المؤلفون: Yee Wen Kong, Cheng Yi Yuan, Katerina Kiburg, Katrin Brown, Steven Trawley, Andi Partovi, Kerryn Roem, Natalie Harrison, Spiros Fourlanos, Elif I. Ekinci, David N. O’Neal

المصدر: Pilot and Feasibility Studies, Vol 9, Iss 1, Pp 1-15 (2023)

مصطلحات موضوعية: Type 1 diabetes, Patch pump, Insulin pump therapy, Treatment satisfaction, Medicine (General), R5-920

الوصف: Abstract Background Insulin pump therapy (IPT) improves glucose control in people with type 1 diabetes (T1D) compared with multiple daily injections (MDI). However, their size, the tethered insulin infusion set, intrusiveness when operating the device and the need to disconnect during showering limit their acceptance to many who may benefit. The Omnipod DASH® Insulin Management System is a small waterproof tubeless device which is wirelessly controlled by a handheld device which may be an acceptable alternative. However, there are no randomised controlled trials focusing on the impact on user perceptions of tubeless insulin pump therapy. This pilot study aims to assess study feasibility and acceptability of patch pump therapy compared with usual care in adults with T1D in Australia to inform power calculations and progression to a large-scale multi-site randomised controlled study. Methods A pilot multi-site parallel randomised controlled study will be conducted in sixty-four adults with T1D who are managed on MDI or IPT and self-monitoring with finger-stick blood glucose from four specialist diabetes centres in Victoria, Australia. Following carbohydrate counting education, participants will be randomised to use Omnipod DASH® System (Omnipod group) or continue usual care (usual care group) for 12 weeks, followed by a 12-week extension phase where all participants will use Omnipod DASH® System. The primary outcome measure is feasibility determined by study completion rates with a threshold of 0.80. Acceptability of the intervention (Omnipod DASH® System) will be assessed by the difference in Diabetes Technology Questionnaire ‘current’ (DTQ-current) score at 12 weeks post-randomisation compared to baseline. Secondary outcomes will include other measures of user acceptance, process outcomes, resource outcomes, participant-centred outcomes, healthcare professional perceptions and glycaemic outcomes. Discussion This pilot study will provide insights regarding the feasibility of the study design and the first data regarding user acceptance of insulin patch pump technology in Australian T1D adults. We anticipate that this study will provide information informing the design of a larger study evaluating the impact of patch pumps on subjective outcomes that are of significance to the person living with T1D. Trial registration Australian New Zealand Clinical Trials Registry ( https://anzctr.org.auTest/ ) ACTRN12621001195842 (8th September 2021). Please refer to Additional file 1: Appendix 1 for full details.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2055-5784Test

الوصول الحر: https://doaj.org/article/d1dc9ea0cb0c4f928fea1985017db7deTest

المؤلفون: Helen Truby, Bradley A. Edwards, Kaitlin Day, Denise M. O’Driscoll, Alan Young, Ladan Ghazi, Claire Bristow, Kerryn Roem, Maxine P. Bonham, Chiara Murgia, Terry P. Haines, Garun S. Hamilton

المصدر: European Journal of Clinical Nutrition. 76:1762-1769

مصطلحات موضوعية: Adult, Male, Sleep Apnea, Obstructive, Nutrition and Dietetics, Continuous Positive Airway Pressure, Weight Loss, Humans, Medicine (miscellaneous), Female, Obesity, Middle Aged, Life Style

الوصف: Background/Objectives Continuous positive airway pressure (CPAP) concomitant with weight loss is a recommended treatment approach for adults with moderate-severe obstructive sleep apnoea (OSA) and obesity. This requires multiple synchronous behaviour changes. The aim of this study was to examine the effectiveness of a 6-month lifestyle intervention and to determine whether the timing of starting a weight loss attempt affects weight change and trajectory after 12 months in adults newly diagnosed with moderate-severe OSA and treated at home with overnight CPAP. Methods Using a stepped-wedge design, participants were randomised to commence a six-month lifestyle intervention between one and six-months post-enrolment, with a 12-month overall follow-up. Adults (n = 60, 75% males, mean age 49.4 SD 10.74 years) newly diagnosed with moderate-severe OSA and above a healthy weight (mean BMI 34.1 SD 4.8) were recruited. Results After 12 months, exposure to the intervention (CPAP and lifestyle) resulted in a 3.7 (95% CI: 2.6 to 4.8, p p = 0.86). Conclusions The lifestyle intervention resulted in a modest reduction in body weight, while timing of commencement did not impact the degree of weight loss at 12 months. These findings support the recommendation of adjunctive weight-loss interventions within six-months of starting CPAP.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3f7ae12c756a9cb3e20cebb08f0ec938Test
https://doi.org/10.1038/s41430-022-01184-5Test

