Insights from ISPAD 2024: Transformative and Urgent Challenges in Youth Diabetes and Obesity Care

As we observe Diabetes Awareness Month this November, I recently returned from the International Society for Pediatric and Adolescent Diabetes (ISPAD 2024), where discussions underscored how critical and complex managing youth diabetes and obesity has become. Some noteworthy themes were:

🔬 Neuroinflammation and Obesity: Research highlights that youth with overweight/obesity experience elevated white matter neuroinflammation, regardless of dysglycemia status. This could influence early brain health, even without progressing to diabetes.

🧬 Gut Microbiome Shifts in Youth-Onset Type 2 Diabetes: A study on metformin and liraglutide in youth shows positive shifts in bile acid and short-chain fatty acid-producing gut microbiota. While the clinical relevance of these microbiome changes is not yet clear, this could guide future treatment paths.

💔 The Global Crisis of Diabetes: 537 million people worldwide live with diabetes, including 9 million with type 1 diabetes (T1D). T1D alone results in an average of 32 years of healthy life lost per person. In the U.S., people with T1D face a daily struggle—spending on average 7 hours in hyperglycemia and over 90 minutes in hypoglycemia.

💡 Rethinking T1D Management: Most people with T1D do not consistently achieve target blood glucose levels. A multidrug approach (insulin + SGLT inhibitors, etc.) may offer a more robust metabolic control to reduce risks, but more studies are needed to build clinical guidance and incentivize investment in these therapies.

📈 Equity in Access to Technology: Diabetes technology access is far from equitable. Many children and families face barriers like the lack of continuous glucose monitors (CGMs) and resources in multiple languages. As one parent expressed, "The pump is one thing...but you should walk out of the hospital with a sensor." The necessity of CGMs for safe, daily management is clear, yet disparities persist.

💤 Psychosocial Impacts on Families: The mental load on caregivers of children with T1D is profound. Psychosocial support, automated insulin delivery, and access to psychologists can dramatically improve quality of life for both the young patient and their families, leading to benefits that begin early and are sustained over time.

⚖️ Weight Loss and Obesity: Youth obesity remains a predictor of future cardiovascular disease. Effective weight management, including surgical options, shows promising improvements in metabolism and appetite control versus restrictive dieting, addressing the broader spectrum of comorbidities linked to obesity.

💬 Empowering Adolescents: Addressing body image, disordered eating, and the psychosocial aspects of T1D is essential. Diabetes education and support for youth must extend beyond clinical targets to encourage healthy body relationships and long-term mental well-being.

Main Takeaways from ISPAD

Diabetes as a Lifelong Health Crisis

With diabetes affecting 537 million globally, the statistics shared were a sobering reminder of the condition’s reach. For individuals with type 1 diabetes (T1D), the daily experience is relentless. The average person with T1D spends seven hours a day in hyperglycemia, plus over an hour and a half hypoglycemic. This “glycemic roller coaster” has serious implications for daily quality of life and cognitive functioning, underscoring how crucial it is to innovate and improve diabetes management. A stronger focus on simplifying glycemic control is essential to empower patients and reduce long-term risks.

Addressing Inequity in Diabetes Technology Access

The discussions around CGM access highlighted the structural barriers that many families face in managing diabetes effectively. While CGMs provide invaluable data for managing T1D, many families lack access to this technology due to socioeconomic factors or language barriers. The insights shared on racial and ethnic disparities in diabetes management hit home. Technology can only be transformative if it’s accessible and adaptable to diverse needs, including in the languages patients and families understand.

Recognizing the Toll on Families

The psychosocial burden on families dealing with T1D is substantial. Studies highlighted how support systems, such as psychologists and advanced technologies like automated insulin delivery, are essential to alleviate this burden. The research on how these interventions improve the mental well-being of both patients and parents reaffirms the value of a holistic approach. It was eye-opening to see how, with the right support, families experience less stress, better sleep, and more confidence in managing the disease.

A New Look at Weight Management and Obesity Treatment

Discussions on the physiological effects of restrictive dieting versus weight loss surgery illuminated why sustainable weight loss is such a challenge for young people. Restrictive diets often lead to physiological compensation—slower metabolism and increased appetite—making long-term weight management difficult. In contrast, surgical interventions seem to have opposite effects, improving factors like appetite control and energy expenditure. It was clear that for youth dealing with obesity and its comorbidities, a tailored, non-restrictive approach may be essential to achieve lasting health benefits.

Empowering Youth with a Holistic Approach

Finally, the emphasis on supporting youth with T1D around body image and disordered eating was a welcome reminder that effective care goes beyond physical health metrics. Adolescents with diabetes face unique challenges around body image, so education that supports both their mental and physical well-being is critical.

The Silent Impacts of Obesity on Brain Health

The research showing elevated neuroinflammation in the white matter of youth with overweight or obesity was compelling, particularly as it occurs independently of blood sugar status (dysglycemia). This underscores the silent but serious neurological impact of excess weight in young people—a reminder of how comprehensive our approach to obesity care must be. It isn’t just about metabolic risk; we may need to consider cognitive and developmental factors early on.

