimize participant burden and enhance communication around study participation.</p><p><strong>Conclusion: </strong>Both the feasibility survey and the CE Studio were useful mechanisms to obtain caregiver input during the study's planning and design phase. Uniquely, the CE Studio approach offers researchers the ability to gain valuable community member input with minimal staff effort.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":" ","pages":"95-99"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10877206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47217144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mason A. Pitts, Ryanne H. Griggs, Macey R. Hall, McKinley S. Tankersley, Jeremy L. Johnson
{"title":"Liraglutide and Robust A1C Reductions Among People With Type 2 Diabetes Requiring Appetite Control: A Review of Two Cases","authors":"Mason A. Pitts, Ryanne H. Griggs, Macey R. Hall, McKinley S. Tankersley, Jeremy L. Johnson","doi":"10.2337/ds23-0052","DOIUrl":"https://doi.org/10.2337/ds23-0052","url":null,"abstract":"","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"8 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138972748","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}
Rebecca E. Luethy, Renee C. Lipinski, Jennifer L. West
Using continuous glucose monitoring (CGM) improves diabetes-related outcomes in the community, yet the fingerstick blood glucose monitoring (BGM) method is the norm in prisons. The purpose of this study was to investigate the safety and patient perceptions of CGM in the carcerate environment, quantify changes in A1C after initiating CGM, and investigate rates of emergency department (ED) visits for diabetes-related complications comparing CGM users to patients using BGM. This pragmatic longitudinal analysis was conducted in two parts. A pilot program was carried out at a single women’s prison. A CGM program was initiated at men’s facilities within a single U.S. state, where A1C change and ED visit rates were investigated. Interested patients at an appropriate security level were invited to use CGM. Pre- and post-CGM surveys of glucose monitoring perceptions were administered during the pilot program. Security and perceptions were analyzed descriptively. A1C change was assessed using a t test. Fisher exact test, Barnard exact test, and post-hoc power analysis were applied to ED visits. Security was not disrupted. Patient perceptions of glucose monitoring improved with CGM use (n = 6). A1C declined by 0.60% with a medium effect size (Cohen’s d −0.45, n = 42). Power to detect a difference in ED visits was low; however, no CGM patients had an ED visit (n = 758). It is safe and efficacious to replace BGM with CGM in prisons when patients are engaged in their care and are at a security level allowing CGM devices in their cells.
在社区中，使用连续血糖监测(CGM)可以改善糖尿病相关的预后，但手指血糖监测(BGM)方法在监狱中仍是常态。本研究的目的是调查在碳化环境中CGM的安全性和患者的认知，量化启动CGM后A1C的变化，并调查CGM使用者与BGM患者的糖尿病相关并发症急诊(ED)就诊率。本文的语用纵向分析分为两部分。在一所女子监狱开展了一项试点方案。一项CGM计划在美国一个州的男性医院启动，调查了A1C变化和ED就诊率。邀请有兴趣且安全等级适当的患者使用CGM。在试点项目中，对cgm前后的血糖监测感知进行了调查。对安全性和感知进行描述性分析。采用t检验评估A1C变化。Fisher精确检验、Barnard精确检验和事后功效分析应用于急诊科就诊。安全没有受到干扰。使用CGM后，患者对血糖监测的感知得到改善(n = 6)。A1C下降0.60%，效果中等(Cohen’s d = - 0.45, n = 42)。在急诊科就诊中发现差异的能力很低;然而，没有CGM患者有ED就诊(n = 758)。在监狱中，当病人正在接受治疗并且处于允许在其牢房中使用CGM装置的安全级别时，用CGM代替BGM是安全有效的。
{"title":"A Pragmatic Rethinking of Glucose Monitoring for the Incarcerated","authors":"Rebecca E. Luethy, Renee C. Lipinski, Jennifer L. West","doi":"10.2337/ds23-0036","DOIUrl":"https://doi.org/10.2337/ds23-0036","url":null,"abstract":"\u0000 \u0000 Using continuous glucose monitoring (CGM) improves diabetes-related outcomes in the community, yet the fingerstick blood glucose monitoring (BGM) method is the norm in prisons. The purpose of this study was to investigate the safety and patient perceptions of CGM in the carcerate environment, quantify changes in A1C after initiating CGM, and investigate rates of emergency department (ED) visits for diabetes-related complications comparing CGM users to patients using BGM.\u0000 \u0000 \u0000 \u0000 This pragmatic longitudinal analysis was conducted in two parts. A pilot program was carried out at a single women’s prison. A CGM program was initiated at men’s facilities within a single U.S. state, where A1C change and ED visit rates were investigated.\u0000 \u0000 \u0000 \u0000 Interested patients at an appropriate security level were invited to use CGM. Pre- and post-CGM surveys of glucose monitoring perceptions were administered during the pilot program. Security and perceptions were analyzed descriptively. A1C change was assessed using a t test. Fisher exact test, Barnard exact test, and post-hoc power analysis were applied to ED visits.