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Vassilopoulos A, Valenzuela JM, Tsikis J, Reitblat L, Blanco EJ, Nicholls S, Wolf RM. Pediatric diabetes patients infrequently access outpatient psychology services following screening and referral: Implications for practice. CHILDRENS HEALTH CARE 2019. [DOI: 10.1080/02739615.2019.1653763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Areti Vassilopoulos
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, USA
- Department of Pediatrics, The Johns Hopkins School of Medicine, Baltimore, USA
| | - Jessica M. Valenzuela
- Department of Pediatrics, Salah Foundation Children’s Hospital at Broward Health Medical Center, Fort Lauderdale, USA
- College of Psychology, Nova Southeastern University, Fort Lauderdale, USA
| | - Joanna Tsikis
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, USA
- Department of Pediatrics, The Johns Hopkins School of Medicine, Baltimore, USA
| | - Lital Reitblat
- Department of Pediatrics, Joe DiMaggio Children’s Hospital, Hollywood, USA
| | - Ernesto J. Blanco
- Department of Pediatrics, Salah Foundation Children’s Hospital at Broward Health Medical Center, Fort Lauderdale, USA
| | - Shelley Nicholls
- Patient Education Department, University of Miami Diabetes Research Institute, Miami, USA
| | - Risa M. Wolf
- Department of Pediatrics, The Johns Hopkins School of Medicine, Baltimore, USA
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Enlow PT, Brown Kirschman KJ, Mentrikoski J, Szabo MM, Butz C, Aballay AM, Duncan CL. The Role of Youth Coping Strategies and Caregiver Psychopathology in Predicting Posttraumatic Stress Symptoms in Pediatric Burn Survivors. J Burn Care Res 2019; 40:620-626. [PMID: 31032515 DOI: 10.1093/jbcr/irz067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Caregiver psychosocial functioning is repeatedly linked with postburn adjustment in pediatric burn survivors. However, few studies have examined youth characteristics as predictors, such as coping strategies. Furthermore, research has not explored how caregiver psychopathology and youth coping strategies interact to predict youth postburn adjustment. The aim of this study was to examine how youth coping strategies and caregiver anxiety and depression predict youth posttraumatic stress symptoms (PTSS). Forty-six youth between 7 and 17 years old (M = 12.5, SD = 2.65) and their caregivers were recruited from two U.S. burn centers. Youth and parents completed questionnaires that assessed demographics, caregiver anxiety, and depression, youth self-reports of coping strategies, and youth PTSS. Burn injury data (e.g. TBSA, time since injury) was obtained from medical record reviews. Hierarchical regressions were conducted with caregiver psychopathology (depression, anxiety), youth coping strategies (active, avoidant, distraction, social support), and the interaction between caregiver psychopathology and youth coping strategies as predictors and youth PTSS as the outcome variable. Higher levels of caregiver anxiety (βs = .36 to .42) and avoidance coping (βs = .38 to .43) were associated with more PTSS. Caregiver anxiety and depression moderated the association between youth use of distraction coping and youth PTSS. These findings reinforce the importance of assessing psychosocial functioning in pediatric burn survivors and their caregivers, and providing interventions to promote better psychosocial outcomes. Coping strategies may help reduce PTSS and buffer against the harmful influence of caregiver psychopathology. Future research may wish to pilot interventions that promote healthy coping.
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Affiliation(s)
- Paul T Enlow
- Center for Healthcare Delivery Science, Nemours/A.I. duPont Hospital for Children, Wilmington, Delaware
| | | | - Janelle Mentrikoski
- Developmental and Behavioral Sciences, Children's Mercy, Kansas City, Missouri
| | - Margo M Szabo
- Department of Child & Adolescent Psychiatry and Behavioral Sciences/Division of Gastroenterology, Hepatology, & Nutrition, Children's Hospital of Philadelphia, Pennsylvania
| | - Catherine Butz
- Department of Psychology, Nationwide Children's Hospital, Columbus, Ohio
| | - Ariel M Aballay
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Christina L Duncan
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, Pennsylvania.,Department of Psychology, West Virginia University, Morgantown, West Virginia
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Rechenberg K, Szalacha L, Salloum A, Grey M. State and Trait Anxiety and Diabetes Outcomes in Youth With Type 1 Diabetes. DIABETES EDUCATOR 2019; 45:477-483. [PMID: 31364483 DOI: 10.1177/0145721719866146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE The purpose of this exploratory pilot study was to examine the associations of state and trait anxiety with glycemic control, self-management, and diabetes-specific quality of life (QOL) in youth 10 to 16 years of age with type 1 diabetes (T1D). METHODS Bivariate Pearson correlations and multiple linear regression modeling were conducted to examine the relationship among anxiety symptoms, hemoglobin A1C (A1C), self-management, QOL, and covariates. RESULTS A sample of 67 adolescents was 50.7% female, and 87.1% were non-Hispanic white, with a mean ± SD age of 13.4 ± 1.85 years and an A1C of 8.3% ± 1.2% (67 mmol/mol). Higher state anxiety was correlated with older age. Better self-management was correlated with lower trait anxiety and lower state anxiety. Higher state and trait anxiety were associated with poorer self-management. Higher state anxiety was associated with higher A1C. Higher trait anxiety was associated with poorer diabetes-specific QOL. CONCLUSIONS State and trait anxiety may differentially affect diabetes outcomes. State anxiety may be a modifiable target for physiologic (A1C) and psychosocial (QOL) outcomes in youth with T1D, while trait anxiety may be a modifiable target for psychosocial outcomes (QOL). Anxiety symptoms should be assessed at regular clinic visits. Interventions to improve anxiety symptoms may in turn improve physiologic and psychosocial outcomes.
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Affiliation(s)
| | - Laura Szalacha
- University of South Florida, College of Nursing, Tampa, Florida
| | - Alison Salloum
- University of South Florida, College of Social Work, Tampa, Florida
| | - Margaret Grey
- Yale University, School of Nursing and School of Medicine, West Haven, Connecticut
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Green C, Jung HY, Wu X, Abramson E, Walkup JT, Ford JS, Grinspan ZM. Do Children with Special Health Care Needs with Anxiety have Unmet Health Care Needs? An Analysis of a National Survey. Matern Child Health J 2019; 23:1220-1231. [PMID: 31292839 DOI: 10.1007/s10995-019-02759-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To describe differences in health care needs between Children with Special Health Care Needs (CSHCN) with and without anxiety and examine the association between anxiety and unmet health care needs. METHODS We analyzed data from the 2009/2010 national survey of CSHCN. The independent variable was anxiety. The main outcomes were health care needs and unmet needs. Covariates included demographics, other co-morbid conditions, and the presence and quality of a medical home. We used bivariate analyses and multivariable logistic regression to assess the relationships among anxiety, covariates, and the outcomes. We stratified our analysis by age (6-11 years, 12-17 years). Propensity score matched paired analysis was used as a sensitivity analysis. RESULTS Our final sample included 14,713 6-11 year-olds and 15,842 12-17-year-olds. Anxiety was present in 16% of 6-11 year-olds and 23% or 12-17 year-olds. In bivariate analyses, CSHCN with anxiety had increased health care needs and unmet needs, compared to CSHCN without anxiety. In multivariable analyses, only children 12-17 years old with anxiety had increased odds of having an unmet health care need compared to those children without anxiety (OR 1.44 [95% CI 1.17-1.78]). This was confirmed in the propensity score matching analysis (OR 1.12, [95% CI 1.02-1.22]). The specific unmet needs for older CSHCN with anxiety were mental health care (OR 1.54 [95% CI 1.09-2.17]) and well child checkups (OR 2.01 [95% CI 1.18-3.44]). CONCLUSION Better integration of the care for mental and physical health is needed to ensure CSHCN with anxiety have all of their health care needs met.
