Welcome to the ATTD 2022 Interactive Program

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Displaying One Session

Session Type
Parallel Session
Date
Sat, 30.04.2022
Session Time
13:00 - 14:30
Room
Hall 114

Patient Reported Outcome when using AID/technology

Session Type
Parallel Session
Date
Sat, 30.04.2022
Session Time
13:00 - 14:30
Room
Hall 114
Lecture Time
13:00 - 13:25

Abstract

Abstract Body

Automated insulin delivery (AID) systems are increasingly being used by children of all ages with type 1 diabetes. Glycemic benefits have been widely reported, with a 70% time in target range reported to be clinically beneficial. The impact of such systems on the quality of life and psychosocial functioning of children and their parents, however, is less well understood. This presentation will explore some of the benefits and burdens of AID technology use amongst young children with type 1 diabetes. These will include competing priorities between children and their parents; relationships with other caregivers and balancing diabetes management with simply growing up. Finally, appropriate ways to assess patient reported outcomes will be explored.

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Diabetes in Low (Medium) Income Countries (L(M)IMC): What technology to prioritize?

Session Type
Parallel Session
Date
Sat, 30.04.2022
Session Time
13:00 - 14:30
Room
Hall 114
Lecture Time
13:25 - 13:50

Abstract

Abstract Body

Background

As in many Low Income Countries (LIMC) countries the situation of type diabetes was catastrophic in Mali a few years ago.

In 2003, The International Diabetes Federation (IDF) estimates that there are a total of 790 new people with Type 1 diabetes [1] in Mali. In 2004, the NGO Santé Diabète (SD) and the International Insulin Foundation (IIF) conducted the RAPIA investigation which allowed the barriers to diabetes care and the reality for the type 1 diabetes in Mali with just 10 patients a live with a life expectancy of less than 1 year after diagnosis [2].

Case description

As in many developing countries, before thinking about technologies the emergency was to strengthen the health system to give access to care for patients with type 1 diabetes.

After this RAPIA study, from 2005 to 2018, Santé Diabète, in collaboration with the Ministry of Health of Mali and the local specialists, developed a comprehensive strategy to address 5 barriers to develop diabetes care in Mali. For the management of type 1 diabetes, the strengthening of the health system, with the support of IDF's LFAC program, has made it possible to detect and manage many children and young adults. The active file has gone from less than 10 DT1 in 2004 to more than 450 in June 2016 [3] and more than 1000 today [4]. With a real active file of type 1 diabetes, since 2015, we started the structuration of type 1 diabetes care with the creation of a sub unit for type 1 diabetes and young adults within the endocrinology and diabetology service in the national hospital and the development of early education tools for T1D. To really achieve better control in the new units we develop also a paper medical record and a logbook for each child to record the first data on T1D in Mali.

Once this care was built, we started to think about how to improve the care and the quality of life of patients. For this we have launched a reflection on the technologies that we could use to support this.

We started with the availability of the Hba1c in the capital Bamako and the different regions by setting up simple devices that can be easily and inexpensively transported to decentralize the possibility of carrying out the HBA1C.

Then, it was through different successive stages to use new technologies to produce quality medical data allowing the production of quality clinical data and research data in connection with the sweet program.

Finally, we are currently studying various other technologies and we will present our analyses with technical strengths and weaknesses as well as economic ones. We will present:

- The potential availability of insulin analogue compared to human insulins;

- The possibility to use pen instead of syringes;

- The possibility to use blood glucose meter such as freestyle (as a tool for reading blood glucose or as a therapeutic education tool) ;

- The possibility to use pump;

- The possibility to use ICT technologies as educational tools (example webdia tool, whatsapp channels, etc.)

Conclusion

To develop the management of type 1 diabetes in many Low Income Countries, a three-step strategy must be followed:

- Strengthening the health system to lift all the barriers to care for T1D

- Construct data collection tools in the country adapted to the national health information system

- Add the technologies that are relevant and financially affordable to strengthen this care and the quality of life of patients

References

1. International Diabetes Federation: Diabetes Atlas, ed. D. Gan. Brussels, 2003

2. Beran, D. Rapid AssessmentProtocol for Insulin Access: overcoming barriers to care. Diabetes Voice.2004;49(2):20-2.

3. Atun R and al. Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol. 2017 Aug;5(8):622-667.

4. Sandy JL, Besançon S, Sidibé AT, Minkailou M, Togo A, Ogle GD. Rapid increases in observed incidence and prevalence of Type 1 diabetes in children and youth in Mali, 2007-2016. Pediatr Diabetes. 2021 Jun;22(4):545-551. doi: 10.1111/pedi.13191. Epub 2021 Feb 22. PMID: 33586301.

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Sleep and diabetes

Session Type
Parallel Session
Date
Sat, 30.04.2022
Session Time
13:00 - 14:30
Room
Hall 114
Lecture Time
13:50 - 14:15

Abstract

Abstract Body

Sleep is a potentially modifiable risk or protective factor for diabetes-related outcomes that has recently gained interest. In addition, new diabetes technology and devices have the potential to both disrupt sleep (with alarms) and improve sleep (through reduced glycemic variability overnight). This session will highlight recent findings from studies of sleep in type 1 diabetes (T1D), with a focus on the role of sleep in self-management, diabetes-specific sleep disturbances, and the potentially modifiable aspects of sleep, as well as emerging evidence from studies of sleep-promoting interventions to improve outcomes in youth with T1D and their caregivers.

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Q&A

Session Type
Parallel Session
Date
Sat, 30.04.2022
Session Time
13:00 - 14:30
Room
Hall 114
Lecture Time
14:15 - 14:30