The annual incidence of type 1 diabetes in children <15 yr in the Auckland population in 1990–2009 was 16.4/100,000 (95% CI 15.3–17.5). Considering the underlying 36% population growth over the 1990–2009 period, there was still a progressive increase in the incidence of new cases (p<0.0001; Figure 1A). By Poisson regression the type 1 diabetes incidence in children <15 yr in 2009 was 22.5 per 100,000 (95% CI 17.5–28.4), in comparison to 10.9 per 100,000 in 1990 (95% CI 7.0–16.1) (Figure 1A). Overall incidence among males and females across the 20-year period was similar (p = 0.49). The increase in incidence was greatest among children 10–14 yr (average increase of +0.81/year; p<0.0001) and lowest among children 0–4 yr (+0.32/year; p = 0.02); incidences by 2009 were 27.0 (95% CI 18.1–38.8) for children 10–14 yr, 25.4 (95% CI 16.5–37.3; +0.66/year; p = 0.0002) for children 5–9 yr, and 14.9 per 100,000 (95% CI 8.4–24.5) for those aged 0–4 yr (Figure 1B).
A total of 793 individuals were referred to the study and assessed for eligibility between June 2015 and November 2016. Of these, 366 were randomised to the intervention and control groups (n=183 each; fig 1). The final nine month follow-up assessments were completed in August 2017, with loss to follow-up (that is, no follow-up data on any outcome) low in both groups (overall 7/366=2%). A total of 12 participants (six per group) were excluded from the primary outcome analysis because of no follow-up HbA1c results after randomisation. Baseline characteristics of participants are presented in table 1, and no adverse events were recorded from the study or protocol deviations.
Ethnicity was recorded by self-report using a prioritised system, such that if multiple ethnicities were selected, the patient was assigned to a single category, following a hierarchical system of classification [18]. Patients were assigned to European, Maori, Pacific Islander, or Other (Asian/Middle Eastern/Latin American/African) groups, which match national census classifications.
Conclusion A tailored, text message based, self management support programme resulted in modest improvements in glycaemic control in adults with poorly controlled diabetes. Although the clinical significance of these results is unclear, the findings support further investigation into the use of SMS4BG and other text message based support for this patient population.
I act as a care giver for my grandparents who both suffer from type 2 diabetes. This article is right on point with having to make changes to one’s diet to help control blood glucose and overall health such as heart disease as well as staying active and exercising. The two naturally go hand in hand, but many diabetics like my grandparents have foot complications with swelling and neuropathy, requiring proper fitting footwear that is hard to find if you don’t know where to look. I found this guide on shoes for diabetics that helps explain what they are and their importance, especially for diabetics. Hopefully others find it as helpful as I did when caring for those diagnosed with diabetes.
Contributors: RW obtained funding for this trial. All coauthors had input into the study protocol. RD, RW, RMu, and MS contributed to the development of the intervention content. RD managed the day-to-day running of the trial and delivery of the intervention. RD and RW collected the data. YJ and RD did the data analyses. All coauthors were involved in the interpretation of the results. RD wrote the article with input from all coauthors. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. All authors approved the final version of this manuscript. RD is guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
The incidence of type 1 diabetes mellitus has been increasing worldwide [1], [2], [3], and it appears to have been particularly pronounced among children <5 years of age (yr) [3], [4], [5]. This increase has been suggested to be associated with the ‘accelerator hypothesis’ [6]. Although this hypothesis is not universally accepted [7], it predicts that higher BMI is associated with younger age at type 1 diabetes diagnosis [8], which has been demonstrated in some studies [9], [10], [11].