المؤلفون: Kerryn Roem, Robyn Compton, Spiros Fourlanos, Sybil A. McAuley

المصدر: Nutritiondietetics: the journal of the Dietitians Association of Australia. 79(5)

مصطلحات موضوعية: Blood Glucose, Nutrition and Dietetics, Diabetes Mellitus, Type 1, Public Health, Environmental and Occupational Health, Medicine (miscellaneous), Humans, Insulin, Nutrition Therapy, Aged

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fc70c3f62e7abb52a75da35118a5cb2cTest
https://pubmed.ncbi.nlm.nih.gov/35543111Test

المؤلفون: Kerryn Roem, Garun S. Hamilton, Denise M. O'Driscoll, Bradley A. Edwards, Chiara Murgia, Terry Haines, Maxine P. Bonham, Ladan Ghazi, Claire C. Bristow, Kaitlin Day, Helen Truby, Alan Young

المصدر: Nutrition & Dietetics. 76:110-117

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, 030309 nutrition & dietetics, medicine.medical_treatment, Overweight, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Weight loss, Weight management, medicine, Humans, Obesity, Prospective Studies, 030212 general & internal medicine, Continuous positive airway pressure, Life Style, Aged, Sleep Apnea, Obstructive, 0303 health sciences, Nutrition and Dietetics, Continuous Positive Airway Pressure, business.industry, Body Weight, Sleep apnea, Middle Aged, medicine.disease, nervous system diseases, respiratory tract diseases, Weight Reduction Programs, Quality of Life, Physical therapy, Female, Nutrition Therapy, medicine.symptom, Sleep, business, Weight gain, Follow-Up Studies, Dieting

الوصف: The majority of adults diagnosed with obstructive sleep apnoea (OSA) are overweight or obese. Continuous positive airway pressure (CPAP) is the most common effective therapy for OSA. However, adherence declines over time with only 50% of patients prescribed CPAP continuing to use it long term. Furthermore, a recent prospective analysis indicated that those more adherent with CPAP therapy have enhanced weight gain trajectories which in turn may negatively impact their OSA.The Sleeping Well Trial aims to establish whether the timing of starting a lifestyle weight loss intervention impacts on weight trajectory in those with moderate-severe OSA treated at home with CPAP, while testing the potential for smart phone technology to improve adherence with lifestyle interventions.A stepped wedge design with randomisation of individuals from 1 to 6 months post-enrolment, with 5 months of additional prospective follow up after completion of the stepped wedge. This design will investigate the effect of the 6-month lifestyle intervention on people undergoing CPAP on body weight, body composition and health-related quality of life.This trial tests whether the timing of supporting the patient through a weight loss intervention is important in obtaining the maximum benefit of a lifestyle change and CPAP usage, and identify how best to support patients through this critical period.The protocol (v1) is registered prospectively with the International Clinical Trials Registry (CTR) ACTRN12616000203459 (public access). Any amendments to protocol will be documented via the CTR. Recruitment commenced in March 2016 with data collection scheduled to finish by May 2018.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6438d6f2bb0a1a034c180a0057e4603bTest
https://doi.org/10.1111/1747-0080.12435Test

المؤلفون: Kerryn Roem

المصدر: Twin Research. 6:514-519

مصطلحات موضوعية: Pediatrics, medicine.medical_specialty, Iron, Weight Gain, Pregnancy, Environmental health, Infant morbidity, medicine, Fetal growth, Humans, Maternal health, Vitamin D, Genetics (clinical), Fatty Acids, Essential, business.industry, Incidence (epidemiology), Obstetrics and Gynecology, Maternal Nutritional Physiological Phenomena, medicine.disease, Quadruplets, Pediatrics, Perinatology and Child Health, Calcium, Female, Pregnancy, Multiple, medicine.symptom, Energy Intake, business, Weight gain, Optimal weight

الوصف: Good nutrition is central to achieving optimal fetal growth and development, and to maintaining maternal health and wellbeing. For multiple pregnancies, there is a growing body of evidence linking good maternal nutrition and weight gain to positive perinatal outcomes including reduced incidence of low birthweight and very low birthweight infants. Nutrition intervention appears to have important clinical implications for infant morbidity and mortality. Nutritional counselling can help women improve and maximise their intake of "at risk nutrients" such as iron, folate, essential fatty acids, calcium and ensure adequate energy intake to meet weight gain targets. Recommended optimal weight gains range from 16-20 kg for twin pregnancies. Expert dietetic guidance is often warranted, especially for women expecting triplets or quadruplets.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cc180fd737cee7c29e1b120494ab6af3Test
https://doi.org/10.1375/136905203322686518Test