\u0000 \u0000 \u0000 \u0000 Security was not disrupted. Patient perceptions of glucose monitoring improved with CGM use (n = 6). A1C declined by 0.60% with a medium effect size (Cohen’s d −0.45, n = 42). Power to detect a difference in ED visits was low; however, no CGM patients had an ED visit (n = 758).\u0000 \u0000 \u0000 \u0000 It is safe and efficacious to replace BGM with CGM in prisons when patients are engaged in their care and are at a security level allowing CGM devices in their cells.\u0000","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"24 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138601110","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}
Judith Nir, A. Liberman, M. Yackobovitch-Gavan, Drora Fraser, Moshe Phillip, Tal Oron
The aim of this study was to assess the extent of nondisclosure of type 1 diabetes in adolescents and investigate its association with several psychosocial parameters and clinical outcomes. This was a cross-sectional study based on data collected from 69 adolescents with type 1 diabetes who were 12–18 years of age and followed at our diabetes clinic. The degree of disclosure, demographics, diabetes management, and psychosocial issues were assessed via questionnaires. Clinical parameters were derived from medical records. Associations between nondisclosure status and clinical and psychosocial study variables were assessed. Fifty-three participants (77%) reported some extent of nondisclosure. Nondisclosure was associated with low self-esteem, reduced friend support, and increased diabetes-related worries. Nondisclosure was also found to be associated with diminished self-care behaviors related to insulin administration and with elevated A1C. Our results demonstrate that nondisclosure of type 1 diabetes in adolescents may be more common than initially recognized and is likely associated with unfavorable psychological outcomes and reduced self-care and diabetes management. Our results emphasize the importance of social interactions and disclosure in adolescents and may serve as a potential stepping stone to address other social barriers hindering diabetes management.
{"title":"Nondisclosure of Type 1 Diabetes in Adolescence: A Single-Center Experience","authors":"Judith Nir, A. Liberman, M. Yackobovitch-Gavan, Drora Fraser, Moshe Phillip, Tal Oron","doi":"10.2337/ds23-0006","DOIUrl":"https://doi.org/10.2337/ds23-0006","url":null,"abstract":"\u0000 \u0000 The aim of this study was to assess the extent of nondisclosure of type 1 diabetes in adolescents and investigate its association with several psychosocial parameters and clinical outcomes.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional study based on data collected from 69 adolescents with type 1 diabetes who were 12–18 years of age and followed at our diabetes clinic. The degree of disclosure, demographics, diabetes management, and psychosocial issues were assessed via questionnaires. Clinical parameters were derived from medical records. Associations between nondisclosure status and clinical and psychosocial study variables were assessed.\u0000 \u0000 \u0000 \u0000 Fifty-three participants (77%) reported some extent of nondisclosure. Nondisclosure was associated with low self-esteem, reduced friend support, and increased diabetes-related worries. Nondisclosure was also found to be associated with diminished self-care behaviors related to insulin administration and with elevated A1C.\u0000 \u0000 \u0000 \u0000 Our results demonstrate that nondisclosure of type 1 diabetes in adolescents may be more common than initially recognized and is likely associated with unfavorable psychological outcomes and reduced self-care and diabetes management. Our results emphasize the importance of social interactions and disclosure in adolescents and may serve as a potential stepping stone to address other social barriers hindering diabetes management.\u0000","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"33 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138600508","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}
{"title":"What Do Adolescents With Type 1 Diabetes Need to Thrive: Perspective of a 16-Year-Old With 4 Years of Experience Living With Type 1 Diabetes","authors":"Nathan J. Bekelman","doi":"10.2337/ds23-0024","DOIUrl":"https://doi.org/10.2337/ds23-0024","url":null,"abstract":"","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270511","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}