There are over 30 million people in the U.S. who have diabetes, even if nearly a quarter of them have not been diagnosed. 13 million individuals in the U.S. have been diagnosed with urinary incontinence, and it is believed that the percentage of undiagnosed incontinence is likely to be significant. Diabetes is a disease, while incontinence is a symptom related to lifestyle choices, physical issues or an underlying medical condition. Urinary incontinence is often linked to diabetes because diabetes is one of the more common medical conditions that contribute to incontinence. (more…)
Diabetes Stops Here will provide snap shots of the people who are committed to putting an end to this disease, from inspiring volunteer stories to moving staff experiences to celebrity stories about how to be successful while living with diabetes. The stories, interviews and news will be shared by the blog’s author, a staff member at the American Diabetes Association, who has lived with type 1 diabetes for nearly ten years. 
Along with a long list of other complications, gum disease can result from diabetes that is not properly controlled. The two main forms of gum disease are gingivitis and periodontitis. With gingivitis, the gums become red and swollen and may easily bleed. If not treated, this milder form of gum disease can become full-blown periodontitis, which is where the gums pull away from the teeth and infection takes a firm hold, leading to bone, tissue and tooth loss.
-Learn to eat well-balanced meals that include healthful food choices (vegetables, fruits, whole grains, etc.) and watch your portion sizes. Even foods that are good for you can add pounds to your waistline, if you consume too much of them. Losing those extra pounds will help you manage not only your diabetes, but also other health problems you may have.

This patient sample came from patients in secondary care diabetes clinics, and therefore, app use may be different amongst patients managed in primary care. Similarly, findings may not generalize to patients with poorer glycemic control as responders had statistically significantly lower HbA1c than non-responders. This was a cross-sectional survey that is useful to assess app use at one point in time, but it is likely that people vary their app use and recommendations over time. It was therefore not possible to assess whether the introduction of an app has significant effect on clinical outcomes. Our study did not address the difference in needs in app features between responders on insulin and those not on insulin. Overall the response rates for both surveys were low and responses were limited by self-report and therefore liable to responder bias.
The look of the Dario appealed straight away to me. Small and compact. Easy for me to carry with my phone which goes everywhere with me. Love the fantastic app on my phone. Clear, informative and easy to use. Love it! I can look back at previous readings to see any patterns. Sara and Assaf have been brilliant at helping out with any issues I have come across, which I thank them hugely for. The Dario Lounge is a great community for all users, who all share advice.
Pre-diabetes and type 2 diabetes are at epidemic proportions in New Zealand with the Auckland region over represented in certain populations. This programme works with those who have the highest rates of pre-diabetes and type 2 diabetes in Auckland creating that awareness and preventing diabetes where possible that is needed on a more intimate level within the community.
Additional data on all patients were collected from the hospital management system, including age, and the most recent values within the previous 12 months from date of survey for blood pressure (BP), glycated hemoglobin (HbA1c), urinary microalbumin to Creatinine ratio (ACR), low density lipoprotein cholesterol (LDL), and total cholesterol to HDL ratio (C:HDL). Prescription of lipid lowering drugs, anti-hypertensive drugs, insulin, or other hypoglycemic medication were also extracted from the medication list from the last visit within the sample period. Type of diabetes was self-reported in the survey (type 1 [T1DM], type 2 [T2DM], other or unknown) and in four participants who had selected ‘other’ or ‘unknown’ diabetes type was determined by examination of the clinical records. For categorization of participants by app use, 4 responders who did not indicate if they had a mobile phone or not were included in the non-app group.

There was a steady increase in the annual number of newly diagnosed cases of type 1 diabetes in children <15 yr (r2 = 0.80; p<0.0001) of 2.0 additional cases per year, from 23 in 1990/1 to 60 cases per year in 2008/9. There was no appreciable difference in the rate of increase between males and females (p = 0.08), but the rise in number of new type 1 diabetes cases did not occur evenly among age groups (p = 0.0001). The yearly increase among older children (10–14 yr) was 3-fold greater than in the youngest (0–4 yr) group (0–4 yr = +0.4/yr; 5–9 yr = +0.8/yr; 10–14 yr = +1.2/yr). Over the 20-year period, new cases were moderately more frequent in winter and less frequent in spring (29.4% and 22.0%, respectively; test of equal proportions across all four seasons: p = 0.02).