Microbiome Research Raises New Questions

The shifts in gut microbiota observed in youth with type 2 diabetes taking metformin or metformin + liraglutide—especially the increase in bile acid concentrations—point to emerging opportunities. Though these changes aren’t directly tied to glycemic outcomes, they hint at complex metabolic pathways that could open doors to more personalized therapies. It’s exciting but also a reminder that our understanding of the microbiome's role in metabolic health is still evolving.

ISPAD 2024 was a powerful reminder of the importance of viewing diabetes and obesity through a multidimensional lens that integrates clinical, psychological, and social factors. As we raise awareness this November, it’s clear that both the clinical and psychosocial dimensions of diabetes and obesity care must advance in tandem. To truly make a difference, we need equitable access to technologies, a strong focus on prevention, and a compassionate approach to family support. This conference reinforced my belief in the need for innovation that is as much about inclusivity and mental well-being as it is about clinical efficacy.

Adhera Health Pioneers Family-Focused Digital Health Solutions for Children with Chronic Conditions

Reveals Transformative Research Results at ISPAD 2024

Adhera Health unveiled groundbreaking research at the International Society for Pediatric and Adolescent Diabetes (ISPAD) conference showcasing how innovative digital interventions can enhance wellbeing for families affected by Type 1 Diabetes (T1D) and childhood obesity.

The first study (NCT05483803), "Impact of a Personalized Digital Intervention on the Wellbeing of Caregivers of Children with Type 1 Diabetes and Diabetes Management," revealed a significant link between caregiver stress and the child's overall wellbeing. The findings underscore the critical importance of providing comprehensive support to the entire family in managing chronic conditions. The study enrolled 90 families of children with type 1 diabetes aged 8-15 years. Caregivers interacted with the Adhera® Caring Digital Program which emphasized education, provided motivational, gradual, and substantiable change recommendations along with a dedicated coach. Caregivers completed surveys on their own wellbeing and their child's quality of life at the start and end of the 3-month program.

Results showed a significant correlation between caregiver stress and poorer child wellbeing (r=-0.37, p<0.001), emphasizing the importance of addressing caregiver wellbeing. Post-intervention, the percentage of families reporting good wellbeing increased from 31.8% to 43.4%, while those with poor caregiver wellbeing decreased from 38.8% to 9.6%.

Adhera Health also presented initial findings from an ongoing study sponsored by the National Institutes of Health/National Institute on Minority Health and Health Disparities (1R43MD018551-01). The presentation was titled " Adaptation of a Digital Health Intervention for Chronic Condition Related Fatigue to the Latino Population.”

This research seeks to rigorously assess the acceptability of a digital intervention within the Latinx community and devise a tailored strategy for its effective implementation in urban Latinx neighborhoods. Adhera Health conducted over 15 participatory workshops, engaging more than 150 families and stakeholders, including parent groups from diverse backgrounds such as African American and non-Hispanic white families. These sessions provided critical insights into the unique needs and preferences of the Latinx population, establishing a foundation for culturally sensitive, community-driven solutions in chronic disease management. Latinx parents of children with T1D rated the Adhera Caring Digital Program positively (77.5-88), while parents of children with obesity scored even higher (94-100). All participants would recommend the program, describing it as "easy," "understandable," and "user-friendly."

"These findings validate our mission to adopting a holistic approach that supports the entire family unit,” said Ricardo C. Berrios, Co-Founder and CEO of Adhera Health. “Our research proves that personalized digital interventions significantly enhance caregiver wellbeing, which in turn enables families to more effectively manage their child’s chronic condition, ultimately leading to improved quality of life for the child and the family as a whole.”

Adhera Health is actively scaling its family-focused model to encompass a broader range of pediatric chronic conditions and communities across the US. Its vision is to ensure that all families of children with chronic illnesses have equitable access to innovative digital health solutions that are tailored to address their specific needs and improve health outcomes.

Adhera Health at HLTH 2024

Adhera Health's team will showcase live demonstrations of the Adhera Caring Digital Program at the Scale Health booth (#3210-13) at HLTH 2024, where attendees can experience how the program empowers families managing pediatric chronic conditions through engaging and personalized support.

This blog article is a reprint of the press release - https://www.einpresswire.com/article/750051619/adhera-health-pioneers-family-focused-digital-health-solutions-for-children-with-chronic-conditions

New Study Reveals Impact of Personalized Digital Companion on Caregivers of Children with Type 1 Diabetes

Adhera Health’s AI-Precision Digital Companion Improves Wellbeing of Caregivers for Children with Type 1 Diabetes

Groundbreaking research on the beneficial effects of Adhera Health’s AI-Precision Digital Companion on the wellbeing of caregivers of children with type 1 diabetes and its effectiveness to support personalized pediatric care is set to be unveiled at the 46th Congress of the Spanish Society of Pediatric Endocrinology – SEEP 2024.

