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Clinical Diabetes/Therapeutics CLINICAL THERAPEUTICS/NEW TECHNOLOGY—GLUCOSECATEGORY MONITORING AND SENSING 2226-PUB CLINICAL THERAPEUTICS/NEW TECHNOLOGY— Development of the Diabetes-Specifi c Risk-Taking Inventory GLUCOSE MONITORING AND SENSING RACHEL M. WASSERMAN, CAROLINE GONYNOR, BARBARA J. ANDERSON, DAVID D. SCHWARTZ, Houston, TX 2228-PUB Risky health behaviors are the primary cause of morbidity and mortal- Limitations of Blood Glucose Self-Monitoring in Patients with Dia- ity for all youth. For youth with type 1 diabetes (T1D), there are additional betes: A Baseline Analysis of the MyStarT Study opportunities to take risks with illness management, especially as many par- HELMUT ANDERTEN, GUIDO FRECKMANN, ANJA BORCK, BERNHARD KULZER, ents transition responsibility for diabetes care to the adolescent. While typi- Hildesheim, Germany, Ulm, Germany, Berlin, Germany, Bad Mergentheim, Germany cal risk-taking behaviors (e.g., alcohol and drug use) have been researched in Background: Patient-based monitoring of blood glucose (BG) has been shown youth with T1D, little is known about diabetes-specifi c risk behaviors. Thus, to improve diabetes control. While most devices are limited to the measure- we developed a diabetes-specifi c risk-taking inventory (DSRI) for adoles- ment of BG alone, MyStar Extra (Sanofi ) also calculates HbA1c estimates, a cents and young adults with T1D. marker commonly used to monitor glucose control over the longer term. It was The target population was youth with T1D (age 15-25). Initial items were the aim of the study to identify determinants of MyStar Extra use. generated based on clinical experience, theories of risk-taking, and review Methods: MyStarT is a non-interventional study conducted at offi ce of published scales of general risk-taking. Feedback on items was solicited based physicians across Germany. Adult patients were included, given that from 5 endocrinologists, 2 endocrinology nurse practitioners, and 4 psychol- they had newly received the MyStar Extra device at baseline. ogists with experience in diabetes research. Based on this input, items were Results: A total of 1,797 patients were included of which 1,521 patients refi ned, dropped, or added until consensus was reached. The questionnaire had a complete 24-week follow-up (85%). Patients had a mean age of was then piloted with 4 youth with T1D (ages 17-19) and cognitive debrief- 60.3±14.0 years, 56.1% were male, and the mean body weight was 90.8±20.2 ings were conducted to ensure participants’ understanding of questions’ kg. Diabetes type was type 1 and 2 in 13.8% and 86.0% of cases, respec- meaning and intent. tively and all received any form of insulin treatment. At baseline, 42.2% of Thirty-six diabetes-specifi c risk-taking behaviors were identifi ed, includ- patients measured their pre-prandial blood glucose at each meal, 6.4% their ing 4 items for insulin pump users. A multiple-choice response format was post-prandial blood glucose at each meal and the mean HbA1c value was agreed upon to assess frequency of each behavior. All cognitive debriefi ng 7.7±1.9%. Overall 64.3% measured their fasting blood glucose 7-times a participants noted the scale was generally easy to understand. Several items week. Reasons to opt for MyStar Extra were (multiple answers possible) a were changed to improve clarity based on cognitive debriefi ng feedback. Therapeutics patient wish for a new device (38.0%), wish for added functionality (35.8%), The present fi ndings support the preliminary face validity of the inventory. Clinical Diabetes/ outdated or defect device (28.5%), a need for closer monitoring (21.0%), and The DSRI may be a useful tool in assessing the prevalence of diabetes-spe- PUBLISHED ONLY others less frequent reasons. Only 9.7% of patients had no glucose meter cifi c risk-taking behaviors and perceptions of risk. Further research is needed available before study entry. to determine validity and reliability of the DSRI. Future research in this area Conclusions: The results illustrate that, even in patients with a device may guide clinical discussion and development of interventions to prevent available, the potential to optimize blood glucose control is not fully uti- adverse health outcomes. lized. Supported By: National Institute of Diabetes and Digestive and Kidney Diseases Supported By: Sanofi -Aventis Deutschland GmbH 2227-PUB 2229-PUB Patient and Educator Engagement in Developing a Connected System Linking Mobile-based Diet and Activity Self-Monitoring WITHDRAWN Data with Electronic Diabetes Education System for Behavioral Goal Monitoring JING WANG, LINDA M. SIMINERIO, CHIN-FUN CHU, DEIDRA COLEMAN, Hous- ton, TX, Pittsburgh, PA Chronicle Diabetes is a web-based system for ADA recognized educa- tion programs on diabetes education documentation. However, follow-up on patient behavioral goals