Cardona-Hernandez, R., Schwandt, A., Alkandari, H., Bratke, H., Chobot, A., Coles, N., Corathers, S., Goksen, D., Goss, P., Imane, Z., Nagl, K., O’Riordan, S.M.P., & Jefferies, C. (2021). Glycemic outcome associated with insulin pump and glucose sensor use in children and adolescents with type 1 diabetes. Data from the international pediatric registry SWEET. Diabetes Care , 44 (5), 1176-1184. Web.
The advantage of this research was that it was a large international retrospective cohort study that retrieved data from the diabetes SWEET registry. The sample size was 25,654 participants diagnosed with type 1 diabetes mellitus (T1DM) more than one year ago and used technology to control their blood glucose (Cardona-Hernandez et al., 2021). Furthermore, the settings mainly were home-based in which the participants reported to the registry; hence, the results can be applied in a broader sense. However, the limitation of this study was the absence of time-in-range data (Cardona-Hernandez et al., 2021). Unfortunately, there were not enough people with this information to include this data into statistical analysis in the latter. The environment was controlled with the comparison group, but the authors missed randomization and blinding. Since this was an international study, the main barrier was the difference in GDP, which is a potential confounding factor. The researchers addressed this issue by implementing linear regression analysis to reveal the actual association between the parameters. Finally, the findings of this study could be implemented to reduce high HbA1c levels and DKA rates among children with T1DM by introducing wearable technology.
McGill, D. E., Volkening, L. K., Butler, D. A., Wasserman, R. M., Anderson, B. J., & Laffel, L. M. (2019). Text‐message responsiveness to blood glucose monitoring reminders is associated with HbA1c benefit in teenagers with Type 1 diabetes. Diabetic Medicine , 36 (5), 600-605. Web.
This study’s strength was that it demonstrated a clear benefit of sending messages to T1DM adolescent patients to encourage glycemic control. Although the sample size was 147, which is not large, it can be easily expanded since the participants were followed not in the clinical setting (McGill et al., 2019). Two primary limitations in this research were indicated by the authors. Firstly, some patients were not followed up for the entire length of the study (McGill et al., 2019). Secondly, the authors did not include the mean number of responses (McGill et al., 2019). It meant that this study could not provide the optimal frequency of sending reminders. Another limitation was that no control group was included, and the researchers did not mention this problem. The potential barrier was that teenagers might not have the balance to report their glucose levels, but the authors addressed this issue by supplying a $5 monthly fee for unlimited messaging (McGill et al., 2019). Notably, these payments were made during the entire length of the study to all participants. Overall, the finding of this study can be implemented to maintain normoglycemia in diabetic adolescents.
Tauschmann, M., & Hovorka, R. (2018). Technology in the management of type 1 diabetes mellitus – Current status and future prospects. Nature Reviews Endocrinology , 14 (8), 464-475. Web.
The most significant strength of this paper is that it provides an extensive review of devices utilized for controlling and monitoring blood glucose levels in diabetic patients. Since this manuscript was a review paper, the concepts of sample size and comparison groups are not applicable in this case. The article’s highlights are helpful in clinical and non-hospital-based settings because it presents studies that tested the efficacy of insulin pumps, pens, and glucose monitors from various manufacturers (Tauschmann & Hovorka, 2018). The main limitation of this review paper was that it was written only by two authors, subjecting it to potential bias. Moreover, the article did not mention any conflicts of interest, which was crucial to indicate here since specific companies that produce devices for diabetic patients were mentioned. It appeared that there were no barriers in this case; thus, the authors did not address them. Finally, this comprehensive review on current and prospective technology that can improve the quality of life of patients with T1DM can be used as guidance for clinicians and researchers.