-Learn to eat well-balanced meals that include healthful food choices (vegetables, fruits, whole grains, etc.) and watch your portion sizes. Even foods that are good for you can add pounds to your waistline, if you consume too much of them. Losing those extra pounds will help you manage not only your diabetes, but also other health problems you may have.
The incidence of type 1 diabetes was higher in New Zealand Europeans than other ethnic groups throughout the study period (Figure 2, p<0.0001). There was little difference in incidence among non-European ethnic groups. The annual incidences (per 100,000) by 2009 were: Europeans 32.5 (95% CI 23.8–43.3), Non-Europeans 14.4 (95% CI 9.2–21.4), Maori 13.9 (95% CI 5.2–29.7), Pacific Islanders 15.4 (95% CI 7.3–28.5), and Other 13.5 (95% CI 5.8–26.8). The rate of increase in incidence over the study period was very similar across all ethnicities, as illustrated by the slopes in Figure 2. However, while the average increase in incidence was higher for Europeans than Non-Europeans in children of all age groups (Table 1), the increase was proportionally lower in Europeans (2-fold) than Non-Europeans (3-fold) due to a lower baseline incidence in the latter group (Figure 2). Nonetheless, in both ethnic groups type 1 diabetes incidence in children 10–14 yr increased at a higher rate than in the youngest 0–4 yr group, with a >2-fold difference observed among both Europeans and Non-Europeans (Table 1). Age at diagnosis across the study period was similar in both ethnic groups (p = 0.47).
-Learn to eat well-balanced meals that include healthful food choices (vegetables, fruits, whole grains, etc.) and watch your portion sizes. Even foods that are good for you can add pounds to your waistline, if you consume too much of them. Losing those extra pounds will help you manage not only your diabetes, but also other health problems you may have.
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support from Waitemata District Health Board for the development of SMS4BG, and support from the Health Research Council of New Zealand in partnership with the Waitemata District Health Board and Auckland District Health Board, and the New Zealand Ministry of Health for the randomised controlled trial; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
The control group also experienced a decrease in HbA1c from baseline to the nine month follow-up, and experienced improvements in secondary outcomes, which could indicate trial effects. Previous research has shown that recruitment to a clinical trial alone can result in improvements in HbA1c,43 but it is not expected that these improvements would be sustainable past the initial few months without intervention.
-Learn to eat well-balanced meals that include healthful food choices (vegetables, fruits, whole grains, etc.) and watch your portion sizes. Even foods that are good for you can add pounds to your waistline, if you consume too much of them. Losing those extra pounds will help you manage not only your diabetes, but also other health problems you may have.
24. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009 Apr;42(2):377–81. doi: 10.1016/j.jbi.2008.08.010. http://linkinghub.elsevier.com/retrieve/pii/S1532-0464(08)00122-6. [PMC free article] [PubMed] [CrossRef]
SMS4BG is an automated self management support programme delivered by SMS (short messaging service) to motivate and support people to engage in the behaviours needed for successful diabetes management. The programme was tailored by the needs and goals of the individual, and demographic factors. As well as core motivational and support messages (in Māori, Pacific, or non-Māori/Pacific cultural versions), participants could opt to receive additional modules including those for: insulin control, young adult support, smoking cessation, lifestyle behaviour (exercise, healthy eating, or stress/mood management), and foot care (further module details in supplementary table 1).

This study shows that the incidence of type 1 diabetes in the Auckland region has increased steadily over the last two decades. However, unlike other studies [3], [4], [5], the rate of increase in incidence has been particularly marked in older children (10–14 yr), which was approximately 2.5-fold greater than that in children 0–4 yr. Interestingly, the incidence of type 1 diabetes in children 0–4 and 10–14 in Auckland are very similar to those reported in Australia, our closest geographical and ethnic neighbours [19], both of which had very high case ascertainment levels (close to 100%).
Pedicures may seem like a modern indulgence, but they actually date back more than 4,000 years to the ancient Babylonians. The word pedicure comes from the Latin “pes” for foot and “cura” for care. Originally practiced to prevent foot problems, today, more popular than ever, pedicures combine nail and skin care with a relaxing and self-pampering experience enjoyed not only by women but more and more by men, also.   (more…)

The message delivery was managed by our content management system, with messages sent and received through a gateway company to allow for participants to be registered with any mobile network. Sending and receiving messages was free for participants. The system maintained logs of all outgoing and incoming messages. Further details of the intervention can be seen in the published pilot study,28 and protocol.30

