Dag Helge Frøisland

• Engen, Katrine; Holte, Kari; Holten-Andersen, Mads Nikolaj; Klingenberg, Claus Andreas; Wentzel-Larsen, Tore & Frøisland, Dag Helge (2026). Continuous glucose monitoring in neonates at risk of hypoglycaemia: a feasibility study. Archives of Disease in Childhood: Fetal and Neonatal Edition. ISSN 1359-2998. doi: 10.1136/archdischild-2025-330011. Full text in Research Archive Show summary

  Objective Hypoglycaemia is common in neonates. Repeated hypoglycaemic episodes impose a risk of subsequent neurodevelopmental impairment. We aimed to assess the feasibility of using continuous glucose monitoring (CGM) in a group of infants at risk of hypoglycaemia. Design Observational feasibility study. Settings Level 2 neonatal unit, Norway. Patients Infants of mothers with diabetes or infants born large for gestational age. Interventions A blinded CGM-device was applied on the upper lateral thigh of the neonate shortly after birth to record tissue glucose during the infant’s admission at the postnatal ward. Capillary blood glucose screening samples were analysed by oxidase method. Main outcomes Accuracy of tissue glucose values. Tissue glucose variations during the first 3 days after birth. Number of silent hypoglycaemic events. Results We included 25 infants. Tissue glucose values were higher than blood glucose values but estimated discrepancy decreased from 1.0 mmol/L at 6 hours to 0.5 mmol/L at 18 hours of age. The lowest tissue glucose values were observed around 50 hours postnatal age. From 28 hours postnatal age until discharge, CGM detected 49 silent hypoglycaemic events in 10 infants. We observed no significant harm from the devices on skin or subcutaneous tissue. Conclusion Accuracy of tissue glucose increased with time in comparison to capillary blood glucose, but the device could not detect glucose values <2.2 mmol/L. Tissue glucose levels were lowest at ~50 hours postnatal age and hypoglycaemia occurred later than expected. CGM may be a feasible supplement, but approved CGM-devices for neonates are called for.

• Frøisland, Dag Helge & Flagstad, Gro (2023). Medfødt hofteleddsdysplasi i Norge. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/TIDSSKR.23.0399. Full text in Research Archive
• Wendel, Kristina; Pfeiffer, Helle Cecilie; Fugelseth, Drude; Nestaas, Eirik; Domellöf, Magnus & Skålhegg, Bjørn Steen [Show all 42 contributors for this article] (2021). Effects of nutrition therapy on growth, inflammation and metabolism in immature infants: a study protocol of a double-blind randomized controlled trial (ImNuT). BMC Pediatrics. 21. doi: 10.1186/s12887-020-02425-x. Full text in Research Archive Show summary

  Background: Current nutritional management of infants born very preterm results in significant deficiency of the essential fatty acids (FAs) arachidonic acid (ARA) and docosahexaenoic acid (DHA). The impact of this deficit on brain maturation and inflammation mediated neonatal morbidities are unknown. The aim of this study is to determine whether early supply of ARA and DHA improves brain maturation and neonatal outcomes in infants born before 29 weeks of gestation. Methods: Infants born at Oslo University Hospital are eligible to participate in this double-blind randomized controlled trial. Study participants are randomized to receive an enteral FA supplement of either 0.4 ml/kg MCT-oil™ (medium chain triglycerides) or 0.4 ml/kg Formulaid™ (100 mg/kg of ARA and 50 mg/kg of DHA). The FA supplement is given from the second day of life to 36 weeks' postmenstrual age (PMA). The primary outcome is brain maturation assessed by Magnetic Resonance Imaging (MRI) at term equivalent age. Secondary outcomes include quality of growth, incidence of neonatal morbidities, cardiovascular health and neuro-development. Target sample size is 120 infants (60 per group), this will provide 80% power to detect a 0.04 difference in mean diffusivity (MD, mm2/sec) in major white matter tracts on MRI. Discussion: Supplementation of ARA and DHA has the potential to improve brain maturation and reduce inflammation related diseases. This study is expected to provide valuable information for future nutritional guidelines for preterm infants. Trial registration: Clinicaltrials.gov ID: NCT03555019 . Registered 4 October 2018- Retrospectively registered.

