🧵 Adult care perspective on interventions for macrovascular complications in #T1D -D Mauricio

⬆️ CVD risk
⬆️ Large gap in CVD outcomes: morbidity + mortality
⬆️ Excess mortality ⬆️ when early onset
⬆️ Years lost consistently proven

#ISPAD2024 #dedoc° @ispad_org @dedocORG #PwD


🧵 Adult care perspective on interventions for macrovascular complications in #T1D -D Mauricio

🫀 Excess CVD risk (average in T1D):
⬆️ Morbidity: 🚹x2.4-3.6 & 🚺 x3.0-7.7
⬆️ Mortality: 🚹x2.6-8.8 & 🚺 x2.7-24.7 😨

Early T1D onset next ⤵️

#ISPAD2024 #dedoc @ispad_org @dedocORG

🧵How can #HCP assist people who chose to use #DYIAID?

The @OPENDiabetesEU ⤵️
▶️ Katarina Braune is a co-founder
▶️ Patient-led
▶️ 2/3 of the international team live w/#T1D
▶️ #OpenSource #AID data

#ISPAD2022 #dedoc°voices #wearenotwaiting @dedocORG @ispad_org 1/n How can #HCP assist people who chose to use #DYIAID?

#wearenotwaiting movement ⤵️
Because DIY #ClosedLoop systems have been so life-changing for them and their kids, they decided to make it available for all.

#ISPAD2022 #dedoc°voices #payitforward @dedocORG @ispad_org 2/n

🧵#AI based decision support systems:

✅ Improves clinical outcomes
✅ Higher access to care
✅ Provides precision medicine
-Revital Nimri

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 1/n #AI based decision support systems:

'Is the quality of care improving?
No, it isn't.
We must do better.'
-Revital Nimri

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 2/n

@lifeforachild /@ispad_org survey - shifting responsibility:
'I am an advocate because I believe that evidence should be made accessible to every stakeholder.'
-Emma Klatman ❤️

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG 1/n @lifeforachild /@ispad_org survey - shifting responsibility:
'Task-shifting & task-sharing: moving a task on from one #HCP to another & where staff from different discipline split the tasks. We are very interested in task-shifting in #T1D'
-Emma Klatman ❤️

ISPAD2022 #dedoc° 2/n

The tragedy of non-diagnosis of #T1D, results from the #T1Dindex -G. Ogle:

Missed T1D diagnoses are legion 💔

1⃣9⃣8⃣7⃣ Sydney: a 15yo boy passed away because of misdiagnosis as he'd just had chicken pox

#ISPAD #ISPAD2022 #dedoc°voices @lifeforachild @ispad_org 1/n The tragedy of non-diagnosis of #T1D, results from the #T1Dindex -G. Ogle:

1⃣9⃣9⃣6⃣ Phnom Penh: no child alive with T1D in Cambodia then.
A boy had a late diagnosis, had had a dose on #insulin, but no fluid yet. He passed away 💔

#BG: 105mmol/1890mg

#ISPAD2022 #dedoc° 2/n

🧵Digital health for improving self-care and mental health in youth with T1D:

Benefits of tech:
▶️ scalable particularly in mental health interventions
▶️ reduce stigma
▶️ accessible 24/7
▶️ taylored tools
-Anna Serlachius

#ISPAD #ISPAD2022 #dedoc°@dedocORG @ispad_org 1/n Digital health for improving self-care and mental health in youth with #T1D:

Challenges of tech:
▶️ access
▶️ literacy
▶️ security
▶️ clinicians awareness
-Anna Serlachius

#ISPAD #ISPAD2022 #dedoc°voices
#diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 2/n

🧵Managing preschool behaviours to optimize diabetes:

Preschool challenges w/T1D - impredictability:
▶️ food intake
▶️ sleeping
▶️ activity
▶️ higher variabiilty in #insulin requirements
-Susana Patton

#ISPAD #ISPAD2022 #dedoc°voices #patientvoice @dedocORG @ispad_org 1/n Managing preschool behaviours to optimize diabetes:

