Publications by authors named "Benjamin J Wheeler"

Aims: Continuous glucose monitoring (CGM) is increasingly popular in the management of type 1 diabetes (T1D). These devices have a remote monitoring function that allows for a third-party individual to monitor the user's glucose levels. While remote monitoring in CGM devices is widely used in T1D management, especially in paediatric populations, there are some individuals with T1D that do not utilise this function.

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Aims: To assess how automated insulin delivery (AID) impacts sleep in young people with type 1 diabetes and suboptimal glycaemia (HbA1c ≥ 69 mmol/mol).

Methods: We conducted a randomised controlled trial comparing AID to usual care in 80 participants (aged 7-25 years) over 13 weeks. Sleep was a secondary outcome assessed at baseline and 13 weeks using questionnaires (subjective) and accelerometry (objective).

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Aims: The MiniMed™ 780G improves glycaemia and reduces burden in type 1 diabetes. We investigated how new all-in-one "Simplera Sync™" sensors and 7-day Extended™ Wear Infusion Sets (EIS) affect glycaemia and system performance in young people with previously elevated HbA1c levels (≥69 mmol/mol [≥8%]) after transitioning from 780G with Guardian 4™ sensors and 3-day infusion sets.

Methods: We conducted an extension phase analysis in 75 participants (aged 7-25 years) initially enrolled in the CO-PILOT randomised controlled trial.

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Aims: The first 26 weeks of the 2GO-CGM trial assessed the efficacy and safety of real-time continuous glucose monitoring (rtCGM) use within a supported specialist model of care in a cohort of community-based adults with insulin-requiring type 2 diabetes in New Zealand.

Methods: A 26-week randomised one-way crossover 'waitlist-controlled' trial comparing rtCGM (Dexcom G6) with self-monitoring of blood glucose (SMBG). All participants completed 2 weeks of SMBG before being randomised to 12 weeks (phase 1) use of SMBG followed by 12 weeks (phase 2) use of rtCGM (Group A) or 24 weeks of rtCGM (Group B).

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Aim: The study aimed to identify active intervention components to improve glucose sensor time in range (TIR; 70-180 mg/dL [3.9-10.0 mmol/L]) by ≥5 % among adolescents and young adults (13 to 20 yrs) with type 1 diabetes and above recommended glycated haemoglobin (HbA1c ≥ 7.

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Rapid improvements in glucose control may lead to early worsening of diabetic retinopathy (EWDR). There is a need to demonstrate safety in people commencing automated insulin delivery (AID) due to the known efficacy in rapid glycemic improvement. We aimed to investigate short-term DR outcomes in people (aged ≥13 years) with type 1 diabetes after initiation of AID (use ≥6 months).

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The International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines represent a rich repository that serves as the only comprehensive set of clinical recommendations for children, adolescents, and young adults living with diabetes worldwide. This chapter builds on the 2022 ISPAD guidelines, and summarizes recent advances in the technology behind glucose monitoring, and its role in glucose-responsive integrated technology that is feasible with the use of automated insulin delivery (AID) systems in children and adolescents. The International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines represent a rich repository that serves as the only comprehensive set of clinical recommendations for children, adolescents, and young adults living with diabetes worldwide.

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Aims: This study aimed to identify key factors with the greatest influence on glycaemic outcomes in young individuals with type 1 diabetes (T1D) and very elevated glycaemia after 3 months of automated insulin delivery (AID).

Materials And Methods: Data were combined and analysed from two separate and previously published studies with similar inclusion criteria assessing AID (MiniMed 780G) efficacy among young individuals naïve to AID (aged 7-25 years) with glycated haemoglobin A1c (HbA1c) ≥69 mmol/mol (≥8.5%).

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Aim: To investigate extension phase outcomes with intermittently scanned continuous glucose monitoring (isCGM 2.0) in children with type 1 diabetes mellitus (T1DM) and elevated HbA (7.5-12.

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Aims: To identify from a parental perspective facilitators and barriers of effective implementation of advanced hybrid closed-loop (AHCL) therapy in children and adolescents with type 1 diabetes (T1D) with elevated glycaemia.

Methods: Semi-structured interviews were conducted with parents of participants while in a post-trial extension phase of the CO-PILOT randomized controlled trial. The Capability, Opportunity, Motivation, Behaviour Model and Theoretical Domain Framework informed the interviews and framework analysis.

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Background: Open-source automated insulin delivery systems are increasingly adopted yet predominantly discussed outside of Asia. This study aimed to describe efficacy and safety of android artificial pancreas (AAPS) in people with type 1 diabetes mellitus (T1DM) from mainland China.

Methods: This real-world study recruited people who initiated AAPS for ≥ 3 months between 2019 and 2024.