• Svensson, Jannet; Sildorf, Stine Møller; Bøjstrup, Julie; Kreiner, Svend; Skrivarhaug, Torild & Hanberger, Lena [Show all 10 contributors for this article] (2020). The DISABKIDS generic and diabetes-specific modules are valid but not directly comparable between Denmark, Sweden, and Norway. Pediatric Diabetes. ISSN 1399-543X. 21(5), p. 900–908. doi: 10.1111/pedi.13036. Full text in Research Archive Show summary

  Background: Type 1 Diabetes (T1D) has a negative impact on psychological and overall well-being. Screening for Health-related Quality of Life (HrQoL) and addressing HrQoL issues in the clinic leads to improved well-being and metabolic outcomes. The aim of this study was to translate the generic and diabetes-specific validated multinational DISABKIDS® questionnaires into Danish, and then determine their validity and reliability. Methods: The questionnaires were translated using a validated translation procedure and completed by 99 children and adolescents from our diabetes-department; all diagnosed with T1D and were aged between 8 and 18 years old. The Rasch and the graphical log linear Rasch model (GLLRM) were used to determine validity. Monte Carlo methods and Cronbach's α were used to confirm reliability. Results: The data did not fit a pure Rasch model but did fit a GLLRM when item six in the independence scale is excluded. The six subscales measure different aspects of HrQoL indicating that all the subscales are necessary. The questionnaire shows local dependency between items and differential item functioning (DIF). Therefore age, gender, and glycated hemoglobin (HbA1c) levels must be taken into account when comparing HrQoL between groups. Conclusions: The Danish versions of the DISABKIDS® chronic-generic and diabetes-specific modules provide valid and objective measurements with adequate reliability. These Danish versions are useful tools for evaluating HrQoL in Danish patients with T1D. However, guidelines on how to manage DIF and local independence will be required, and item six should be rephrased. Keywords: Adolescents; Children; Chronic condition; DISABKIDS; Diabetes type 1; HrQoL; Rasch.

• Roberts, Calum T.; Owen, Louise S.; Frøisland, Dag Helge; Doyle, Lex W; Davis, Peter G & Manley, Brett J. (2019). Predictors and Outcomes of Early Intubation in Infants Born at 28-36 Weeks of Gestation Receiving Noninvasive Respiratory Support. Journal of Pediatrics. ISSN 0022-3476. 216, p. 109–116.e1. doi: 10.1016/j.jpeds.2019.09.026. Full text in Research Archive Show summary

  Abstract OBJECTIVE: To identify predictors and outcomes of early intubation in preterm infants with respiratory distress, and predictors of need for brief respiratory support (≤1 day). STUDY DESIGN: Secondary analysis of data from a randomized trial comparing nasal high-flow with continuous positive airway pressure as primary respiratory support in preterm infants born at 28-36 weeks of gestation. Intubation was assessed within 72 hours of randomization. RESULTS: There were 564 included infants with a mean (SD) gestational age of 32.0 (2.2) weeks and birth weight 1744 (589) g; 76 infants (13.5%) received early intubation. On multivariable analysis, lower gestational age and higher pre-randomization fraction of inspired oxygen (FiO2) predicted intubation. A test based on gestational age of <30 weeks and an FiO2 of ≥0.30 produced a likelihood ratio of 9.1. Intubation was associated with prolonged duration of respiratory support and supplemental oxygen, with pneumothorax and nasal trauma, and in infants born at <32 weeks of gestational, with bronchopulmonary dysplasia and patent ductus arteriosus requiring treatment. Greater gestational age and lower FiO2 predicted the need for ≤1 day of respiratory support. A test based on a gestational age of ≥34 weeks and an FiO2 of 0.21 produced a likelihood ratio of 4.7. CONCLUSIONS: In preterm infants 28-36 week of gestation receiving primary noninvasive respiratory support, lower gestational age, and higher FiO2 predicted need for intubation within 72 hours. Intubation was associated with adverse respiratory outcomes. Greater gestational age and lower FiO2 predicted need for ≤1 day of respiratory support. It may be reasonable to defer the use of respiratory support in more mature infants with low FiO2 requirements. TRIAL REGISTRATION AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY: ACTRN12613000303741.

