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Biomedical subjects

Mary Halvorson

Publications and source records attributed to Mary Halvorson.

6 recordsLinked to original sources
PubMed2007

A pilot trial in pediatrics with the sensor-augmented pump: combining real-time continuous glucose monitoring with the insulin pump.

Real-time continuous glucose monitoring and the insulin pump have been combined into the Sensor-Augmented Pump system (Medtronic MiniMed, Northridge, CA). This short-term pilot trial demonstrated that pediatric subjects with type I diabetes improved mean hemoglobin A1c (A1c) and glucose levels and reduced hypoglycemia and hyperglycemia using the Sensor-Augmented Pump system.

Adolescent↗
PubMed2006

Feasibility of a hospital-based, family-centered intervention to reduce weight gain in overweight children and adolescents.

OBJECTIVE: To evaluate the effects of a hospital-based, family-centered lifestyle program (Kids N Fitness) on weight and health in overweight 7-17-year-old children. DESIGN: The Kids N Fitness program consisting of up to twelve 90-min sessions was conducted in an outpatient setting. The program comprised interactive nutrition and exercise sessions with behavior modification. Subjects completed a logbook and child's health questionnaire. Measures and surveys were taken before, during, and after the program. PARTICIPANTS: Two hundred and sixty-four overweight children (137 female, 73% Hispanic), mean age 11.5+/-2.1 years, with body mass index (BMI)=85th percentile, no physical limitations, and attendance of >or=50% of sessions. A subgroup of 115 children was observed for up to 6 months prior to program. INTERVENTION RESULTS: Weight and BMI velocity, and BMI, and BMI z-score were lower during the program than during the pre-program observation period. Compared, subjects in the 12-week program had significantly reduced gains in weight and greater losses in body mass index, than in 8 weeks. Improvements in emotional well-being and behavior correlated positively with weight loss (p=0.005). CONCLUSIONS: Positive health outcomes suggest that family-centered programs, stressing healthy eating strategies, participation in team-oriented physical activities, and behavior modification, are effective in improving weight dynamics and psychological functioning.

Adolescent↗
PubMed2002

Characteristics of glycemic control in young children with type 1 diabetes.

BACKGROUND: The Diabetes Control and Complications Trial (DCCT) demonstrated that the rate-limiting step to the intensification of diabetes management in adolescents and adults was hypoglycemia. Young children were presumed to be at even greater risk for hypoglycemia with severe consequences, particularly if they had HbA1c levels < 8%. SUBJECTS: A retrospective chart review was performed on 148 patients with type 1 diabetes on insulin injection therapy who were < 8 yr of age (mean age 5.7 +/- 1.5, mean diabetes duration 3.0 +/- 1.4 yr) followed quarterly from July 1999 to June 2001. METHODS: The subjects were divided into two groups based on their mean HbA1c values (< 8 vs. > or = 8%) averaged over the 2-yr time period. The following variables were analyzed comparing the two groups: age, duration of diabetes, insulin dose, severe hypoglycemic episodes, episodes of diabetic ketoacidosis (DKA), percentage of glucose levels above, within, and below the target range, and number of diabetes home-management competencies obtained. RESULTS: Patients with HbA1c < 8% spent more time within target range (40.0 vs. 29.5%, p = 0.0001) and less time above their target range (36.9 vs. 51.2%, p = 0.0003). There was no difference in the percentage of glucose levels below target (23.2 vs. 19.4%, p = NS), percentage of severe hypoglycemic episodes (3 vs. 7 episodes per 100 patient-yr, p = NS), or episodes of DKA (1 vs. 3 episodes per 100 patient-yr, p = NS) between the two groups. SUBJECTS with lower HbA1c levels had acquired more home-management competencies (4.0 vs. 3.5, p = 0.01). CONCLUSIONS: If families are competent in fundamental diabetes management, young children can achieve HbA1c levels < 8.0% without increasing the risk of hypoglycemia.

Journal Article↗
PubMed2002

Nocturnal hypoglycemia detected with the Continuous Glucose Monitoring System in pediatric patients with type 1 diabetes.

OBJECTIVE: To use the Continuous Glucose Monitoring System (CGMS, MiniMed, Sylmar, Calif) to determine if bedtime blood glucose levels were associated with the occurrence of nocturnal hypoglycemia. STUDY DESIGN: Patients (n = 47, 18 boys, mean age 11.8 +/- 4.6 years) with type 1 diabetes used CGMS for 167 nights. Data were analyzed for glucose </=40 or </=50 mg/dL, comparing bedtime blood glucose levels of </=100 or >100 mg/dL and </=150 or >150 mg/dL. RESULTS: A glucose value of </=40 mg/dL occurred on 27% of nights and </=50 mg/dL on 35% of nights. There was a 2-fold increase (45% vs 22%, P =.015) in the incidence of hypoglycemia with a bedtime glucose </=100 mg/dL and a 1.7-fold increase (46% vs 26%, P =.01) with a value of </=150 mg/dL; most episodes occurred between 9 PM and 1 AM. There was no difference in hypoglycemia duration (86.4 minutes for glucose </=100 mg/dL vs 84.5 minutes for >100 mg/dL, P = NS), and no bedtime glucose value between 110 and 300 mg/dL decreased the incidence of nocturnal hypoglycemia to </=10%. The incidence of nocturnal hypoglycemia was similar for patients using insulin pump and injection therapy, and there was no correlation between hemoglobin A1c and incidence or duration of hypoglycemia. CONCLUSIONS: Nocturnal hypoglycemia is frequent, of long duration, associated with bedtime glucose values </=100 to 150 mg/dL, and predominately in the early part of the night. CGMS is a useful tool to diagnose asymptomatic nocturnal hypoglycemia.

Adult↗
PubMedDate not supplied

Case management: an evaluation at Childrens Hospital Los Angeles.

This prospective, quantitative, and qualitative evaluation of the case management program at CHLA clearly demonstrated the value of professional service coordination of care for children with complex, special health needs. Most specifically, the program documented improvement in three discrete areas of evaluation: 1. Financial, with decreased unnecessary expenditures and increased revenue. 2. Patient satisfaction, documented with validated questionnaires. 3. Clinical process improvement, using quantifiable clinical outcomes. At the very least, case management is an extremely valuable service in the present managed health care environment, and may in fact be indispensable.

Case Management↗