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Article Synopsis
  • The study aimed to explore the experiences of adolescents and young adults (ages 13-25) with chronic high glucose levels who switched from multiple daily injections (MDI) to advanced hybrid closed-loop (AHCL) therapy.
  • Researchers conducted semi-structured interviews with 14 participants after three months on the AHCL, identifying three key themes: improved glucose levels enhanced overall health perceptions, AHCL features supported self-management, and insulin delivery automation reduced care burden.
  • The transition to AHCL therapy resulted in positive impacts on physical, mental, and social well-being, although some participants experienced transient pseudo-hypoglycaemia, highlighting the need for individualized support to facilitate uptake.
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Background: Automated insulin delivery is the treatment of choice in adults with type 1 diabetes. Data are needed on the efficacy and safety of automated insulin delivery for children and youth with diabetes and elevated glycated hemoglobin levels.

Methods: In this multicenter, open-label randomized controlled trial, we assigned patients with type 1 diabetes in a 1:1 ratio either to use an automated insulin delivery system (MiniMed 780G) or to receive usual diabetes care of multiple daily injections or non--automated pump therapy (control).

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Background: Multiple clinician adjustable parameters impact upon glycemia in people with type 1 diabetes (T1D) using Medtronic Mini Med 780G (MM780G) AHCL. These include glucose targets, carbohydrate ratios (CR), and active insulin time (AIT). Algorithm-based decision support advising upon potential settings adjustments may enhance clinical decision-making.

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Purpose: Advanced hybrid closed loop (AHCL) systems have the potential to improve glycemia and reduce burden for people with type 1 diabetes (T1D). Children and youth, who are at particular risk for out-of-target glycemia, may have the most to gain from AHCL. However, no randomized controlled trial (RCT) specifically targeting this age group with very high HbA has previously been attempted.

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Aims: To explore the lived experiences of initiating real-time continuous glucose monitoring (rt-CGM) use in individuals with type 2 diabetes using insulin.

Methods: Twelve semi-structured interviews were conducted amongst individuals with type 2 diabetes taking insulin who were enrolled in the 2GO-CGM randomised controlled trial and had completed 3 months of rtCGM. Interviews were transcribed verbatim and analysed to identify common themes regarding their experiences.

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Iron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.

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Aims: To investigate the impact of real-time continuous glucose monitoring (rtCGM) on glycaemia in a predominantly indigenous (Māori) population of adults with insulin-requiring type 2 diabetes (T2D) in New Zealand.

Methods: Twelve-week, multicentre randomised controlled trial (RCT) of adults with T2D using ≥0.2 units/kg/day of insulin and elevated glycated haemoglobin (HbA1c) ≥64 mmol/mol (8.

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Aims: To survey the national workforce that manages children and adolescents with type 1 diabetes (T1D) in Aotearoa New Zealand and compare with glycaemic outcomes for 2021.

Methods: A representative from each tertiary and regional diabetes service in Aotearoa New Zealand was asked to participate in an online survey assessing health-care professional (HCP) workforce numbers operating for the 2021 calendar year. Regional full-time-equivalent (FTE), glycaemic outcomes and population demographics were compared to a previously reported workforce surveys (2015 and 2019).

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Aim: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the effectiveness of real-time continuous glucose monitoring (rtCGM) versus intermittently scanned continuous glucose monitoring (isCGM) on key glycaemic metrics (co-primary outcomes HbA1c and time-in-range [TIR] 70-180 mg/dL, 3.9-10.0 mmol/L) among people with type 1 diabetes (T1D).

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Article Synopsis
  • The study aims to examine the impact of real-time continuous glucose monitoring (rtCGM) on glycaemic control in adults with type 2 diabetes (T2D) who have poor blood sugar levels, alongside assessing its cost-effectiveness and safety.
  • Conducted across three locations in New Zealand, the trial will involve 80 adults with T2D, who will be split into two groups: one using rtCGM and the other using standard blood glucose monitoring for three months, followed by a crossover phase.
  • The main goal is to measure how long participants maintain their glucose levels within a target range, while also analyzing other health metrics, dietary habits, and overall cost-effectiveness throughout the trial.
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Postnatally, severe vitamin D deficiency commonly results in rickets as well as potential defects in tooth mineralization. The effects of milder deficiency on oral health outcomes later in life are still unclear. This study used micro-computed tomography (μCT), energy dispersive X-ray analysis (EDX), and Raman spectroscopy to investigate mineral density, total density, and elemental composition of enamel and dentine in 63 exfoliated primary incisors from participants with known 25-hydroxyvitamin D levels (25-OHD) at birth.

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Aims/hypothesis: Type 1 diabetes is one of the most common chronic diseases of childhood. It is hypothesised that the metabolic and psychosocial consequences of type 1 diabetes may affect educational outcomes; however, existing literature presents conflicting results. This study aimed to assess whether educational outcomes differ for young people with and without type 1 diabetes in Aotearoa/New Zealand (NZ).

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Article Synopsis
  • The study investigates how young adults with type 1 diabetes experience and manage alcohol consumption, highlighting their social drinking habits along with the associated challenges.
  • Four main themes emerged from interviews: inconsistent understanding of alcohol's effects, difficulties in maintaining glycaemic control while socializing, implementation of harm-reduction strategies when feasible, and the role of modern diabetes tech in improving safety.
  • The findings suggest a need for better education and support regarding safe drinking practices for this group to prevent safety issues, such as hypoglycaemia, while leveraging diabetes technology to facilitate better management.
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