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Affiliation(s)
- Cori Green
- New York Presbyterian/Weill Cornell Medicine Department of Pediatrics, 525 East 68th Street, Room 628b, Box 139, New York, NY, 10065, USA.
| | - Hye-Young Jung
- New York Presbyterian/Weill Cornell Medicine Department of Healthcare Policy & Research, New York, NY, USA
| | - Xian Wu
- New York Presbyterian/Weill Cornell Medicine Department of Healthcare Policy & Research, New York, NY, USA
| | - Erika Abramson
- New York Presbyterian/Weill Cornell Medicine Department of Pediatrics, 525 East 68th Street, Room 628b, Box 139, New York, NY, 10065, USA.,New York Presbyterian/Weill Cornell Medicine Department of Healthcare Policy & Research, New York, NY, USA
| | - John T Walkup
- Ann & Robert H. Lurie Children's Hospital of Chicago/Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Zachary M Grinspan
- New York Presbyterian/Weill Cornell Medicine Department of Pediatrics, 525 East 68th Street, Room 628b, Box 139, New York, NY, 10065, USA.,New York Presbyterian/Weill Cornell Medicine Department of Healthcare Policy & Research, New York, NY, USA
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Dhada BL, Blackbeard DR. Caregivers of children with diabetes mellitus: challenges of caring for and perceptions of consultations in a South African public sector context. S Afr Fam Pract (2004) 2019. [DOI: 10.1080/20786190.2019.1606491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- BL Dhada
- Department of Paediatrics & Child Health, Grey’s Hospital, Pietermaritzburg, South Africa
- Department of Paediatrics & Child Health, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - DR Blackbeard
- Department of Clinical Psychology, Grey’s Hospital, Pietermaritzburg, South Africa
- Department of Psychiatry, University of KwaZulu-Natal, Pietermaritzburg, South Africa
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Weissberg-Benchell J, Vesco AT, Rychlik K. Diabetes camp still matters: Relationships with diabetes-specific distress, strengths, and self-care skills. Pediatr Diabetes 2019; 20:353-360. [PMID: 30793473 DOI: 10.1111/pedi.12836] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/10/2019] [Accepted: 02/11/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Prior studies suggest diabetes camps improve psychosocial well-being in youth with type 1 diabetes but these studies suffer from variable levels of rigor. The present study assessed associations between camp participation and diabetes distress, perceived independence in diabetes self-care, and diabetes strengths in a large sample of children, adolescents, and their parents across 44 camps in the United States. Analyses compared viewpoints of study participants, identified moderators of change, and assessed perceived benefits of camp participation. METHODS There were 2488 youth and 2563 parents consented for participation in the online survey. Participants reported diabetes distress and perceived independence in youth care, their new experiences and best parts of camp, and changes in behavior following camp. T-tests, regressions, Cohen's d, and relative frequencies were used as appropriate to assess baseline differences between reporters, pre-post outcome differences, and moderators of change. RESULTS Parents as compared to youth reported higher pre-camp distress and lower perception of youth independence in self-care. Youth experienced a statistically significant decrease in distress and increase in independence in self-care. Diabetes strengths did not change. Higher A1c prior to camp was associated with higher levels of distress across camp participation. Campers and their parents endorsed a high frequency of positive firsts, bests, and benefits of camp. CONCLUSIONS Data from a large sample youth with type 1 diabetes across multiple camps showed broad-based psychosocial benefits of camp participation.
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Affiliation(s)
- Jill Weissberg-Benchell
- Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Anthony T Vesco
- Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Karen Rychlik
- Stanley Manne Children's Research Institute, Biostatistics Research Core, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Yayan EH, Zengin M, Erden Karabulut Y, Akıncı A. The relationship between the quality of life and depression levels of young people with type I diabetes. Perspect Psychiatr Care 2019; 55:291-299. [PMID: 30614548 DOI: 10.1111/ppc.12349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 11/11/2018] [Accepted: 12/09/2018] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The aim of this study is to examine the relationship between the quality of life and depression levels of the youth with type I diabetes. DESIGN AND METHODS: The study was a cross-sectional descriptive study. FINDINGS It was found that there is a negative correlation between participants' HbA1c levels and quality of life, and a positive correlation between HbA1c levels and depression. It was determined that quality of life and depression are significant predictors of HbA1c (R 2 = 0.72, P < 0.01). PRACTICE IMPLICATIONS The depression levels of the young people with increased and their metabolic control was affected negatively as the quality of life levels decreased. Depression measurements should be made during the routine control of youth with diabetes who have difficulty in maintaining metabolic control.
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Affiliation(s)
- Emriye Hilal Yayan
- Department of Child Health and Disease Nursing, Health Sciences of Faculty, İnönü University, Malatya, Turkey
| | - Mürşide Zengin
- Department of Nursing, School of Health, Adıyaman University, Adıyaman, Turkey
| | | | - Ayşehan Akıncı
- Department of Pediatric Endocrinology, İnönü University, Turgut Özal Medical Center, Malatya, Turkey
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Troncone A, Cascella C, Chianese A, Zanfardino A, Confetto S, Piscopo A, Iafusco D. Parental assessment of disordered eating behaviors in their children with type 1 diabetes: A controlled study. J Psychosom Res 2019; 119:20-25. [PMID: 30947813 DOI: 10.1016/j.jpsychores.2019.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/03/2019] [Accepted: 02/03/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The purpose of this research is to examine the presence of disordered eating behaviors (DEBs) in youths with type 1 diabetes (T1D) according to their parents' evaluations. The roles of demographic and diabetes-related variables were also analyzed. METHODS In 54 patients with T1D (aged 10.07-15.08) and in 54 age- and gender-matched healthy controls, DEBs were assessed using a parent-report standardized measure. BMI was calculated from height and weight. Glycemic control was assessed based on the most recent glycosylated hemoglobin value (HbA1c). The association of demographic and clinical factors with DEBs was evaluated through correlation and linear regression analyses. RESULTS DEBs were observed more frequently in participants with T1D (33.3%) than in controls (11%) (χ2 = 6.501, p = .04). The clinical sample obtained a higher score than controls in PEBEQ total score (t(106) = 2.464, p = .01), as well as in the Exaggerated interest in food (t(106) = 2.723, p = .008) and Rejection/disinterest in food subscales (t(106) = 2.216, p = .01). No gender differences were observed. In participants with T1D, but not in controls, PEBEQ total score was positively correlated with age (r = 0.203, p = .04), HbA1c (r = 0.335, p = .01), and zBMI (r = 0.298, p = .002); HbA1c (standardized beta =0.284, p = .04) was found to uniquely predict the PEBEQ total score. CONCLUSION Parents' evaluations may contribute to prompt detection of DEBs, which is crucial in developing appropriate strategies for timely intervention, especially during adolescence.
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Survonen A, Salanterä S, Näntö‐Salonen K, Sigurdardottir AK, Suhonen R. The psychosocial self-efficacy in adolescents with type 1 diabetes. Nurs Open 2019; 6:514-525. [PMID: 30918702 PMCID: PMC6419123 DOI: 10.1002/nop2.235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 10/29/2018] [Accepted: 11/20/2018] [Indexed: 01/09/2023] Open
Abstract
AIM To analyse psychosocial self-efficacy in adolescents with type 1 diabetes, evaluate associations between self-efficacy and metabolic control and background variables and determine psychometric properties of the Finnish Diabetes Empowerment Scale (Fin-DES-28). DESIGN A descriptive correlational survey. METHODS The data were collected with the Finnish Diabetes Empowerment Scale from 13-16-year-old adolescents with type 1 diabetes (N = 189, 34%) in one university hospital district area in 2014. RESULTS The level of psychosocial self-efficacy was quite good. The highest scores were in managing the psychosocial aspects of diabetes, followed by assessing dissatisfaction and readiness to change and setting and achieving diabetes goals. The self-efficacy did not correlate with metabolic control or background variables. A positive association was found between self-efficacy and understanding of diabetes and its treatment, adjustment of diabetes to life and the relationship with the doctor and the nurse. The internal consistency of the Finnish Diabetes Empowerment Scale was adequate. The low response rate limits generalization.
