Integrating an Automated Diabetes Management System Into the Family Management of Children With Type 1 Diabetes
Results from a 12-month randomized controlled technology trial
- Tammy R. Toscos, PHD1,2⇓,
- Stephen W. Ponder, MD, CDE3,4,
- Barbara J. Anderson, PHD5,
- Mayer B. Davidson, MD6,
- Martin L. Lee, PHD, CSTAT, CSCI7,
- Elaine Montemayor-Gonzalez, RD8,
- Patricia Reyes8,
- Eric Link, BA9 and
- Kevin L. McMahon, BS9
- 1School of Health and Human Services, Indiana University-Purdue University, Fort Wayne, Indiana
- 2Center for Health Services Research, Regenstrief Institute, Indianapolis, Indiana
- 3Lone Star Diabetes and Endocrinology, Odessa, Texas
- 4Texas Tech University School of Medicine-Permian Basin, Odessa, Texas
- 5Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- 6Department of Endocrinology, Charles R. Drew University, Los Angeles, California
- 7University of California Los Angeles School of Public Health, Los Angeles, California
- 8The Diabetes and Endocrine Center of South Texas at Driscoll Children's Hospital, Corpus Christi, Texas
- 9Diabetech, Sacramento, California
- Corresponding author:
Tammy R. Toscos, .
OBJECTIVE The study objective was to evaluate how the use of a pervasive blood glucose monitoring (BGM) technology relates to glycemic control, report of self-care behavior, and emotional response to BGM of children with type 1 diabetes and their parents.
RESEARCH DESIGN AND METHODS Forty-eight children aged less than 12 years (mean 8.8 years) with type 1 diabetes were randomly assigned to one of two study groups, a control group (conventional care without technology) or an experimental group (conventional care with technology), and followed for 12 months. Families in the experimental group were given the Automated Diabetes Management System (ADMS), which automatically collects blood glucose (BG) values and sends to parent(s) a 21-day BG trending report via e-mail each night. Measures of glycemic control (HbA1c) were collected at baseline and at quarterly diabetes clinic visits; BGM effect and diabetes self-care behavior measures were obtained at the baseline, 6-month, and 12-month visits.
RESULTS Children in the experimental group had significantly (P = 0.01) lower HbA1c at 12 months (7.44 ± 0.94, −0.35 from baseline) than controls (8.31 ± 1.24, +0.15 from baseline). Improvement in HbA1c was more profound in families using the ADMS more frequently. In addition, in these families, parents showed a significant improvement in BGM effect (P = 0.03) and children became more meticulous in diabetes self-care (P = 0.04). Children in both experimental and control groups experienced no change in their emotional response to BGM.
CONCLUSIONS Using the ADMS 1–3 times/week may help children with type 1 diabetes improve glycemic control and gain diabetes self-management skills, as well as improve the BGM effect of parents.
- Received August 26, 2011.
- Accepted December 3, 2011.
- © 2012 by the American Diabetes Association.
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