Tips to take back:
▶️ safe space to talk about meal or changing sites that can bring distress and higher #BG
▶️ recognise what's going well
-Susana Patton

#ISPAD #ISPAD2022 #dedoc°voices #payitforward @dedocORG @ispad_org

🧵 Sleep quality and patterns in children with #T1D:

Sleep deprivation can ⬆️ mental health issues like depression, a greater emotional response & difficulty to control emotions.
-Alice Gregory

#ISPAD #ISPAD2022 #dedoc°voices #patientvoice #payitforward @dedocORG @ispad_org 1/n Sleep quality and patterns in children with #T1D:

T1D is a 24/7 monitoring. It never stops at night.
Kids w/T1D have shorter sleep patterns and have poorer sleep quality.
-Alice Gregory

#ISPAD #ISPAD2022 #dedoc°voices #patientvoice #payitforward @dedocORG @ispad_org 2/n

🧵#ISPAD #dedoc° symposium:

Dedoc° started 10y ago on Twitter:
✅ Peer support
✅ Meetings outside of scientific conferences cause #PwD were not allowed in

#ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 1/n #ISPAD #dedoc° symposium:

ISPAD was the 1st scientific conference that organised a Dedoc° symposium in 2021 🙏
-@tadorna

#ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 2/n

🧵Microbiota: can they prevent #TID?
Incidence of T1D is rising particularly in the young.
Environmental factors could drive this pattern observed across the globe.
-N. Hanssen

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 1/n Microbiota: can they prevent #TID?
+ rapid destruction of #BetaCells in kids than adults.
#PwD with residual beta cells have higher #TIR.
-N. Hanssen

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 2/n

🧵#diabetes prevention : are we on the right track?
Here are the players in the development of #T1D 👇
-M. Knip

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #patientvoice #payitforward @dedocORG @ispad_org 1/n #diabetes prevention : are we on the right track?
The different stages of #betaCells autoimmunity:
1⃣ Normoglycemia
2⃣ Presymptomatic dysglycemia
3⃣ Symptomatic dysglycemia
Primary prevention shld start during pregnancy.
-M. Knip

#ISPAD2022 #dedoc°voices @dedocORG @ispad_org 2/n

Potential role of antiviral treatment in #T1D:

Pathogenesis:
1⃣ Genetic susceptibility
2⃣ Something triggers autoimmunity in the 1st years of life or later
3⃣ #BetaCell destruction
4⃣ Diagnosis
-L. Krogvold

#ISPAD #ISPAD2022 #dedoc°voices #patientvoice @dedocORG @ispad_org 1/n Potential role of antiviral treatment in #T1D:

'The time trend is the best proof that there are environmental factors triggering T1D.
Heredity as well.'
-L. Krogvold

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 2/n

The last mile for #T1D cure:
'I believe that cell therapy can be the T1D cure. We've had landmark results in the last 2y.
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs
#diabetesadvocacy #patientvoice #payitforward @dedocORG @ispad_org 1/n The last mile for #T1D cure:
'We know now that #BetaCell replacement can cure T1D. This is the #BG profile of someone who used to live with #diabetes 1y 1/2 ago.'
-L. Piemonti

#ISPAD #ISPAD2022 #dedoc°voices #NothingAboutUsWithoutUs #payitforward @dedocORG @ispad_org 2/n

Digitalization in Diabetes Education and Care:
'We know that autoimmunity starts way before #T1D diagnosis - if screened. We learnt that #cpeptide might not be relevant thanks to models'
-Dr A. Galderisi

#ISPAD #ISPAD2022 #dedoc°voices
#patientvoice #payitforward @dedocORG 1/n Digitalization in Diabetes Education and Care:
'We can find heterogeneity in #T1D even before diagnosis. Important to individualise treatment.'-Dr A. Galderisi

Yes, every #PwD has their own #diabetes.