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Affiliation(s)
- Anne Survonen
- Department of Nursing Science, Turku University HospitalUniversity of TurkuTurkuFinland
| | - Sanna Salanterä
- Department of Nursing Science, Turku University HospitalUniversity of TurkuTurkuFinland
| | | | - Arun K. Sigurdardottir
- School of Health SciencesUniversity of AkureyriAkureyriIceland
- Akureyri HospitalAkureyriIceland
| | - Riitta Suhonen
- Department of Nursing ScienceUniversity of Turku and Turku University Hospital, and City of Turku, Welfare DivisionTurkuFinland
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Kwon HJ, Lee YA, Shin CH, Kim K. Association between physical activity and self-rated health in pediatric patients with type 1 diabetes mellitus. J Exerc Rehabil 2019; 15:155-159. [PMID: 30899752 PMCID: PMC6416507 DOI: 10.12965/jer.1836576.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/08/2019] [Indexed: 01/09/2023] Open
Abstract
Patients with type 1 diabetes mellitus (T1DM) tend to experience poor self-rated health. However, few studies have examined the association between physical activity and self-rated health in pediatric patients with T1DM. The purpose of this study was to investigate the association between regular physical activity, regular muscle strength exercise, and self-rated health in pediatric patients with T1DM who lacked diabetes care. The eligible participants for this study were 37 pediatric patients with T1DM aged 9 to 17 years. Physical activity was divided into regular physical activity and regular muscle strength exercise to analyze the relationship with self-rated health using binomial logistic regression analysis. The results showed that self-rated health of pediatric patients with T1DM who did not engage in regular muscle strength exercise was significantly lower than those who did (odds ratio [OR], 0.100; 95% confidence interval [CI], 0.012-0.855; P<0.05). However, the association between regular physical activity and self-rated health was not statistically significant (OR, 0.211; 95% CI, 0.041-1.088; P=0.06). In conclusion, regular muscle strength exercise in pediatric patients with T1DM who lacked diabetes care was effective in contributing to optimal self-rated health. Future research is needed to collect physical activity data using objective assessment methods and to analyze the association between variables applying diverse factors for pediatric patients with T1DM, which might be able to effect on their health.
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Affiliation(s)
- Hyun Jin Kwon
- Department of Kinesiology and Health, College of Education Human Development, Georgia State University, Atlanta, GA, USA
| | - Young Ah Lee
- Department of Pediatrics, College of Medicine, Seoul National University Children's Hospital, Seoul, Korea
| | - Choong Ho Shin
- Department of Pediatrics, College of Medicine, Seoul National University Children's Hospital, Seoul, Korea
| | - Kijeong Kim
- School of Exercise & Sport Science, College of Natural Sciences, University of Ulsan, Ulsan, Korea
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Law E, Fisher E, Eccleston C, Palermo TM. Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database Syst Rev 2019; 3:CD009660. [PMID: 30883665 PMCID: PMC6450193 DOI: 10.1002/14651858.cd009660.pub4] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Psychological therapies for parents of children and adolescents with chronic illness aim to improve parenting behavior and mental health, child functioning (behavior/disability, mental health, and medical symptoms), and family functioning.This is an updated version of the original Cochrane Review (2012) which was first updated in 2015. OBJECTIVES To evaluate the efficacy and adverse events of psychological therapies for parents of children and adolescents with a chronic illness. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, and trials registries for studies published up to July 2018. SELECTION CRITERIA Included studies were randomized controlled trials (RCTs) of psychological interventions for parents of children and adolescents with a chronic illness. In this update we included studies with more than 20 participants per arm. In this update, we included interventions that combined psychological and pharmacological treatments. We included comparison groups that received either non-psychological treatment (e.g. psychoeducation), treatment as usual (e.g. standard medical care without added psychological therapy), or wait-list. DATA COLLECTION AND ANALYSIS We extracted study characteristics and outcomes post-treatment and at first available follow-up. Primary outcomes were parenting behavior and parent mental health. Secondary outcomes were child behavior/disability, child mental health, child medical symptoms, and family functioning. We pooled data using the standardized mean difference (SMD) and a random-effects model, and evaluated outcomes by medical condition and by therapy type. We assessed risk of bias per Cochrane guidance and quality of evidence using GRADE. MAIN RESULTS We added 21 new studies. We removed 23 studies from the previous update that no longer met our inclusion criteria. There are now 44 RCTs, including 4697 participants post-treatment. Studies included children with asthma (4), cancer (7), chronic pain (13), diabetes (15), inflammatory bowel disease (2), skin diseases (1), and traumatic brain injury (3). Therapy types included cognitive-behavioural therapy (CBT; 21), family therapy (4), motivational interviewing (3), multisystemic therapy (4), and problem-solving therapy (PST; 12). We rated risk of bias as low or unclear for most domains, except selective reporting bias, which we rated high for 19 studies due to incomplete outcome reporting. Evidence quality ranged from very low to moderate. We downgraded evidence due to high heterogeneity, imprecision, and publication bias.Evaluation of parent outcomes by medical conditionPsychological therapies may improve parenting behavior (e.g. maladaptive or solicitous behaviors; lower scores are better) in children with cancer post-treatment and follow-up (SMD -0.28, 95% confidence interval (CI) -0.43 to -0.13; participants = 664; studies = 3; SMD -0.21, 95% CI -0.37 to -0.05; participants = 625; studies = 3; I2 = 0%, respectively, low-quality evidence), chronic pain post-treatment and follow-up (SMD -0.29, 95% CI -0.47 to -0.10; participants = 755; studies = 6; SMD -0.35, 95% CI -0.50 to -0.20; participants = 678; studies = 5, respectively, moderate-quality evidence), diabetes post-treatment (SMD -1.39, 95% CI -2.41 to -0.38; participants = 338; studies = 5, very low-quality evidence), and traumatic brain injury post-treatment (SMD -0.74, 95% CI -1.25 to -0.22; participants = 254; studies = 3, very low-quality evidence). For the remaining analyses data were insufficient to evaluate the effect of treatment.Psychological therapies may improve parent mental health (e.g. depression, anxiety, lower scores are better) in children with cancer post-treatment and follow-up (SMD -0.21, 95% CI -0.35 to -0.08; participants = 836, studies = 6, high-quality evidence; SMD -0.23, 95% CI -0.39 to -0.08; participants = 667; studies = 4, moderate-quality evidence, respectively), and chronic pain post-treatment and follow-up (SMD -0.24, 95% CI -0.42 to -0.06; participants = 490; studies = 3; SMD -0.20, 95% CI -0.38 to -0.02; participants = 482; studies = 3, respectively, low-quality evidence). Parent mental health did not improve in studies of children with diabetes post-treatment (SMD -0.24, 95% CI -0.90 to 0.42; participants = 211; studies = 3, very low-quality evidence). For the remaining analyses, data were insufficient to evaluate the effect of treatment on parent mental health.Evaluation of parent outcomes by psychological therapy typeCBT may improve parenting behavior post-treatment (SMD -0.45, 95% CI -0.68 to -0.21; participants = 1040; studies = 9, low-quality evidence), and follow-up (SMD -0.26, 95% CI -0.42 to -0.11; participants = 743; studies = 6, moderate-quality evidence). We did not find evidence for a beneficial effect for CBT on parent mental health at post-treatment or follow-up (SMD -0.19, 95% CI -0.41 to 0.03; participants = 811; studies = 8; SMD -0.07, 95% CI -0.34 to 0.20; participants = 592; studies = 5; respectively, very low-quality evidence). PST may improve parenting behavior post-treatment and follow-up (SMD -0.39, 95% CI -0.64 to -0.13; participants = 947; studies = 7, low-quality evidence; SMD -0.54, 95% CI -0.94 to -0.14; participants = 852; studies = 6, very low-quality evidence, respectively), and parent mental health post-treatment and follow-up (SMD -0.30, 95% CI -0.45 to -0.15; participants = 891; studies = 6; SMD -0.21, 95% CI -0.35 to -0.07; participants = 800; studies = 5, respectively, moderate-quality evidence). For the remaining analyses, data were insufficient to evaluate the effect of treatment on parent outcomes.Adverse eventsWe could not evaluate treatment safety because most studies (32) did not report on whether adverse events occurred during the study period. In six studies, the authors reported that no adverse events occurred. The remaining six studies reported adverse events and none were attributed to psychological therapy. We rated the quality of evidence for adverse events as moderate. AUTHORS' CONCLUSIONS Psychological therapy may improve parenting behavior among parents of children with cancer, chronic pain, diabetes, and traumatic brain injury. We also found beneficial effects of psychological therapy may also improve parent mental health among parents of children with cancer and chronic pain. CBT and PST may improve parenting behavior. PST may also improve parent mental health. However, the quality of evidence is generally low and there are insufficient data to evaluate most outcomes. Our findings could change as new studies are conducted.