{"title":"About Richard M. Bergenstal: Guest Editor","authors":"","doi":"10.2337/ds23-ge04","DOIUrl":"https://doi.org/10.2337/ds23-ge04","url":null,"abstract":"","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"55 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135764836","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}
Elizabeth Lorenzo, Alicia Lynn O’Neal, Lisbeth Cantu Garcia, Kenny Mendoza, Rebecca E. Lee
Objective The objective of this study was to synthesize English and Spanish literature to determine whether electronic health interventions (EHIs) such as telehealth, telemedicine, digital health, and mobile health (mHealth) improve A1C, blood glucose, BMI, and/or weight among Hispanic/Latino adults with type 2 diabetes or overweight/obesity in the Americas. Design and methods Searches were conducted in June 2021 using the Scientific Electronic Library Online, Cumulative Index of Nursing and Allied Health Literature, PubMed, and PsycInfo literature databases. Studies were identified that investigated the effect of an EHI on A1C, blood glucose, BMI, or weight in populations that were ≥12% Hispanic/Latino adults with type 2 diabetes or overweight/obesity, were conducted in the Americas, and were published in English or Spanish. Study quality was determined using the Quality Index Score. Data were extracted and synthesized, and themes were identified. Results Twenty-five studies met inclusion criteria, including 23 in English (from the United States) and two in Spanish (from Chile). A total of 22 investigated type 2 diabetes, and three investigated overweight/obesity. The studies encompassed 6,230 participants, including 3,413 Hispanic/Latino adults. Sixty-three percent of studies demonstrated significant improvements in A1C or blood glucose and 67% in weight. Thirteen studies offered an EHI in both English and Spanish, six offered the intervention in either English or Spanish alone. All EHIs involving mHealth exclusively and most (90%) involving more than one electronic modality demonstrated a higher number of significant findings compared with those having only one EHI modality, especially telehealth (44.4%). EHIs lasting ≤12 months had more significant findings (72.7%) than those lasting >12 months (50%). Six studies had industry-related funding, with 83.3% of those demonstrating significant improvements in outcomes. Conclusion EHIs improved A1C and weight in adults (n = 4,355), including 45.5% Hispanic/Latino adults. mHealth and EHIs using more than one electronic modality and those lasting ≤12 months were especially effective. However, overall study quality was modest. Future research should be conducted in Spanish-speaking countries in Latin America and should compare the effectiveness of different EHI modalities.
{"title":"Electronic Health Interventions for Type 2 Diabetes and Obesity in Hispanic or Latino Adults: A Systematic Review of English and Spanish Studies","authors":"Elizabeth Lorenzo, Alicia Lynn O’Neal, Lisbeth Cantu Garcia, Kenny Mendoza, Rebecca E. Lee","doi":"10.2337/ds22-0083","DOIUrl":"https://doi.org/10.2337/ds22-0083","url":null,"abstract":"Objective The objective of this study was to synthesize English and Spanish literature to determine whether electronic health interventions (EHIs) such as telehealth, telemedicine, digital health, and mobile health (mHealth) improve A1C, blood glucose, BMI, and/or weight among Hispanic/Latino adults with type 2 diabetes or overweight/obesity in the Americas. Design and methods Searches were conducted in June 2021 using the Scientific Electronic Library Online, Cumulative Index of Nursing and Allied Health Literature, PubMed, and PsycInfo literature databases. Studies were identified that investigated the effect of an EHI on A1C, blood glucose, BMI, or weight in populations that were ≥12% Hispanic/Latino adults with type 2 diabetes or overweight/obesity, were conducted in the Americas, and were published in English or Spanish. Study quality was determined using the Quality Index Score. Data were extracted and synthesized, and themes were identified. Results Twenty-five studies met inclusion criteria, including 23 in English (from the United States) and two in Spanish (from Chile). A total of 22 investigated type 2 diabetes, and three investigated overweight/obesity. The studies encompassed 6,230 participants, including 3,413 Hispanic/Latino adults. Sixty-three percent of studies demonstrated significant improvements in A1C or blood glucose and 67% in weight. Thirteen studies offered an EHI in both English and Spanish, six offered the intervention in either English or Spanish alone. All EHIs involving mHealth exclusively and most (90%) involving more than one electronic modality demonstrated a higher number of significant