• Manley, Brett J.; Roberts, Calum T.; Frøisland, Dag Helge; Doyle, Lex W; Davis, Peter G. & Owen, Louise S. (2018). Refining the Use of Nasal High-Flow Therapy as Primary Respiratory Support for Preterm Infants. Journal of Pediatrics. ISSN 0022-3476. 196, p. 65–70.e1. doi: 10.1016/j.jpeds.2018.01.031. Full text in Research Archive
• Roberts, Calum T.; Owen, Louise S.; Manley, Brett J.; Frøisland, Dag Helge; Donath, Susan M. & Dalziel, Kim M. [Show all 11 contributors for this article] (2016). Nasal high-flow therapy for primary respiratory support in preterm infants. New England Journal of Medicine. ISSN 0028-4793. 375(12), p. 1142–1151. doi: 10.1056/NEJMoa1603694. Full text in Research Archive
• Mills, Bernice A.; Janvier, Annie; Argus, Brenda M; Davis, Peter G & Frøisland, Dag Helge (2015). Attitudes of Australian neonatologists to resuscitation of extremely preterm infants. Journal of Paediatrics and Child Health. ISSN 1034-4810. 51(9), p. 870–874. doi: 10.1111/jpc.12862. Full text in Research Archive
• Frøisland, Dag Helge & Årsand, Eirik (2015). Integrating visual dietary documentation in mobile-phone-based self-management application for adolescents with type 1 diabetes. Journal of Diabetes Science and Technology. 9(3), p. 541–548. doi: 10.1177/1932296815576956. Full text in Research Archive
• Frøisland, Dag Helge; Graue, Marit; Markestad, Trond; Skrivarhaug, Torild; Wentzel-Larsen, Tore & Dahl-Jørgensen, Knut (2013). Health-related quality of life among Norwegian children and adolescents with type 1 diabetes on intensive insulin treatment: a population-based study. Acta Paediatrica. ISSN 0803-5253. 102(9), p. 889–895. doi: 10.1111/apa.12312. Full text in Research Archive
• Wisting, Line Norøm; Frøisland, Dag Helge; Skrivarhaug, Torild; Dahl-Jørgensen, Knut & Rø, Øyvind (2013). Disturbed Eating Behavior and Omission of Insulin in Adolescents Receiving Intensified Insulin Treatment A nationwide population-based study. Diabetes Care. ISSN 0149-5992. 36(11), p. 3382–3387. doi: 10.2337/dc13-0431. Full text in Research Archive
• Wisting, Line Norøm; Frøisland, Dag Helge; Skrivarhaug, Torild; Dahl-Jørgensen, Knut & Rø, Øyvind (2013). Psychometric Properties, Norms, and Factor Structure of the Diabetes Eating Problem Survey - Revised in a Large Sample of Children and Adolescents With Type 1 Diabetes. Diabetes Care. ISSN 0149-5992. 36(8), p. 2198–2202. doi: 10.2337/dc12-2282. Full text in Research Archive
• Frøisland, Dag Helge; Årsand, Eirik & Skårderud, Finn (2012). Improving Diabetes Care for Young People With Type 1 Diabetes Through Visual Learning on Mobile Phones: Mixed-Methods Study. Journal of Medical Internet Research (JMIR). ISSN 1439-4456. 14(4), p. 113–125. doi: 10.2196/jmir.2155. Full text in Research Archive Show summary