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Affiliation(s)
- Emily Law
- Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA
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Schierloh U, Wilinska ME, Pit-ten Cate IM, Baumann P, Hovorka R, De Beaufort C. Lower plasma insulin levels during overnight closed-loop in school children with type 1 diabetes: Potential advantage? A randomized cross-over trial. PLoS One 2019; 14:e0212013. [PMID: 30849076 PMCID: PMC6408001 DOI: 10.1371/journal.pone.0212013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/23/2019] [Indexed: 02/04/2023] Open
Abstract
Background Studies have shown that overnight closed-loop insulin delivery can improve glucose control and reduce the risk of hypoglycemia and hence may improve metabolic outcomes and reduce burden for children with type 1 diabetes and their families. However, research so far has not reported insulin levels while comparing closed-loop to open-loop insulin delivery in children. Therefore, in this study we obtained glucose levels as well as plasma insulin levels in children with type 1 diabetes to evaluate the efficacy of a model—based closed-loop algorithm compared to an open-loop administration. Methods Fifteen children with type 1 diabetes, 6–12 years, participated in this open-label single center study. We used a randomized cross over design in which we compared overnight closed-loop insulin delivery with sensor augmented pump therapy for two nights in both the hospital and at home (i.e., 1 night in-patient stay and at home per treatment condition). Only during the in-patient stay, hourly plasma insulin and blood glucose levels were assessed and are reported in this paper. Results Results of paired sample t-tests revealed that although plasma insulin levels were significantly lower during the closed-loop than in the open-loop (Mean difference 36.51 pmol/l; t(13) = 2.13, p = .03, effect size d = 0.57), blood glucose levels did not vary between conditions (mean difference 0.76 mmol/l; t(13) = 1.24, p = .12, d = 0.37). The administered dose of insulin was significantly lower during the closed-loop compared with the open-loop (mean difference 0.10 UI; t(12) = 2.45, p = .02, d = 0.68). Conclusions Lower insulin doses were delivered in the closed-loop, resulting in lower plasma insulin levels, whereby glucose levels were not affected negatively. This suggests that the closed-loop administration is better targeted and hence could be more effective.
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Affiliation(s)
- Ulrike Schierloh
- Pediatric Clinic, Centre Hospitalier de Luxembourg, Luxembourg, GD de Luxembourg
- * E-mail:
| | - Malgorzata E. Wilinska
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
- Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Ineke M. Pit-ten Cate
- Faculty of Language and Literature, Humanities, Arts and Education, University of Luxembourg, Luxembourg, GD de Luxembourg
| | - Petra Baumann
- Joanneum Research Forschungsgesellschaft, Graz, Austria
| | - Roman Hovorka
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
- Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Carine De Beaufort
- Pediatric Clinic, Centre Hospitalier de Luxembourg, Luxembourg, GD de Luxembourg
- Department of Pediatrics, University Hospital Brussels, Brussels, Belgium
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63
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Bekker CI, Deacon E, Segal D. Meaning in life experienced by parents of children living with diabetes. Health Psychol Open 2019; 6:2055102919832221. [PMID: 30858981 PMCID: PMC6402055 DOI: 10.1177/2055102919832221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In this study, nine parents of children living with well-controlled diabetes participated in semi-structured interviews to explore how they make meaning of living with a child with diabetes. Creating a state of normalcy that incorporates the diabetes care plan, empowering their children to successful transition to independent care, positive relationships with their medical team as well as acquiring and sharing diabetes-related knowledge and skills add to the meaning in life of these parents. Health practitioners should facilitate conversations with parents to help them realise their motivation for adhering to the diabetes care plan.
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64
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Duca LM, Reboussin BA, Pihoker C, Imperatore G, Saydah S, Mayer-Davis E, Rewers A, Dabelea D. Diabetic ketoacidosis at diagnosis of type 1 diabetes and glycemic control over time: The SEARCH for diabetes in youth study. Pediatr Diabetes 2019; 20:172-179. [PMID: 30556249 PMCID: PMC6361710 DOI: 10.1111/pedi.12809] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/05/2018] [Accepted: 12/10/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The diagnosis of type 1 diabetes (T1D) in youth is often associated with diabetic ketoacidosis (DKA). We aimed to evaluate if the presence of DKA at diagnosis of T1D is associated with less favorable hemoglobin A1c (HbA1c) trajectories over time. METHODS The SEARCH for Diabetes in Youth study of 1396 youth aged <20 years with newly diagnosed T1D were followed for up to 13 (median 8 [interquartile range or IQR 6-9]) years after diagnosis. Of these, 397 (28%) had DKA (bicarbonate level < 15 mmol/L and/or pH < 7.25 (venous) or < 7.30 (arterial or capillary) or mention of DKA in medical records) at diabetes onset. Longitudinal HbA1c levels were measured at each follow-up visit (average number of HbA1c measures 3.4). A linear piecewise mixed effects model was used to analyze the effect of DKA status at diagnosis of T1D on long-term glycemic control, adjusting for age at diagnosis, diabetes duration at baseline, sex, race/ethnicity, household income, health insurance status, time-varying insulin regimen and glucose self-monitoring, study site, and baseline fasting C-peptide level. RESULTS At baseline, HbA1c levels were significantly higher in youth with T1D diagnosed in DKA vs those who were not (9.9% ± 1.5% vs 8.5% ± 1.4%, respectively). After the first year with diabetes, there was a significant difference in the rate of change in HbA1c levels by DKA status: HbA1c was 0.16% higher each year in youth with DKA compared to those without (interaction P-value<0.0001), after adjusting for aforementioned covariates. CONCLUSIONS DKA at T1D diagnosis is associated with worsening glycemic control over time, independent of demographic, socioeconomic, and treatment-related factors and baseline fasting C-peptide.
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Affiliation(s)
- Lindsey M Duca
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Beth A Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Catherine Pihoker
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Giuseppina Imperatore
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sharon Saydah
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth Mayer-Davis
- Departments of Nutrition and Medicine, Gillings School of Global Public Health and School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Arleta Rewers
- Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
| | - Dana Dabelea
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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65
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Essaddam L, Ben Mansour A, Ben Amor A, Ravens-Sieberer U, Klein TM, Ben Becher S. Validation of the Arabic and Tunisian Arabic version of the KINDL questionnaires for children with diabetes type 1. Libyan J Med 2019; 14:1537457. [PMID: 30481145 PMCID: PMC6263104 DOI: 10.1080/19932820.2018.1537457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Aim: We aimed to validate the Arabic and Tunisian Arabic versions of diabetes- specific quality of life (QOL) instrument KINDL-R Diabetes Module for Tunisian children population with type 1 diabetes. Patients and methods: This a cross-sectional study to validate Arabic and Tunisian KINDL QOL instrument that we translate in literary and dialectal Arabic. Both forward and backward translations from the German version of KINDL QOL into Arabic version were performed. Our project received a GPED grant in August 2014. After the face validity of the Arabic version was established, it was then pilot-tested. Finally, the validity and reliability of the final version of the Arabic KINDL questionnaire were evaluated. Results: The KINDL-R Diabetes Module (DM) questionnaire of QOL was given to 212 persons : 108 children (aged 3–17 years) with T1DM and 104 parents. The Cronbach’s alpha coefficients of the overall items and the main domains was about 0.7. The mean total score of the KINDL-R DM was 69,56  ± 14,01 in children aged 7–13 years, 59.93± 15.17 in children aged 13–17 years and 56.6± 9.9 in parents (higher scores indicate better QOL). The parents reported lower diabetes-specific HRQOL than the children themselves (p < 0.01).Emotional score was correlated to environment (p = 0,03). Self-esteem was reported to environment (p = 0,02) and mother’s instruction level’s (p = 0,014). Conclusions: The KINDL-R Diabetes Module (DM) of QOL in literary and dialectal Arabic have sufficient acceptability, reliability and validity so as to be used for the purposes of a comparative in Tunisian and Arabic populations.
