Background and Aims / Part 1

Diabetes technologies represent the most advanced devices possible to support optimal diabetes self-management and reduce risks of diabetes-related complications. Use of such devices, whilst beneficial for many, has proven unsatisfactory or too burdensome for others. High levels of drop-out or lack of engagement are two of the barriers to achieving the outcomes promised by such technologies. This lecture will examine the onboarding needs of people with diabetes and of healthcare professionals in the context of selecting appropriate diabetes technologies to meet the individual needs of each user.

Methods

Evidence review of onboarding experience.

Methods / Part 2

Results

Data will be presented identifying the unmet needs of both healthcare professionals and people with diabetes in relation to onboarding of novel technologies.

Results / Part 3

Conclusions

Traditional and novel approaches will be discussed

Conclusions / Part 4

Background and Aims / Part 1

Type 1 diabetes mellitus is a chronic condition with a high degree of self-management burden that can significantly negatively impact quality of life. Advances in diabetes technology have led to improvements in overall metabolic control but have been less successful at decreasing user and caregiver burden. Advanced diabetes devices and integrated automated systems hold the promise to finally simultaneously improve glycemic control and quality of life. Successful adoption of these devices, however, requires not only that they can improve glycemic control, but that they can also be introduced and incorporated into daily living. Such human factors issues as comfort, wearability, trust, and ease of use are as important as accuracy and precision. In this presentation we will discuss how human factors issues have shaped the evolution of advanced diabetes devices and highlight features important to potential users of these devices.

Background and Aims

Epidemiological research is showing that the incidence of type 1 diabetes in childhood is increasing with 3-4% on yearly basis all over the world. Many reports also show an that the age at diagnose is decreasing. So we must be aware that the number of children with T1D that need support in kindergarten or school is increasing. Diabetes can enter in life of babies, children and adolescents in different moments. Children can also, as their parents feel fear, worries and uncertainty which are caused by symptoms and the diagnose of diabetes. Because of diabetes children can miss out school, they can feel misunderstood by their friends and schoolmates.

In many countries children stay in schools more than 8 or 10 hours daily, having two or three meals in the school environment, which is a significant proportion of their time, and a serious reason to optimize diabetes treatment at school; otherwise these children will have a poor metabolic control.

And without support from their caregivers, if coping strategies fail to function, the fact that diabetes is a serious illness, can result in developing signs of depression, anxiety in these groups of children.

Methods

Technological advances in the modern diabetes treatment with new insulin pump generations, continuous or flash glucose monitoring are entering to most of the countries, challenging children, their families but also caregivers and teachers. Children need support not only in blood glucose measuring, injecting insulin or deciding about the insulin dose, nowadays they are dealing with pumps, internal pump calculators and real time subcutaneous glucose monitoring next to intermittently scanned continuous glucose monitoring systems with complicated rules of carbo counting, and can be overwhelmed by the number of information’s technology brings. This all together make the need for support in school as one of the priorities for a complete care for these children.

Education of school personnel, sports trainers, and other teachers tis a must! Without proper education caregivers can be confused with dietary needs, different types of glucometers, pen injectors, insulin pumps and also continuous glucose monitoring systems. When they first meet the child with diabetes the fear of acute complications can be extreme and can change their decisions when dealing with diabetes.

The school must understand that the child needs a safe place to perform blood glucose measurements, insulin injecting, a proper diet is important (the importance of carb counting must be emphasized) as well and technically skilled caregivers to support the youngest using the pump and the sensor as well.

Results

A small survay was started in Slovenia to get informations who enters the educational program for schools, that started in 2004. 168 caregivers shared their answers, giving to the educational program an avarage note of 4,5 out of 5 points. They emphasized that more informations in the field of dietary counseling, psychological background is needed, next to practical workshops and more informations about the sensor and the pump with the possibility of reeducation.

Conclusions

Diabetes teams / families / caregivers should perform team work, school stuff should be well educated, responsibility on administering medication must be recognized and roles and responsibilities clearly given. Individual Health Care Plans can be supportive, next to an emergency plan for hypo/hyperglycemia with exact instructions for severe hypoglycaemia and early recognition of ketoacidosis.