Browsing by Author "Danne, T"
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- Personalizing Early-Stage Type 1 Diabetes in ChildrenPublication . Limbert, C; von dem Berge, T; Danne, T
- Telemonitoring, Telemedicine and Time in Range During the Pandemic: Paradigm Change for Diabetes Risk Management in the Post-COVID FuturePublication . Danne, T; Limbert, C; Puig Domingo, M; Del Prato, S; Renard, E; Choudhary, P; Seibold, APeople with diabetes are at greater risk for negative outcomes from COVID-19. Though this risk is multifactorial, poor glycaemic control before and during admission to hospital for COVID-19 is likely to contribute to the increased risk. The COVID-19 pandemic and restrictions on mobility and interaction can also be expected to impact on daily glucose management of people with diabetes. Telemonitoring of glucose metrics has been widely used during the pandemic in people with diabetes, including adults and children with T1D, allowing an exploration of the impact of COVID-19 inside and outside the hospital setting on glycaemic control. To date, 27 studies including 69,294 individuals with T1D have reported the effect of glycaemic control during the COVID-19 pandemic. Despite restricted access to diabetes clinics, glycaemic control has not deteriorated for 25/27 cohorts and improved in 23/27 study groups. Significantly, time in range (TIR) 70-180 mg/dL (3.9-10 mmol/L) increased across 19/27 cohorts with a median 3.3% (- 6.0% to 11.2%) change. Thirty per cent of the cohorts with TIR data reported an average clinically significant TIR improvement of 5% or more, possibly as a consequence of more accurate glucose monitoring and improved connectivity through telemedicine. Periodic consultations using telemedicine enables care of people with diabetes while limiting the need for in-person attendance at diabetes clinics. Reports that sustained hyperglycaemia and early-stage diabetic ketoacidosis may go untreated because of the lockdown and concerns about potential exposure to the risk of infection argue for wider access to glucose telemonitoring. Therefore, in this paper we have critically reviewed reports concerning use of telemonitoring in the acute hospitalized setting as well as during daily diabetes management. Furthermore, we discuss the indications and implications of adopting telemonitoring and telemedicine in the present challenging time, as well as their potential for the future.
- The COVID-19 Pandemic Affects Seasonality, With Increasing Cases of New-Onset Type 1 Diabetes in Children, From the Worldwide SWEET RegistryPublication . Reschke, F; Lanzinger, S; Herczeg, V; Prahalad, P; Schiaffini, R; Mul, D; Clapin, H; Zabeen, B; Pelicand, J; Phillip, M; Limbert, C; Danne, T; Alonso, GT; Rhodes, ET; Davis, E; Veeze, HJ; Maahs, D; Cardona-Hernandez, R; Sumnik, Z; Corathers, S; Bratina, N; Danne, T; Gevers, E; Imane, Z; Piccini, B; Forsander, G; Pacaud, D; Maffeis, C; Campbell, F; Bonfanti, R; de Sanctis, L; Krone, RE; Toth-Heyn, P; Witsch, M; Arsanoglu, I; Jefferies, C; Landry, A; Beltrand, J; Amed, S; Rami-Merhar, B; Barat, P; Szypowska, A; Zabeen, B; Casteels, K; Savova, R; Cherubini, V; de Bock, M; Todorovic, S; Limbert, C; Moravej, H; Pozgaj Sepac, M; Mazur, A; Gerasimidou-Vazeou, A; Iotova, V; O’Riordan, S; Chobot, A; Herbst, A; Ngwu, U; Cody, D; Birkebæk, NH; Hanas, R; Goksen, D; Sarda, A; Chobot, J; Mirante, A; Richmond Padilla, E; Tsiroukidou, K; Saboo, B; Kanaka-Gantenbein, C; Schiaffini, R; Foskett, D; Jali, S; Verkauskiene, R; Castro-Correia, C; Kumar Guness, P; Pelicand, J; Cotterill, A; Kumari Mohan, M; Spehar Uroic, A; Goss, P; Svensson, J; Ramchandani, GD; Coutant, R; Mantilla, L; Sima, A; Hyun Kim, J; Galli-Tsinopoulou, A; Ribeiro, R; O’Gorman, C; Fonna, H; Bratke, H; El Habashy, S; Gokalani, R; Scharf Pinto, M; Chavda, VObjective: To analyze whether the coronavirus disease 2019 (COVID-19) pandemic increased the number of cases or impacted seasonality of new-onset type 1 diabetes (T1D) in large pediatric diabetes centers globally. Research design and methods: We analyzed data on 17,280 cases of T1D diagnosed during 2018-2021 from 92 worldwide centers participating in the SWEET registry using hierarchic linear regression models. Results: The average number of new-onset T1D cases per center adjusted for the total number of patients treated at the center per year and stratified by age-groups increased from 11.2 (95% CI 10.1-12.2) in 2018 to 21.7 (20.6-22.8) in 2021 for the youngest age-group, <6 years; from 13.1 (12.2-14.0) in 2018 to 26.7 (25.7-27.7) in 2021 for children ages 6 to <12 years; and from 12.2 (11.5-12.9) to 24.7 (24.0-25.5) for adolescents ages 12-18 years (all P < 0.001). These increases remained within the expected increase with the 95% CI of the regression line. However, in Europe and North America following the lockdown early in 2020, the typical seasonality of more cases during winter season was delayed, with a peak during the summer and autumn months. While the seasonal pattern in Europe returned to prepandemic times in 2021, this was not the case in North America. Compared with 2018-2019 (HbA1c 7.7%), higher average HbA1c levels (2020, 8.1%; 2021, 8.6%; P < 0.001) were present within the first year of T1D during the pandemic. Conclusions: The slope of the rise in pediatric new-onset T1D in SWEET centers remained unchanged during the COVID-19 pandemic, but a change in the seasonality at onset became apparent.