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Hypoglycaemia in Diabetes

Iatrogenic hypoglycaemia is one of the main limiting factors in the glycaemic management of diabetes. It causes negative biological, psychological, and social consequences in most people with type 1 diabetes and in many with advanced type 2 diabetes. This chapter explores physiological homeostatic mechanisms that prevent hypoglycaemia through glucose counter-regulation, before discussing specific acquired defects of glucose counter-regulation in diabetes, which provides an insight into risk factors for hypoglycaemia.

Small-area geographical variation in the prevalence of diabetes amongst Australian youth aged <20 years in 2021

To characterise small-area geographical variation in the prevalence of diabetes in Australian youth. A combined statistical reconstruction and small-area estimation algorithm was applied to privacy-modulated data from the 2021 Australian Census. 

Psychological and self care outcomes for children and adolescents living with type 1 diabetes and their caregivers attending diabetes camp: A mixed methods study

Diabetes camps for children and adolescents living with Type 1 Diabetes (T1D) offer an important opportunity to foster self-efficacy and 'common humanity', a sense that they are not alone in their challenges. The current study primarily aimed to assess whether psychological wellbeing, diabetes self care behaviours and HbA1c improved amongst campers and their caregivers, and whether these would be sustained at 3- and 6-months.

Care provided to women during and after a pregnancy complicated by hyperglycaemia: the impacts of a multi-component health systems intervention

Aboriginal and Torres Strait Islander women experience a disproportionate burden of hyperglycaemia in pregnancy. A multi-component health systems intervention aiming to improve antenatal and postpartum care was implemented across Australia’s Northern Territory (NT) and Far North Queensland (FNQ) between 2016 and 2019. Components included clinician education, improving recall systems, enhancing policies and guidelines, and embedding Diabetes in Pregnancy (DIP) Clinical Registers in systems of care. This program was evaluated to determine impacts on clinical practice and maternal health.

"i Think i Could Have Used It Better": Experiences of Youth with High HbA1c Commencing Advanced Hybrid Closed-Loop Therapy in a Clinical Trial Setting - A Qualitative Research

Advanced hybrid closed-loop (AHCL) therapy improves glycemia. However, it is not known if there is an improvement in overall outcomes with AHCL for youth with type 1 diabetes (T1D) at high risk of diabetes-related complications. The study aimed to capture the experiences of youth with suboptimal glycemic control when commencing AHCL therapy in a clinical trial setting. 

Contributions of digital technologies for resilience capacity in a type 1 diabetes transition clinic: A qualitative study

A type 1 diabetes (T1D) transition clinic in Sydney, Australia, provides age specific care for young adults (aged 16-25 years) and for adults (aged 21 years and above), and has reported improved clinical outcomes post transition to adult care over a 21-year period. This study investigated the contribution of digital technology to long-term resilient capacity of the clinic.

Six months of hybrid closed-loop therapy improves diabetes-specific positive well-being, and reduces diabetes distress and fear of hypoglycemia: secondary analysis of a controlled trial

This analysis aimed to investigate diabetes-specific psychological outcomes among adults with type 1 diabetes (T1D) using hybrid closed-loop (HCL) versus standard therapy. 

The use of automated insulin delivery around physical activity and exercise in type 1 diabetes: a position statement of EASD and ISPAD

Regular physical activity and exercise (PA) are cornerstones of diabetes care for individuals with type 1 diabetes. In recent years, the availability of automated insulin delivery (AID) systems has improved the ability of people with type 1 diabetes to achieve the recommended glucose target ranges. PA provide additional health benefits but can cause glucose fluctuations, which challenges current AID systems.

Disparities in Diabetes Technology Uptake in Youth and Young Adults With Type 1 Diabetes: A Global Perspective

Globally, nearly 9 million people are living with type 1 diabetes (T1D). Although the incidence of T1D is not affected by socioeconomic status, the development of complications and limited access to modern therapy is overrepresented in vulnerable populations. Diabetes technology, specifically continuous glucose monitoring and automated insulin delivery systems, are considered the gold standard for management of T1D, yet access to these technologies varies widely across countries and regions, and varies widely even within high-income countries.

Real-world glycaemic outcomes in children and young people on advanced hybrid closed-loop therapy: A population-based study in Western Australia

To evaluate real-world glycaemic outcomes in children with type 1 diabetes commencing advanced hybrid closed loop therapy and to explore these outcomes based on the cohort's clinical and socioeconomic characteristics.