Led by researchers from Hospital Universitario Miguel Servet and Adhera Health and sponsored by Novo Nordisk, this study (CARING-T1D) sheds light on the transformative potential of personalized digital interventions to enhance health outcomes for families managing chronic conditions. Building upon previous findings released at SEEP and other endocrinology conferences, the study underscores the pivotal role of personalized digital companions in providing tailored support, empowering caregivers, and driving positive engagement and behavior change to better integrate care for families affected by type 1 diabetes.

Dr. Antonio de Arriba, Pediatric Endocrinologist at the Hospital Universitario Miguel Servet and the principal investigator, will present the new findings at this year’s SEEP meeting, which takes place May 8 to 10, 2024, in Las Palmas de Gran Canaria (Spain).

“The findings highlight how Adhera Health’s personalized digital companion and interventions impact the wellbeing of caregivers and children with type 1 diabetes, revolutionizing pediatric healthcare by offering targeted support, educational content, and empowering the entire family unit,” remarked Dr. de Arriba, “This study illustrates the potential of delivering precision medicine that acknowledges the uniqueness of each family, which is essential in pediatric care for all conditions.”

Results of the new study demonstrate that a digital intervention program delivered by the Adhera AI-Precision Digital Companion had a positive effect on the overall wellbeing of the parents while also supporting integrated care via advanced AI algorithms. This means that the intervention not only positively impacted the parents’ emotional and psychological state but helped clinicians better understand the needs of families.

"The wellbeing of the entire family is paramount in managing diabetes effectively," emphasized Ricardo C. Berrios, co-founder, and CEO of Adhera Health. "Our study, alongside others we've conducted, highlights the importance of involving the whole family unit in the design of interventions and treatment plans for pediatric diabetes. It's crucial for healthcare strategies to address the needs of both children and their primary caregivers to achieve better health outcomes. Our findings support that data-driven solutions can help personalize pediatric care by considering the distinct needs of each family."

The study results also show that stratifying families based on the child’s metabolic control and the wellbeing of the caregiver provides a valuable approach for assessing the overall wellbeing of the family unit. By considering these factors together, healthcare professionals can gain a more nuanced understanding of the family’s health, and subsequently tailor interventions more effectively to meet the specific needs of each family.

This blog article is a reprint of the press release - https://www.einpresswire.com/article/709927170/new-study-reveals-impact-of-personalized-digital-companion-on-caregivers-of-children-with-type-1-diabetes

National Minority Health Month - Be the Source for Better Health

Since 2002, the National Institute on Minority Health and Health Disparities (NIMHD) has annually celebrated National Minority Health Month in April. This initiative traces its roots back to 1915 with the establishment of National Negro Health Week by T. Washington, marking a longstanding commitment to addressing disparities in healthcare access and outcomes*.

The FDA defines health equity as “the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, and other factors that affect access to care and health outcomes.” Despite strides made in awareness and policy, significant work remains to achieve this vision.

In the realm of digital health, there’s growing evidence of the positive impact digital tools can have on chronic condition self-management. However, studies indicate a concerning trend: low adoption rates among minority populations in the U.S., which often stem from poor adaptation of digital health solutions to minorities’ specific needs. This can be attributed to a systemic lack of involvement of minority groups in the design of these digital health solutions. Consequently, this is raising concerns about potential exacerbation of health inequalities.

Recognizing the potential of digital health solutions to improve health outcomes, Adhera Health prioritizes inclusiveness as a value in both our daily operations and our product development. We believe that personalized solutions tailored to the unique needs of health minorities are essential for achieving health equity. In line with this commitment, we were honored to receive a NIH/NIMHD award in September 2023 for advancing our Adhera Precision Digital Companionä platform for chronic conditions and adapting it to the U.S. Latinx population with the aim of reducing health inequalities.

Adhera Health is privileged to collaborate with Dr. Jennifer Raymond, MD, MCR, Chief of the Division of Endocrinology, Diabetes, and Metabolism at Children’s Hospital Los Angeles, on the NIH/NIMHD award. Dr. Raymond is enthusiastic about our project and is particularly eager to spearhead the clinical research on pediatric diabetes, encompassing the comprehensive care of both the physical and mental wellbeing of family caregivers of Latinx children with type 1 diabetes.

Dr. Raymond strongly advocates for leveraging digital health technologies to alleviate distress among young individuals with diabetes, particularly those residing in marginalized communities. A study published in 2023 by the Journal of Diabetes Science and Technology, led by Dr. Raymond and her colleagues, revealed that adolescents and young adults with type 1 diabetes who primarily engage in diabetes clinic visits via telehealth exhibit improved overall attendance and experience lower levels of diabetes-related distress compared to those attending in person.

To support our efforts and raise awareness, we encourage you to explore the Minority Health and Health Equity Resources Catalog, which offers a comprehensive list of resources available in multiple languages: https://www.fda.gov/consumers/minority-health-and-health-equity/minority-health-and-health-equity-resources

Together, let’s strive for a future where everyone has equal access to quality healthcare, regardless of their background or identity. 

Sources: 

* https://www.nimhd.nih.gov/programs/edu-training/nmhm/