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Affiliation(s)
- Leïla Essaddam
- a University of Tunis El Manar , Tunis , Tunisia.,b Children Hospital of Tunis , Tunis , Tunisia
| | - Asma Ben Mansour
- a University of Tunis El Manar , Tunis , Tunisia.,b Children Hospital of Tunis , Tunis , Tunisia
| | - Arwa Ben Amor
- a University of Tunis El Manar , Tunis , Tunisia.,c Bougatfa Hospital of Bizert , Bizert , Tunisia
| | - Ulribe Ravens-Sieberer
- d Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Toni Maria Klein
- d Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Saayda Ben Becher
- a University of Tunis El Manar , Tunis , Tunisia.,b Children Hospital of Tunis , Tunis , Tunisia
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66
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Davis SL, Kaulfers AM, Lochman JE, Morrison SA, Pryor ER, Rice M. Depressive Symptoms, Perceived Stress, and Cortisol in School-Age Children With Type 1 Diabetes: A Pilot Study. Biol Res Nurs 2018; 21:166-172. [DOI: 10.1177/1099800418813713] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Despite adequate insulin regimens and concurrent treatments for Type 1 diabetes (T1D), many children have trouble achieving glycemic control, as evidenced by elevated HbA1c levels. Maternal and child depressive symptoms, as well as child perceived stress, are associated with less optimal glycemic control. Cortisol, a stress hormone, may mediate the relationships among depressive symptoms, perceived stress, and glycemic control. The purposes of this pilot study were to (1) examine the feasibility of collecting salivary samples to measure cortisol change in prepubertal school-age children diagnosed with T1D and (2) determine effect sizes for the relationships among maternal depressive symptoms and child depressive symptoms, perceived stress, cortisol levels, and glycemic control. Participants were recruited using convenience sampling from a pediatric endocrinology clinic in the southeastern United States. All data, including surveys, salivary samples, HbA1c, height, and weight, were collected the same day as a clinic visit. The study included 30 children, ages 6.9–12.2 years, and their mothers. Most children were female (70%) and Caucasian (76.7%), but the sample was socioeconomically diverse. HbA1c values ranged from 6.1% to 12.2%. Of the children, 18 showed normal declines in cortisol over 3 hr, while 12 had increases in cortisol. Results show recruitment, participation, and data collection are feasible in school-age children with T1D. Examination of relevancy thresholds for effect sizes between variables of interest supports the need for future research in a larger, more representative sample on research questions that include the role cortisol plays as a potential mediator among examined variables.
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Affiliation(s)
- Sara L. Davis
- College of Nursing, University of South Alabama, Mobile, AL, USA
| | | | | | - S. A. Morrison
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Erica R. Pryor
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marti Rice
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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67
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Steinberg DM, Anderson BJ, de Wit M, Hilliard ME. Positive Well-Being in Youth With Type 1 Diabetes During Early Adolescence. THE JOURNAL OF EARLY ADOLESCENCE 2018; 38:1215-1235. [PMID: 30319165 PMCID: PMC6177217 DOI: 10.1177/0272431617692444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Developmental shifts during early adolescence relate to type 1 diabetes (T1D) self-management, increased risk of emotional distress, and worsening health status. Less is known about positive experiences related to T1D. This study evaluated associations of positive well-being (PWB) with diabetes burden, self-management, and glycemic control. Youth (N = 55, age = 12-13 years; X̄ age = 12.75 + 0.56 years, 50.9% male, 38.2% non-Caucasian) reported PWB, depressive symptoms, and diabetes burden. Parents reported on overall T1D adherence. Adherence behaviors and glycemic control were assessed objectively. Higher PWB correlated with lower depressive symptoms (r s = -.45), less diabetes burden (r s = -.48), and better glycemic control (r s = -.43), all p < .01. When controlling for diabetes duration, higher PWB correlated with lower depressive symptoms and better glycemic control. PWB was not related to demographics or adherence. Initial exploration suggests PWB is related to key diabetes constructs, and maybe valuable to consider along with efforts to support youth with T1D during a vulnerable developmental period.
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Affiliation(s)
- Dara M. Steinberg
- Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | | | - Maartje de Wit
- VU University Medical Center, Amsterdam, The Netherlands
| | - Marisa E. Hilliard
- Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
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68
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Rechenberg K, Grey M, Sadler L. "Anxiety and Type 1 diabetes are like cousins": The experience of anxiety symptoms in youth with Type 1 diabetes. Res Nurs Health 2018; 41:544-554. [PMID: 30375003 DOI: 10.1002/nur.21913] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/09/2018] [Indexed: 01/09/2023]
Abstract
Type 1 diabetes (T1D) is one of the most common chronic health conditions in youth in the United States, and its incidence is rising worldwide. Youth with T1D are at a high risk of psychological comorbidity, for example, anxiety, depression, and eating disorders. Psychological comorbidities, especially anxiety symptoms, have been correlated with poorer diabetes outcomes, but anxiety symptoms have not been well studied in these youth. The primary aim of this study was to describe the experience of anxiety symptoms in youth with T1D, especially as those symptoms relate to diabetes self-management tasks. We used a qualitative descriptive approach, consisting of an in-depth, semi-structured interview comprising 10 open-ended questions with follow-up probes. The analysis was guided by the principles of thematic analysis. Demographic data, Hemoglobin A1c levels, and the State-Trait Anxiety Inventory for Children survey data were also collected and analyzed. We identified four themes and seven sub-themes. Participants (n = 29, ages 10-16, 55% female) reported that T1D was an extra layer of responsibility that took time away from their ability to participate fully in other aspects of their lives. Some participants were able to integrate diabetes management into their lives, while others were not. Some participants were dependent on parents and the school nurse for diabetes management. Participants described two types of anxiety symptoms, general and diabetes-specific, and they noted that their experience of anxiety was associated with poor quality sleep, general lifestyle factors, and diabetes.
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Affiliation(s)
| | - Margaret Grey
- Yale University School of Nursing, West Haven, Connecticut
| | - Lois Sadler
- Yale University School of Nursing, West Haven, Connecticut
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69
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Delamater AM, de Wit M, McDarby V, Malik JA, Hilliard ME, Northam E, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Psychological care of children and adolescents with type 1 diabetes. Pediatr Diabetes 2018; 19 Suppl 27:237-249. [PMID: 30058247 DOI: 10.1111/pedi.12736] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 01/09/2023] Open
MESH Headings
- Adaptation, Psychological/physiology
- Adolescent
- Burnout, Psychological/psychology
- Burnout, Psychological/therapy
- Child
- Consensus
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 1/therapy
- Endocrinology/organization & administration
- Endocrinology/standards
- Humans
- International Cooperation
- Neurodevelopmental Disorders/therapy
- Pediatrics/organization & administration
- Pediatrics/standards
- Practice Patterns, Physicians'/standards
- Psychotherapy/methods
- Psychotherapy/standards
- Quality of Life/psychology
- Resilience, Psychological
- Societies, Medical/organization & administration
- Societies, Medical/standards
- Stress, Psychological/etiology
- Stress, Psychological/therapy
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Affiliation(s)
- Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Maartje de Wit
- Department of Medical Psychology, EMGO Institute for Health & Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Vincent McDarby
- National Children's Research Centre and Our Lady's Children's Hospital, Dublin, Ireland
| | - Jamil A Malik
- Center of Excellence, National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | | | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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70
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Pulungan AB, Afifa IT, Annisa D. Type 2 diabetes mellitus in children and adolescent: an Indonesian perspective. Ann Pediatr Endocrinol Metab 2018; 23:119-125. [PMID: 30286566 PMCID: PMC6177658 DOI: 10.6065/apem.2018.23.3.119] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/01/2018] [Accepted: 09/17/2018] [Indexed: 02/03/2023] Open
Abstract
The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents has increased globally over the past 2 decades. Metabolic syndrome, including obesity and overweight at a young age, increases the occurrence of T2DM. Studies in Indonesia have found that obese children and adolescents are more likely to have insulin resistance, a risk factor for T2DM. There are no data on the current incidence of T2DM in youth in Indonesia, but there has been a significant rise in the prevalence of overweight in adolescents. The diagnosis of T2DM in youth is similar to that in adults, with special consideration of when to test asymptomatic children. Management of T2DM in Indonesia follows the recommendations of the Indonesian Pediatric Society, which include lifestyle modifications, such as improving dietary habits and exercise, as well as appropriate medications. Metformin is the drug of choice for young T2DM patients; if marked hyperglycemia is present, basal insulin is given with metformin. Monitoring of T2DM is generally done through selfmonitoring of blood glucose and glycosylated hemoglobin.