  Background: Only 17% of Norwegian children and adolescents with diabetes achieve international treatment goals measured by glycated hemoglobin (HbA1c). Classic patient–physician consultations seem to be poorly adapted to young children. New strategies that are better attuned to young people to improve support of adolescents’ self-management of diabetes need to be tested and evaluated. Objective: (1) To explore how applications for mobile phones can be used in follow-up of adolescents with type 1 diabetes, and (2) to use the findings to guide further development of the applications and as a basis for future studies. Method: We pilot tested two mobile phone applications: (1) an application that contained a picture-based diabetes diary to record physical activity and photos taken with the phone camera of food eaten, where the phone also communicated with the glucometer by Bluetooth technology to capture blood glucose values, and (2) a Web-based, password-secured and encrypted short message service (SMS), based on access using login passwords received via SMS to be used by participants to send messages to their providers when they faced obstacles in everyday life, and to send educational messages to the participants. At the end of the 3-month pilot study, 12 participants (7 girls and 5 boys ) aged 13–19 years completed semistructured interviews. The participants had a mean HbA1c value of 8.3 (SD 0.3), mean age of 16.2 (SD 1.7) years, mean body mass index of 23.3 (SD 3.2) kg/m2, and mean diabetes duration of 7.5 (SD 4.6) years. We applied three additional measurements: change in metabolic control as measured by HbA1c, the System Usability Scale, and diabetes knowledge. Results: From the interviews, three main categories emerged: visualization, access, and software changes. Participants appreciated the picture-based diary more than the SMS solution. Visualization of cornerstones in diabetes self-care (ie, diet, insulin dosage, physical activity, and pre- and postprandial glucose measurements all transformed into one picture) in the mobile diary was found to be an important educational tool through reflections in action. This led to a change in participants’ applied knowledge about the management of their disease. Additional measurements supplemented and supported the qualitative findings. However, changes in HbA1c and participants’ theoretical knowledge as tested by a 27-item questionnaire, based on a national health informatics’ diabetes quiz, before and after the intervention were not statistically significant (P = .38 and P = .82, respectively, paired-samples t test). Participants suggested additional functionality, and we will implement this in the design of the next software generation. Conclusion: Participants reported an increased understanding of applied knowledge, which seem to positively affect diabetes self-care. Visual impressions seem well adapted to the maturation of the adolescent brain, facilitating the link between theoretical knowledge and executive functions. SMS gave the adolescents a feeling of increased access and security. Participants gave valuable input for further development of these applications.

• Frøisland, Dag Helge; Markestad, Trond; Wentzel-Larsen, Tore; Skrivarhaug, Torild; Dahl-Jørgensen, Knut & Graue, Marit (2012). Reliability and validity of the Norwegian child and parent versions of the DISABKIDS Chronic Generic Module (DCGM-37) and Diabetes-Specific Module (DSM-10). Health and Quality of Life Outcomes. 10. doi: 10.1186/1477-7525-10-19. Full text in Research Archive Show summary

  Background International guidelines on type 1 diabetes advocate routine screening of health-related quality of life (HRQOL). DISABKIDS questionnaires are the first instruments developed across cultures and nations to provide age-appropriate measures of HRQOL in children with chronic diseases. DISABKIDS includes a Chronic Generic Module 37 (DCGM-37) and disease-specific modules. The purpose of this study was to examine reliability and validity of the Norwegian versions of the DISABKIDS questionnaires in children and adolescents with type 1 diabetes. Methods The DCGM-37 and the Diabetes Specific Module-10 (DDM-10) were translated into Norwegian using standard forward-backward translation. Eight to 19 year old children and adolescents with type 1 diabetes scheduled for routine follow-up at three diabetic clinics in Norway and one of their parents were invited to complete the DCGM-37 and the DDM-10. Internal consistency was determined using Cronbach's alpha. Results were compared with those of the Child Health Questionnaire Children Form-87 (CHQ-CF87) and Child Health Questionnaire Parent Form-50 which are established generic questionnaires. DISABKIDS results were related to age, gender, duration of diabetes, mode of insulin delivery and metabolic control. Clinical data were obtained from the Norwegian Childhood Diabetes Registry. Results Of 198 eligible child-parent dyads, 103 (52%) completed the questionnaires. Mean age was 13.6 (2.6), range 8-19 yrs, 52% were boys. Cronbach's alpha was > 0.70 for all the DISABKIDS sub-scales except two (physical ability and social inclusion). There were moderate to high correlations (0.65-0.81) between the DISABKIDS scales and mental/emotional sub-scales of CHQ-CF87. Increasing age and higher HbA1c were significantly associated with reduced HRQOL scores. Parents tended to score their child's HRQOL lower than the children/adolescents themselves. Conclusions The study shows that the DISABKIDS instruments are applicable to a Norwegian childhood diabetes population. They seem to be a relevant supplement to other clinical indicators in medical practice and research