Stutt's Diabetes Depot carries all the well-known brands of insulin pump supplies, including Accu-check infusion sets, Deltec Cozmo insulin cartridges/reservoirs, Animas infusion sets, Lantus Solostar Pens, Medtronic MiniMed Paradigm infusion sets, pen needle tips, Lifesource blood pressure monitors and ErecAid vacuum devices for erectile dysfunction.
We saw no significant interaction between the treatment group and any of the prespecified subgroups: type 1 versus type 2 diabetes (P=0.82), non-Māori/non-Pacific versus Māori/Pacific ethnicity (P=0.60), high urban versus high rural/remote region (P=0.38). Adjusted mean differences on change in HbA1c from baseline to nine months for patients with type 1 and type 2 diabetes were −5.75 mmol/mol (95% confidence interval −10.08 to −1.43, P=0.009) and −3.64 mmol/mol (−7.72 to 0.44, P=0.08), respectively. Adjusted mean differences for non-Māori/non-Pacific and Māori/Pacific people were −4.97 mmol/mol (−8.51 to −1.43, P=0.006) and −3.21 mmol/mol (−9.11 to 2.70, P=0.28), respectively. Adjusted mean differences for participants living in high urban and high rural/remote areas were −4.54 mmol/mol (−8.40 to −0.68, P=0.02) and −3.94 mmol/mol (−9.00 to 1.12, P=0.13), respectively (table 3).
As published in the protocol, a sample size of 500 participants (250 per arm) was estimated to provide 90% power at the 5% significance level to detect a clinically meaningful group difference of 0.5% (5.5 mmol/mol) in HbA1c at nine months, assuming a standard deviation of 1.7% (18.6 mmol/mol). Despite extensive efforts, recruitment for the study was slower than expected, and with the limited overall study period available, a post hoc power calculation was conducted in September 2016. A revised sample size of 366 participants (183 per arm) was targeted, which would provide 80% power to detect the same effect size under the same assumptions.
Diabetes has become so common in the U.S. that there may be a danger of losing sight of just how serious a disease it is. In the diabetic community, there has long been a saying that diabetes won’t kill you, but its complications will. The list of complications is long and includes, heart disease, nerve damage, kidney failure, foot and leg amputation, blindness, Alzheimer’s and a host of others. And, while the saying about diabetes not killing you may be catchy, the truth, according to the American Diabetes Association, is that, “Diabetes remains the 7th leading cause of death in the United States in 2015, with 79,535 death certificates listing it as the underlying cause of death, and a total of 252,806 death certificates listing diabetes as an underlying or contributing cause of death.” (more…)
The {Dario} device has been perfect, I love it. I love that it’s small and discreet enough. I can now test my sugars within 20 seconds, all from the bottom of my iPhone and no one around is none the wiser… I also love that it’s “all in one”. I’ve been using it now for around 4 – 5 months. The app is great at logging and motivation with its % scoring system.
The growing prevalence of diabetes is considered to be one of the biggest global health issues.1 People of ethnic minorities, including Pacific and Māori (New Zealand indigenous population) groups, are particularly vulnerable to the development of diabetes, experience poorer control, and increased rates of complications.23456 In New Zealand, 29% of patients with diabetes were found to have HbA1c levels indicative of poor control (≥65 mmol/mol or 8%), putting them at risk for the development of debilitating and costly complications.7 Diabetes complications can be prevented or delayed with good blood glucose control, which is not only advantageous for a person’s quality of life but also will substantially reduce healthcare costs associated with treating or managing the complications.89101112
Only children aged <15 yr were included. Type 1 diabetes was diagnosed based on clinical features. All patients had elevated blood glucose at presentation: either a random measurement of ≥11.1 mmol/l and presence of classical symptoms, or fasting blood glucose ≥7.1 mmol/l. In addition, all patients met at least one of the following criteria: a) diabetic ketoacidosis; b) presence of at least two type 1 diabetes antibodies (to glutamic acid decarboxylase, islet antigen 2, islet cell, or insulin autoantibodies); or c) ongoing requirement for insulin therapy. Clinical and demographic data were prospectively recorded on all patients at each outpatient visit.
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