has proven to be challenging for both patients and diabetes educators despite the availability of this tool. After rounds of inter- views seeking educators’ insights on their needs, we developed an interface in the Chronicle Diabetes system that enables educators to view patients’ self-monitoring data, captured via a fi tness tracker and its companion smart- phone application. This self-monitoring data was presented in Chronicle Dia- betes in a monthly calendar view, and included weekly totals and averages calories consumed and burned, steps, and macro-nutrient content. The aim of this study was to describe the patient and educator engagement during 2230-PUB the development and usability evaluation processes of this connected system. A think-aloud protocol was developed for user testing with 7 educa- WITHDRAWN tors to identify their concerns with the use of the connected system in their work setting and for follow-up on behavioral goals related to diet and physi- cal activity. After further refi nement on the system based on the think-aloud testing with the educators, a 2-week pilot study was conducted to test the connected interface with 8 patient-educator dyads. Patients and educators rated highly on perceived usefulness and acceptability of the system. Quali- tative interviews further showed the system in facilitating patients setting realistic goals, receiving more personalized care, and improving communica- tion with educators. Patient and educator experiences, issues, and sugges- tions in using the connected system were summarized. Engaging patients and educators in the development and testing of the connected system improved system usability, lending promise for easy adoption and dissemi- nation of the system in a larger scale. 2231-PUB Supported By: Robert Wood Johnson Foundation Blood Glucose Profi le in Chinese with Diabetes in Real World JIANZHONG XIAO, LING-WANG AN, Beijing, China Background: Self-blood glucose monitoring (SBGM) is important for diabe- tes care. Data that describe the blood glucose profi le in Chinese with diabe- tes in real world were rare. Method: In collaboration with Tencent, from May, 1st, 2015 to October 31st 2015, patients with diabetes from 6 hospitals of Beijing Ruijing Diabe- tes Hospitals Limited Company received meters and test strips for free. The For author disclosure information, see page A696. ADA-Supported Research A564 CLINICAL THERAPEUTICS/NEWCATEGORY TECHNOLOGY—INSULINS SBGM results at home were automatically transferred to the Tencent Infor- years, 56.1% were male, the mean body weight was 90.8±20.2 kg, the mation Center. Five thousand and one hundred ninety four patients recruited mean HbA1c value was 7.7±1.9% and 13.8% had type 1 and 86.0% type (men= 2692, women=2502, aged 60.9±13.4). 2 diabetes. Mean patient satisfaction (available for n=1006) with their Result: A total 266,385 SBGM measurements were recorded. The fre- old device was 69.1 points and showed a mean increase of 10.4 (95% CI quency of SBGM was 12.9/month. 1.) Time of measurement: When 24 hours 8.6 to 12.3, p<0.0001) points 12 weeks after the introduction of the study divided into 4 six-hour equally, 51.2% data came from 5 AM to 11 AM, only device. The mean satisfaction with the study device indicated by the phy- 3.6% BG measurements came from 11 PM to 5 AM. 2.) Hypoglycemia: BG sician was 83.5 points (available for n=236). The correlation between phy- of 3901 measurements was lower than 3.9 mmol/l. The hypoglycemia pre- sician and patient satisfaction was 0.35 (95% CI 0.3 to 0.41; p<0.0001). The sented more frequently in the evening (10.13% of all tests form 1 AM to 2 AM). majority of patients (42.5% very likely and 44.5% probably) would recom- 3.) Hyperglycemia: 40% of post-breakfast and 42.4% of post-lunch BG were mend the study device. greater than 10 mmol/l. 4.) Fasting BG: The BG between 0 AM and 6 AM Conclusions: The use of the study device was associated with a high phy- was referred to fasting BG, proportion of patients reached the target goal sician satisfaction and an improved patient satisfaction. The device gets (3.9-6.9 mmol/l) for corresponding hour were 35.68%, 36.08%, 41.67%, recommendation from the majority of patients in this study. 45.49%, 42.56%, 41.30%, respectively. 5.) Time trend of BG: Among 711 Supported By: Sanofi -Aventis Deutschland GmbH cases monitored for 6 months, the frequency of hypoglycemia decreased from 1.89% to 0.98%. Patients with higher BG in the fi rst month got a better glycemic control with 6 months (from 0.5mmol/l to 4.8 mmol/l for BG>10 CLINICAL THERAPEUTICS/NEW TECHNOLOGY— mmol/l). INSULINS Conclusion: The majority of patients with diabetes did not reach target goal of blood glucose. Hypoglycemia was more common between 1 am to 2 am. SBMG is useful for improving diabetes control both for hypoglycemia 2234-PUB and hyperglycemia.
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