• Årsand, Eirik; Frøisland, Dag Helge; Skrøvseth, Stein Olav; Chomutare, Taridzo; Tatara, Naoe & Hartvigsen, Gunnar [Show all 7 contributors for this article] (2012). Mobile Health Applications to Assist Patients with Diabetes: Lessons Learned and Design Implications. Journal of Diabetes Science and Technology. 6(5), p. 1197–1206. doi: 10.1177/193229681200600525. Full text in Research Archive
• Frøisland, Dag Helge; Solevåg, Anne Lee & Markestad, Trond (2009). Insulinpumpe ved behandling av diabetes hos barn og unge. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 129(11), p. 1094–1097. Full text in Research Archive

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• Frøisland, Dag Helge; Graue, Marit; Markestad, Trond; Wentzel-Larsen, Tore; Skrivarhaug, Torild & Dahl-Jørgensen, Knut (2017). Norwegian adolescents with Type 1 diabetes undergoing intensive insulin treatment generally report levels of diabetes-related emotional distress. Furthermore, the short version of the Problem Areas in diabetes (PAID5)questionnaire functions as a valid and practical instrument for routine clinical avaluations. Full text in Research Archive Show summary

  https://diabetesjournals.org/diabetes/issue/66/Supplement_1 Norwegian Adolescents score low on diabetes-related distress measured with PAID. A small group have a high score on PAID associated with low score on WHO-5. We suggest PAID-5 as a useful short screening tool among adolescents with type 1 diabetes in order to reveal those with elevated diabetes-related emotional distress.

• Frøisland, Dag Helge (2017). Nicotine withdrawal syndrome in a newborn baby after maternal use of oral applied moist tobacco (snus), should result in greater awareness to the use of snus among pregnant women. Acta Paediatrica. ISSN 0803-5253. 106(9), p. 1531–1531. doi: 10.1111/apa.13913. Full text in Research Archive
• Wisting, Line Norøm; Frøisland, Dag Helge; Skrivarhaug, Torild; Dahl-Jørgensen, Knut; Bang, Lasse & Natvig, Henrik [Show all 8 contributors for this article] (2015). Type 1 diabetes and Disturbed Eating Behaviors - Comorbidity, Prevalence, Psychological Correlates and Metabolic Control. Full text in Research Archive
• Wisting, Line Norøm; Frøisland, Dag Helge; Skrivarhaug, Torild; Dahl-Jørgensen, Knut; Bang, Lasse & Natvig, Henrik [Show all 8 contributors for this article] (2015). Comorbid type 1 diabetes and disturbed eating behaviors - assessment, prevalence, psychological correlates and metabolic Control. Full text in Research Archive
• Frøisland, Dag Helge; Graue, Marit; Markestad, Trond; Wenzel-Larsen, Tore; Drivvoll, A. K. & Skrivarhaug, Torild (2012). Health Related Quality of Life Among Norwegian Children and Adolescents with Type 1 Diabetes on Intensive Insulin Treatment. A Population Based Study. Full text in Research Archive
• Frøisland, Dag Helge (2012). Barn og unge diabetes, helse og livskvalitet. Full text in Research Archive
• Frøisland, Dag Helge (2012). Barn og unge med diabetes : hvordan har de det? Full text in Research Archive
• Frøisland, Dag Helge (2012). Diabetes care for young persons with Type 1 diabetes using smart phone applications. Full text in Research Archive
• Frøisland, Dag Helge (2012). Barn og unge med diabetes :hvordan har de det? Full text in Research Archive
• Frøisland, Dag Helge & Skaare, Sigrun Dancke (2012). App gir bedre diabetes-forståelse. Forskning.no. ISSN 1891-635X. Full text in Research Archive
• Frøisland, Dag Helge; Dahl-Jørgensen, K.; Markestad, T; Årsand, Eirik & Skaarderud, Finn (2011). Innovation in Practice: Development of Mobile Phone Applications, Involving Adolescents with Type 1 Diabetes. A Pilot Study. Full text in Research Archive
• Frøisland, Dag Helge (2011). Reliability and Validity of the Norwegian Version of DISABKIDS Questionnaires. Full text in Research Archive
• Frøisland, Dag Helge (2010). Den vanskelige nyfødtmedisinen. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 130(16), p. 1596–1596. Full text in Research Archive
• Skårderud, Finn; Söderström, Kerstin & Frøisland, Dag Helge (2009). A dialogue between projects on competences and dysfunctional behaviour in clinical populations. Full text in Research Archive

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