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Affiliation(s)
- Aman Bhakti Pulungan
- Endocrinology Division, Child Health Department, Faculty of Medicine University of Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Diadra Annisa
- Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
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71
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López Siguero JP, Pérez González O, Gómez Gila AL, Leiva Gea I. Situación de la diabetes mellitus tipo 1 en Andalucía. Datos asistenciales, uso de terapias avanzadas y recursos humanos. An Pediatr (Barc) 2018; 89:111-116. [DOI: 10.1016/j.anpedi.2017.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/16/2017] [Accepted: 09/22/2017] [Indexed: 01/09/2023] Open
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72
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Kazak AE, Hwang WT, Chen FF, Askins MA, Carlson O, Argueta-Ortiz F, Barakat LP. Screening for Family Psychosocial Risk in Pediatric Cancer: Validation of the Psychosocial Assessment Tool (PAT) Version 3. J Pediatr Psychol 2018; 43:737-748. [PMID: 29509908 DOI: 10.1093/jpepsy/jsy012] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/10/2018] [Indexed: 01/09/2023] Open
Abstract
Objective Family psychosocial risk screening is an important initial step in delivering evidence-based care. The Psychosocial Assessment Tool (PAT) is a brief parent report screener based on the trilevel Pediatric Psychosocial Preventative Health Model (PPPHM; Universal, Targeted, Clinical). The current article validates a revised PAT (version 3.0) in pediatric oncology that includes new items (for families of younger patients; clinically relevant risk items) and applicable to broad health literacy levels (a 4th grade reading level). Methods Primary caregivers of 394 children newly diagnosed with cancer participated in this multisite investigation, completing the PAT and validation measures using REDCap. Results The original structure of the PAT, with seven subscales (Family Structure, Social Support, Child Problems, Sibling Problems, Family Problems, Stress Reactions, and Family Beliefs) was supported using a confirmatory factor analysis. Internal consistency for the total score (Kuder-Richardson 20 coefficient [KR20] = 0.81) and the subscales (KR20 = 0.59-0.85) was moderate to strong. Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. The validation measures varied significantly, as expected, across the three levels of the PPPHM. Receiver operating characteristic (ROC) analyses showed that the PAT total and subscale scores can discriminate families above and below clinical thresholds. Conclusions Results reinforce the psychometric properties of this approach for screening of family psychosocial risk. The PAT provides an evidence-based screener that identifies families at three levels of risk and can provide the basis for further evaluation and treatment of children with cancer and their families.
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Affiliation(s)
- Anne E Kazak
- Nemours Children's Health System
- Sidney Kimmel Medical School, Thomas Jefferson University
| | | | - Fang Fang Chen
- Nemours Children's Health System
- Sidney Kimmel Medical School, Thomas Jefferson University
| | | | | | | | - Lamia P Barakat
- Perelman School of Medicine, University of Pennsylvania
- The Children's Hospital of Philadelphia
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73
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The situation as regards diabetes mellitus type 1 in Andalusia. Care data, use of advanced therapies and human resources. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.anpede.2017.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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74
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Green C, Stein REK, Storfer-Isser A, Garner AS, Kerker BD, Szilagyi M, Hoagwood KE, Horwitz SM. Do Subspecialists Ask About and Refer Families with Psychosocial Concerns? A Comparison with General Pediatricians. Matern Child Health J 2018; 23:61-71. [DOI: 10.1007/s10995-018-2594-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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75
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Troncone A, Cascella C, Chianese A, Galiero I, Zanfardino A, Confetto S, Perrone L, Iafusco D. Changes in body image and onset of disordered eating behaviors in youth with type 1 diabetes over a five-year longitudinal follow-up. J Psychosom Res 2018; 109:44-50. [PMID: 29773151 DOI: 10.1016/j.jpsychores.2018.03.169] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine changes over a five-year period in body image accuracy and dissatisfaction, as well as relationships with disordered eating behaviors (DEBs), in young patients with type 1 diabetes. METHODS Of 81 children (42 male, 39 female) with type 1 diabetes first assessed at ages 5.1-10.06 years, 67 (83%) were re-enrolled and interviewed as adolescents (aged 10.07-15.08 years) at follow-up. DEBs were assessed using a parent-report standardized measure. Height and weight were determined, and BMI was calculated. Glycemic control was assessed by glycated hemoglobin. RESULTS BMI increased from childhood to adolescence. The general tendency towards body size underestimation (i.e., perceiving the body to be smaller than it is) and dissatisfaction, already described at baseline, was found unchanged at follow-up, revealing continuing attitude towards body image problems. Body-size perception accuracy, degree of body-size dissatisfaction, and HbA1c did not increase significantly over five years, but the presence of DEBs was observed. Degree of body dissatisfaction was found to be a significant predictor for DEBs (standardized beta = 0.272, p < 0.05). CONCLUSION Body image problems persisted over the five-year study period and were found associated with higher levels of DEBs. Identification of such body image characteristics may be useful in developing strategies for intervention early in the course of illness.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "L. Vanvitelli", Italy.
| | | | | | - Ilaria Galiero
- Department of Psychology, University of Campania "L. Vanvitelli", Italy
| | - Angela Zanfardino
- Department of the Women, of the Child, and General, Specialized Surgery, University of Campania "L. Vanvitelli", Italy
| | - Santino Confetto
- Department of the Women, of the Child, and General, Specialized Surgery, University of Campania "L. Vanvitelli", Italy
| | - Laura Perrone
- Department of the Women, of the Child, and General, Specialized Surgery, University of Campania "L. Vanvitelli", Italy
| | - Dario Iafusco
- Department of the Women, of the Child, and General, Specialized Surgery, University of Campania "L. Vanvitelli", Italy
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Hilliard ME, Iturralde E, Weissberg-Benchell J, Hood KK. The Diabetes Strengths and Resilience Measure for Adolescents With Type 1 Diabetes (DSTAR-Teen): Validation of a New, Brief Self-Report Measure. J Pediatr Psychol 2018; 42:995-1005. [PMID: 28549160 DOI: 10.1093/jpepsy/jsx086] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 05/09/2017] [Indexed: 01/09/2023] Open
Abstract
Objective Despite the challenges of managing type 1 diabetes, many adolescents achieve optimal outcomes. A validated measure of diabetes-specific strengths is needed to measure adaptive behaviors and attitudes associated with overcoming challenges and achieving "resilient" outcomes. Methods Baseline data from 260 adolescents (age 14-18 years, M = 15.7 ± 1.1, 60% female, 33% Non-Caucasian, M A1c = 9.1 ± 1.9%) and caregivers in a behavioral intervention trial were analyzed to evaluate psychometric properties of the 12-item self-report Diabetes Strengths and Resilience measure for adolescents (DSTAR-Teen). Reliability and validity were examined in relation to measures of related constructs, regimen adherence, and glycemic outcomes, and confirmatory factor analysis was conducted. Results Reliability was good (internal consistency: α = .89; item-total correlations: r range = .55-.78). Significant correlations demonstrated construct and criterion validity. A two-factor structure reflecting intrapersonal and interpersonal processes fit the data better than a one-factor solution. Conclusions The DSTAR-Teen has strong psychometric properties, captures adaptive aspects of adolescents' diabetes management (i.e., "strengths"), and is related to clinical outcomes.
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Affiliation(s)
- Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital
| | - Esti Iturralde
- Department of Pediatrics, Stanford University School of Medicine
| | - Jill Weissberg-Benchell
- Department of Psychiatry and Behavioral Sciences, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine
| | - Korey K Hood
- Department of Pediatrics, Stanford University School of Medicine
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77
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Hilliard ME, De Wit M, Wasserman RM, Butler AM, Evans M, Weissberg-Benchell J, Anderson BJ. Screening and support for emotional burdens of youth with type 1 diabetes: Strategies for diabetes care providers. Pediatr Diabetes 2018; 19:534-543. [PMID: 28940936 PMCID: PMC5862727 DOI: 10.1111/pedi.12575] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 01/09/2023] Open
Abstract
Multiple sources of burden for youth with type 1 diabetes (T1D) impact key outcomes including quality of life, self-management, and glycemic control. Professional diabetes organizations recommend diabetes care providers screen for psychosocial and behavioral challenges and implement strategies to support youth with T1D. The purpose of this article is to review the literature and recommend practical strategies medical providers can use for screening and behavioral support for youth with diabetes and their families. As part of their routine medical care, diabetes care providers are well-positioned to identify and intervene to address emotional distress related to the burdens of living with diabetes. In collaboration with multidisciplinary team members, including psychologists and mental health professionals, medical providers may be able to successfully implement brief behavioral strategies for screening and providing emotional support.
