The effect of an mHealth intervention for adolescents with Type 1 diabetes and their parents.

BACKGROUND: Past research has demonstrated that adolescents with Type 1 diabetes (T1D) typically have a decline in health outcomes as they begin to assume more self-management activities. Mobile app interventions have been suggested as one possible way to improve this behavior. PURPOSE: The primary aim of this study was to address declines in health outcomes by pilot testing the satisfaction, use and feasibility of an app-based family communication intervention aimed to assist in adolescent self-management of T1D. METHODS: Thirty-three adolescent-parent pairs were enrolled in and completed the 12-week pilot study. Participants were randomized 2:1 to intervention (app use) or control group. Pre/post quantitative and qualitative data were collected, including HbA1c and surveys. Paired-sample t-tests and ANOVA statistics were conducted. RESULTS: The parents and adolescents reported high satisfaction with the app, and that it was easy to use. Results showed HbA1c stability in the intervention group and significant worsening in the control group. There were also significant improvements in adherence to diabetes management and quality of life for the parents in the intervention group. The adolescents did not show any improvement in quality-of-life measures. CONCLUSION: This study suggests that the app intervention is acceptable, shows promise for improving health outcomes for adolescents with T1D, and may improve family communication. The public health implications of this work are that app interventions have a potential role in positively influencing chronic disease outcomes. Additional research with a more extensive and diverse sample is needed to determine generalizability.

Hyperglycemia and Cancer: A State-of-the-Science Review.

PROBLEM IDENTIFICATION: Hyperglycemia can increase the risk for adverse events and outcomes in patients undergoing treatment for cancer. The purposes of this state-of-the-science review were to explore the complexity of hyperglycemia in patients with cancer and to analyze physiologic mechanisms and outcomes in individuals with or at risk for cancer. LITERATURE SEARCH: PubMed® and the Cochrane Library databases were searched, and 95 articles were included. Findings were evaluated for their methods and analyses. Studies assessed as methodologically flawed were not included. DATA EVALUATION: The synthesis of the articles provided the evidence for describing normal and glycemic pathways. Hyperglycemia in patients with cancer was explored through chronic inflammatory mechanisms that lead to increased risks for adverse events and outcomes. SYNTHESIS: This article discusses normal glucose regulation and hyperglycemic pathways, hyperglycemia in patients with cancer, hyperglycemia and cancer-related inflammation, and outcomes (e.g., infections, mortality, symptoms). IMPLICATIONS FOR RESEARCH: Understanding the contributors to and consequences of hyperglycemia can guide the development of screening tools to predict which individuals are at the greatest risk for hyperglycemic episodes prior to starting cancer therapies. Research can lead to glycemic guidelines specific to patients with cancer for better outcomes.