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.
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.


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 (HbA(1c)) 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 HbA(1c) at 12 months (7.44 ± 0.94, -0.35 from baseline) than controls (8.31 ± 1.24, +0.15 from baseline). Improvement in HbA(1c) 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.
School of Health and Human Services, Indiana University-Purdue University, Fort Wayne, Indiana, USA. ttoscos@indiana.edu
Tammy R
TR
Toscos
Stephen W
SW
Ponder
Barbara J
BJ
Anderson
Mayer B
MB
Davidson
Martin L
ML
Lee
Elaine
E
Montemayor-Gonzalez
Patricia
P
Reyes
Eric
E
Link
Kevin L
KL
McMahon
D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male
D001786:Blood Glucose; D006442:Glycated Hemoglobin