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Affiliation(s)
- Marisa E Hilliard
- Department of Pediatrics, Psychology Section, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Maartje De Wit
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Rachel M Wasserman
- Department of Pediatrics, Psychology Section, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Ashley M Butler
- Department of Pediatrics, Psychology Section, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Meredyth Evans
- Northwestern University's Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Jill Weissberg-Benchell
- Northwestern University's Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Barbara J Anderson
- Department of Pediatrics, Psychology Section, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
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Lindkvist EB, Kristensen LJ, Sildorf SM, Kreiner S, Svensson J, Mose AH, Birkebaek N, Thastum M. A Danish version of self-efficacy in diabetes self-management: A valid and reliable questionnaire affected by age and sex. Pediatr Diabetes 2018; 19:544-552. [PMID: 29094452 DOI: 10.1111/pedi.12601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 08/18/2017] [Accepted: 09/29/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Managing the chronic illness type 1 diabetes (T1D) is extremely demanding, especially during adolescence. Self-efficacy is belief in one's own capabilities and this is crucial for diabetes management. Having a valid method for measuring self-efficacy is important. OBJECTIVE Our aims were to psychometrically validate a Danish version of the self-efficacy in diabetes management (SEDM) questionnaire, and to examine the relationship between background variables and self-efficacy. METHODS All Danish adolescents with T1D (n = 1075) were invited to participate in our study. In total, 689 agreed to participate and 602 completed the study. Data were collected using a web-based survey. All participants were asked to provide a blood sample for HbA1c measurement. Graphical log-linear Rasch modeling (GLLRM) was used to validate the questionnaire and its reliability was assessed using Monte Carlo simulation. RESULTS We found the questionnaire to be valid and reliable, but it had a dual structure that suggested a need for 2 separate subscales. One subscale related to practical (SEDM1) and the other to emotional (SEDM2) aspects of diabetes management. Both subscales were targeted toward adolescents with lower self-efficacy and were associated with HbA1c. SEDM1 was influenced by treatment modality and age. In SEDM2 we found an interaction between age and sex. CONCLUSION The Danish version of the SEDM questionnaire should be divided into two parts, each with a valid and reliable subscale for self-efficacy measurement. The relationship between self-efficacy and age seems to differ between boys and girls.
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Affiliation(s)
- Emilie Bundgaard Lindkvist
- Department of Paediatrics, Copenhagen Diabetes Research Center (CPH-DIRECT), Herlev University Hospital, Herlev, Denmark
| | - Lene Juel Kristensen
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Stine Møller Sildorf
- Department of Paediatrics, Copenhagen Diabetes Research Center (CPH-DIRECT), Herlev University Hospital, Herlev, Denmark
| | - Svend Kreiner
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jannet Svensson
- Department of Paediatrics, Copenhagen Diabetes Research Center (CPH-DIRECT), Herlev University Hospital, Herlev, Denmark
| | | | - Niels Birkebaek
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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79
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Hoey H, Lange K, Skinner TC, Mortensen H, Swift P, Aanstoot HJ, Castaňo L, Cameron F, de Beaufort C. Hvidoere Smiley Faces: International diabetes quality of life assessment tool for young children. Pediatr Diabetes 2018; 19:553-558. [PMID: 29165880 DOI: 10.1111/pedi.12602] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 09/05/2017] [Accepted: 10/01/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Few diabetes-specific quality of life (QOL) tools are available for young children. OBJECTIVES To design and evaluate, a new age-specific QOL questionnaire and its associations with treatment regimens and metabolic control. METHODS Clinical, demographic data and centrally analyzed HbA1c were collected on 1133 children <11 years (girls 48%; mean ± SD age 8.0 ± 2.1 years; diabetes duration ≥1 year) from 18 centers (Europe, Japan, North America and Australia). Children completed the 10-item Smiley Faces QOL questionnaire constructed for the study, and children ≥7 years also completed the KIDSCREEN-10 Index. RESULTS In total, 1035 children completed the new Smiley Faces questionnaire which was well understood by 993 (70% ≥4 years and 96% ≥5 years, respectively). Internal consistency and reliability were good (Cronbach's α = .73). Inter-item correlation ranged r = 0.047 to 0.451 indicating each item measures separate aspects of children's satisfaction construct. Convergent validity assessed by comparison to the HrQOL KIDSCREEN-10 Index showed moderate correlation coefficient 0.501. Factor analysis revealed 3 factors explaining 51% of the variance. Children reported good QOL with most items positive, mean values between 1 and 2 on a 5-point scale (lower scores indicating greater QOL). Diabetes satisfaction was unrelated to age, diabetes duration, HbA1c, or severe hypoglycemia. Girls were more satisfied than boys. Children on intensive regimens reported better QOL (P < .02). Main dissatisfaction related to insulin injections and blood sugar testing. CONCLUSIONS The Smiley Faces questionnaire enables QOL assessment in young children and identification of areas of dissatisfaction and other clinically relevant items relating to diabetes management.
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Affiliation(s)
- Hilary Hoey
- Department of Paediatrics, Trinity College Dublin, National Children's Hospital, Dublin, Ireland
| | - Karin Lange
- Hannover Medical School, Medical Psychology, Hannover, Germany
| | - T C Skinner
- School Psychological Sciences, Charles Darwin University, Darwin, Australia
| | - Henrik Mortensen
- Department of Paediatrics, Faculty of Health and Medical Sciences, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Peter Swift
- Children's Hospital, Leicester Royal Infirmary, Leicester, UK
| | - Henk-Jan Aanstoot
- Diabeter, Center for Paediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Luis Castaňo
- Endocrinology and Diabetes Research Group, Hospital de Cruces, Spain
| | - Fergus Cameron
- Department of Endocrinology and Diabetes Royal Children's Hospital, Melbourne, Australia
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80
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Dybdal D, Tolstrup JS, Sildorf SM, Boisen KA, Svensson J, Skovgaard AM, Teilmann GK. Increasing risk of psychiatric morbidity after childhood onset type 1 diabetes: a population-based cohort study. Diabetologia 2018; 61:831-838. [PMID: 29242985 DOI: 10.1007/s00125-017-4517-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/06/2017] [Indexed: 01/09/2023]
Abstract
AIMS/HYPOTHESIS The aim of this study was to investigate psychiatric morbidity following childhood onset of type 1 diabetes. METHODS In a matched, population-based cohort study based on Danish national registers, we identified children and adolescents who had been diagnosed as an in- or outpatient with type 1 diabetes before the age of 18, and afterwards diagnosed with a psychiatric disorder (n = 5084). Control individuals were matched according to sex and date of birth (n = 35,588). The Cox proportional hazards model was used to assess associations between type 1 diabetes and the incidence of psychiatric disorders as well as the effects of age at onset and duration of type 1 diabetes on the risk of subsequently developing psychiatric morbidities. RESULTS An increased risk of being diagnosed with mood disorders and anxiety, dissociative, eating, stress-related and somatoform disorders was observed in both sexes in the years following type 1 diabetes onset, with the highest risk observed five years or more after onset (HR 1.55 [95% CI 1.38, 1.74]). The risk of psychoactive substance-misuse disorders increased significantly only in boys, and the risk of personality disorders increased only in girls. CONCLUSIONS/INTERPRETATION In the years following type 1 diabetes onset, an increased risk of eating disorders, anxiety and mood disorders, substance misuse, and personality disorders was found. These findings highlight a clinical need to monitor the mental health of children and adolescents in the years following type 1 diabetes onset to identify and treat psychiatric problems associated with type 1 diabetes.
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Affiliation(s)
- Daniel Dybdal
- Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Dyrehavevej 29, DK 3400, Hillerød, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Stine M Sildorf
- Department of Paediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark
| | - Kirsten A Boisen
- Centre of Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Jannet Svensson
- Department of Paediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Grete K Teilmann
- Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Dyrehavevej 29, DK 3400, Hillerød, Denmark.
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81
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Patel NJ, Datye KA, Jaser SS. Importance of Patient-Provider Communication to Adherence in Adolescents with Type 1 Diabetes. Healthcare (Basel) 2018; 6:E30. [PMID: 29597246 PMCID: PMC6023481 DOI: 10.3390/healthcare6020030] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/19/2018] [Accepted: 03/26/2018] [Indexed: 01/15/2023] Open
Abstract
Effective communication between pediatric diabetes patients and their providers has the potential to enhance patient satisfaction and health outcomes, as well as improve diabetes-related self-management. In this review, we highlight the importance of communication between patients and providers, focusing on the effect of communication on adherence in the high-risk population of adolescents with type 1 diabetes. We synthesize the literature describing patient-provider communication in pediatric populations and provide implications for practice that focus on the most relevant, modifiable factors for improving self-management in adolescents with type 1 diabetes.