#ISPAD #ISPAD2022 #dedoc°voices
#nothingaboutuswithoutus @dedocORG 2/n

Betting for the next best thing in digital #diabetes technology:

'#AID systems & algorithms are very effective.
Unfortunately, they are used by a minority of ppl who cld benefit from them.'
-Steven Russell

#EASD2022 #dedoc°voices #nothingaboutuswithoutus @dedocORG 1/n Betting for the next best thing in digital #diabetes technology:

'In addition to the challenges of getting hybrid #AID systems, they still require setups. They still require the user to #carbcount for meals & initiate correction boluses.'
-Steven Russell

#EASD2022 #dedoc 2/n

Are we becoming robots? #AID systems for everyone with #T1D:

'#CGM is the Archimedean point of #diabetes technology. This is when the idea of closing the loop really emerged.'
-Moshe Phillip

#EASD2022 #dedoc°voices #nothingaboutuswithoutus @EASDnews @dedocORG 1/n Are we becoming robots? #AID systems for everyone with #T1D:

'#CGM opened our eyes to the fact that the data we used to get was very different from the reality #PwD live.'
-Moshe Phillip

So true. Connecting the red dots' never been our reality.

#EASD2022 #dedoc° @dedocORG 2/n

About to start watching the inspiring advocates of the #dedoc° symposium that was held earlier today at #EASD2022 🍿

Sad I couldn't watch it live. Couldn't wait to catch up here ▶️

#nothingaboutuswithoutus #diabetesadvocacy
@EASDnews @dedocORG 1/n I already know many happy tears will be shed listening to their inspiring advocacy work 🥲

#EASD2022 #dedoc°voices #nothingaboutuswithoutus #diabetesadvocacy #languagematters
@EASDnews @dedocORG 2/n

1/ #COVID-19 et #diabete : une contamination #SARScov2 peut-elle être un élément déclencheur ?

Très long (vraiment très long) #thread 🧵 ⤵️ 2/ La plupart des personnes qui vivent avec une maladie chronique sont conscientes d’être plus à risque en cas de contamination #COVID. Celles qui vivent avec un #diabete #DT1 #DT2 ou autre, savent aussi qu’une infection, quelle qu'elle soit, peut provoquer une certaine

[#thread] Déception à la lecture de la newsletter du @CeeD_Diabete qui paraphrase l’ANSM sur les #BouclesFermées DIY. Avec +5 ans d’expérience utilisateurs les développeurs du #DIY ont ouvert la voie aux boucles commerciales 🚀

▶️ ceed-diabete.org/blog/alerte-su…

#DIYAPS #DT1 Les #BouclesFermées commerciales ne sont pas encore disponibles en France, et le seront à un public restreint. Elles le sont depuis 2 ans dans d’autres pays. Les #DT1 ne peuvent plus attendre et construisent leur propre boucle avec du matériel marqué CE.

#WeAreNotWaiting

#ControlIQ Tandem T:slim #closedloop's aim at improving #TIR. To activate Control IQ, are required:
▶️ current weight
▶️ total daily #Insulin
▶️ carb ratio
▶️ ISF
▶️ correction factors
▶️ meal bolus still required

#dedoc° #dedocvoices #EASD2020 @EASDnews #NothingAboutUsWithoutUs 36 wk-trial #ControlIQ in teens and adults in 2019:
▶️ #TIR +11% from 61 to 71%
▶️ major #BG improvement at night 2 to 8am
▶️ average #A1c 7% (#PwD witth A1c >6.5% improved too)
▶️ less #hypos
- Dr Marc Breton, University of Virginia

#dedoc° #dedocvoices #EASD2020 @EASDnews

The implication of the wider spread of #DIYAPS on out-of-pocket expenses for people with #T1D- Timothée Froment on the conomic burden associated with #diabetes technologies

#dedoc° #dedocvoices #EASD2020 #EASD @EASDnews #NothingAboutUsWithoutUs The amount of out-of-pocket expenses for people with #T1D depends on the limited health coverage of #diabetes technologies & supplies in most countries
- Timothée Froment

#dedoc° #dedocvoices #EASD2020 #EASD @EASDnews #NothingAboutUsWithoutUs