findings compared with those having only one EHI modality, especially telehealth (44.4%). EHIs lasting ≤12 months had more significant findings (72.7%) than those lasting &gt;12 months (50%). Six studies had industry-related funding, with 83.3% of those demonstrating significant improvements in outcomes. Conclusion EHIs improved A1C and weight in adults (n = 4,355), including 45.5% Hispanic/Latino adults. mHealth and EHIs using more than one electronic modality and those lasting ≤12 months were especially effective. However, overall study quality was modest. Future research should be conducted in Spanish-speaking countries in Latin America and should compare the effectiveness of different EHI modalities.","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136113826","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}
Erin C. Cobry, Tim Vigers, Cari Berget, Laurel H. Messer, R. Paul Wadwa, Laura Pyle, Gregory P. Forlenza
Background Meeting glycemic recommendations is challenging for youth with type 1 diabetes. Diabetes technology, including continuous glucose monitoring (CGM) and hybrid closed-loop (HCL) automated insulin delivery systems, significantly increase achievement of glycemic targets; however, many youth struggle to sustain use of early HCL systems. Nocturnal alarm fatigue contributes to disrupted sleep and device discontinuation. Methods We examined the frequency and causes of nocturnal (10:00 p.m. to 6:00 a.m.) alarms in pediatric patients (N = 76, median age 14.5 years [interquartile range 11.8–17.0 years, range 7–24 years]) starting on a first-generation HCL system in a prospective observational study. Device data were analyzed with linear mixed effects models to examine change across time at 3-month intervals for 12 months. Results At baseline (HCL system in nonautomated mode), participants averaged 3.3 ± 0.6 alarms per night. In the 2 weeks after starting HCL (automated) mode, alarm frequency significantly increased to 5.4 ± 0.5 time per night (P <0.001). Alarm frequency decreased through the remainder of the observational period; however, CGM sensor and HCL system use also declined. The types of alarms were evenly distributed among sensor maintenance, sensor threshold, pump, and HCL-specific alarms. Conclusion These data show that HCL system nocturnal alarms are frequent and may be barriers to sleep quality and device use. Further research is needed to assess the impact of diabetes technology on sleep and to determine method to improve sleep quality with technology use.
{"title":"Frequency and Causes of Nocturnal Alarms in Youth and Young Adults With Type 1 Diabetes Using a First-Generation Hybrid Closed-Loop System","authors":"Erin C. Cobry, Tim Vigers, Cari Berget, Laurel H. Messer, R. Paul Wadwa, Laura Pyle, Gregory P. Forlenza","doi":"10.2337/ds23-0003","DOIUrl":"https://doi.org/10.2337/ds23-0003","url":null,"abstract":"Background Meeting glycemic recommendations is challenging for youth with type 1 diabetes. Diabetes technology, including continuous glucose monitoring (CGM) and hybrid closed-loop (HCL) automated insulin delivery systems, significantly increase achievement of glycemic targets; however, many youth struggle to sustain use of early HCL systems. Nocturnal alarm fatigue contributes to disrupted sleep and device discontinuation. Methods We examined the frequency and causes of nocturnal (10:00 p.m. to 6:00 a.m.) alarms in pediatric patients (N = 76, median age 14.5 years [interquartile range 11.8–17.0 years, range 7–24 years]) starting on a first-generation HCL system in a prospective observational study. Device data were analyzed with linear mixed effects models to examine change across time at 3-month intervals for 12 months. Results At baseline (HCL system in nonautomated mode), participants averaged 3.3 ± 0.6 alarms per night. In the 2 weeks after starting HCL (automated) mode, alarm frequency significantly increased to 5.4 ± 0.5 time per night (P &lt;0.001). Alarm frequency decreased through the remainder of the observational period; however, CGM sensor and HCL system use also declined. The types of alarms were evenly distributed among sensor maintenance, sensor threshold, pump, and HCL-specific alarms. Conclusion These data show that HCL system nocturnal alarms are frequent and may be barriers to sleep quality and device use. Further research is needed to assess the impact of diabetes technology on sleep and to determine method to improve sleep quality with technology use.","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135059470","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}
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