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Affiliation(s)
- Niral J Patel
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
| | - Karishma A Datye
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
| | - Sarah S Jaser
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
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82
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Haneda M, Noda M, Origasa H, Noto H, Yabe D, Fujita Y, Goto A, Kondo T, Araki E. Japanese Clinical Practice Guideline for Diabetes 2016. J Diabetes Investig 2018; 9:657-697. [PMID: 29582574 PMCID: PMC5934251 DOI: 10.1111/jdi.12810] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/25/2018] [Indexed: 01/09/2023] Open
Affiliation(s)
| | | | | | | | - Daisuke Yabe
- Department of Diabetes, Endocrinology and NutritionKyoto University Graduate School of MedicineKyotoJapan
| | | | - Atsushi Goto
- Center for Public Health SciencesNational Cancer CenterTokyoJapan
| | - Tatsuya Kondo
- Department of Metabolic MedicineKumamoto UniversityKumamotoJapan
| | - Eiichi Araki
- Department of Metabolic MedicineKumamoto UniversityKumamotoJapan
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83
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Ziegler R, Neu A. Diabetes in Childhood and Adolescence. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:146-156. [PMID: 29563012 PMCID: PMC5876549 DOI: 10.3238/arztebl.2018.0146] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 08/01/2017] [Accepted: 01/30/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND The incidence of type 1 diabetes mellitus in childhood and adolescence is steadily rising and now stands at 22.9 new cases per year per 100 000 persons up to age 15. METHODS This review is based on pertinent publications retrieved by a selective literature search, with special attention to the current German S3 guideline on diabetes in childhood and adolescence. RESULTS Polydipsia, polyuria, and weight loss are the characteristic presenting symptoms of diabetes mellitus. The acutely presenting patient needs immediate stabilization because of the danger of rapid metabolic decompensation (risk of keto - acidosis, 21.1%). Long-term insulin therapy can be delivered either by subcutaneous injection or by an insulin pump. The goals of treatment are the near-normalization of glucose metabolism (HbA1c <7.5%), the avoidance of acute complications (hypoglycemia and ketoacidosis), the reduction of diabetes-specific sequelae (retinopathy, nephropathy, neuropathy, hypertension, and hyperlipidemia), unrestricted participation in age-appropriate everyday activities, and normal physical and psychosocial development. Children and adolescents with diabetes need individualized treatment with frequent adjustments and holistic overall care so that these goals can be effectively met. CONCLUSION Every physician must be able to diagnose the initial presentation of diabetes and to initiate the first steps in its management. The patient should be referred as soon as possible to a diabetes team that has experience in the treatment of children and adolescents.
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84
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Young-Hyman D, de Groot M, Hill-Briggs F, Gonzalez JS, Hood K, Peyrot M. Response to Comment on Young-Hyman et al. Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016;39:2126-2140. Diabetes Care 2018; 41:e33-e34. [PMID: 29463672 PMCID: PMC5864144 DOI: 10.2337/dci17-0037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Deborah Young-Hyman
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD
| | - Mary de Groot
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Felicia Hill-Briggs
- Department of Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Department of Medicine and New York Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY
| | - Korey Hood
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Mark Peyrot
- Department of Sociology, Loyola University Maryland, Baltimore, MD
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85
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Snoek FJ, Hermanns N, de Wit M, Huber J, Sturt J, Pouwer F, Lloyd CE, Willaing I, Nouwen A. Comment on Young-Hyman et al. Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016;39:2126-2140. Diabetes Care 2018; 41:e31-e32. [PMID: 29463671 DOI: 10.2337/dc17-1102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Frank J Snoek
- Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands.,Department of Medical Psychology, Academic Medical Center, Amsterdam, the Netherlands
| | - Norbert Hermanns
- Research Institute of the Diabetes Academy Mergentheim, Bad Mergentheim, Germany
| | - Maartje de Wit
- Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands
| | - Jörg Huber
- School of Health Sciences, University of Brighton, Brighton, U.K
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, U.K
| | - François Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Cathy E Lloyd
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, U.K
| | - Ingrid Willaing
- Diabetes Management Research, Steno Diabetes Center, Copenhagen, Denmark
| | - Arie Nouwen
- Department of Psychology, Middlesex University, London, U.K.
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86
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Ledwoń E, Szlenk-Czyczerska E, Gawlik M. Relationship with peers of young school-aged children with type 1 diabetes. MEDICAL SCIENCE PULSE 2018. [DOI: 10.5604/01.3001.0010.8532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: Functioning in a peer group plays an important role in child development. Building self-esteem of children depends on many factors such as physical health, self-evaluation of their physical performance, academic achievement, social support, family relationships, as well as relationships with peers and teachers. Importance of contacts with peers increases during school-age. At this time children are not able to reject the opinion of other people and subject their behaviour completely to the expectations of their peers. When the need for
emotional contact is not satisfied, the complex of being different appears. Isolation within group causes a sense of inferiority, the child becomes passive and resigned. Children, who are chronically ill, rejected or isolated often follow negative emotions in their actions, they become aggressive towards other children or do not want to continue learning. Often the decision about an individual teaching plan results in further isolation of the child. The child’s position in the peer group affects the developing personality, self-confidence and self-esteem.
Aim of the study: The aim of the study was to determine the interpersonal relationships of young school-aged children with type 1 diabetes in their peer groups. Material and methods: The study was conducted on children with type 1 diabetes and their parents, who are
supervised by Clinic of Diabetes, Regional Medical Center in Opole. The research tool used in both groups was a questionnaire consisting of open and closed questions elaborated by the authors of this study. Results: 73% (41) of evaluated children declared that diabetes does not hinder their performance at school. 93% (55) children claimed that they do not hide their condition from their peers. In addition, 61% (34) talk about their illness with their peers and 69% (38) of them can count on their peers’ help in self-control of diabetes. 71.9% (46) of parents of children with type 1 diabetes allow their children to participate in school trips and 68.8% (44) to participate in school competitions.
Conclusions: In most children, diabetes does not affect children’s performance at school. They participate in classes, are accepted and liked in their peer group. Chronically ill children should be able to participate in all types of activities as much as their healthy peers. It seems necessary to continue studies on performance of young school-aged children with type 1 diabetes in their peer group.
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Affiliation(s)
- Ewa Ledwoń
- Opole Medical School, Poland Nursing Faculty
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87
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Almeida MC, Claudino DA, Grigolon RB, Fleitlich-Bilyk B, Claudino AM. Psychiatric disorders in adolescents with type 1 diabetes: a case-control study. ACTA ACUST UNITED AC 2018; 40:284-289. [PMID: 29412336 PMCID: PMC6899402 DOI: 10.1590/1516-4446-2017-2259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/03/2017] [Indexed: 01/09/2023]
Abstract
Objectives: To study the prevalence of psychiatric disorders in adolescents with and without type 1 diabetes, the factors associated with its presence, and to test the reliability of a screening tool for use in clinical settings. Methods: Eighty-one adolescents were enrolled in this case-control study, including 36 diabetic participants and 45 controls. Clinical and sociodemographic data were collected and psychiatric symptoms and diagnoses were obtained from adolescents and their parents using a screening tool (Strengths & Difficulties Questionnaire) and a semi-structured interview (Development and Well-Being Assessment). Results: Psychiatric disorders were identified in 22.2% of the sample (30.56% among diabetic adolescents vs. 15.56% of controls: OR = 2.39, 95%CI 0.82-6.99; p = 0.11). Overweight (body mass index percentile ≥ 85) was the only factor associated with psychiatric disorder (OR = 3.07; 95%CI 1.03-9.14; p = 0.04). Compared to the semi-structured interview, the screening instrument showed 80% sensitivity, 96% specificity, 88.9% positive predictive value and 92.3% negative predictive value for the presence of psychiatric diagnoses in adolescents. Conclusion: Psychiatric morbidity was high in this sample of adolescents, especially among those with diabetes. Routine use of the Strengths and Difficulties Questionnaire can help with early detection of psychiatric disorders in this at-risk group.
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Affiliation(s)
- Mireille C Almeida
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Denise A Claudino
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ruth B Grigolon
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Bacy Fleitlich-Bilyk
- Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (IPQ-FMUSP), São Paulo, SP, Brazil
| | - Angélica M Claudino
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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88
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McGill DE, Volkening LK, Pober DM, Muir AB, Young-Hyman DL, Laffel LM. Depressive Symptoms at Critical Times in Youth With Type 1 Diabetes: Following Type 1 Diabetes Diagnosis and Insulin Pump Initiation. J Adolesc Health 2018; 62:219-225. [PMID: 29212599 PMCID: PMC5803334 DOI: 10.1016/j.jadohealth.2017.09.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE Depressive symptoms occur at various times during the life cycle in persons with type 1 diabetes. We investigated depressive symptoms prospectively in youth with new-onset type 1 diabetes and in those beginning pump therapy. METHODS Youth with type 1 diabetes (N = 96), ages 10-17 years, completed the Children's Depression Inventory (CDI) at baseline and at 1, 6, and 12 months after diabetes onset or pump start; scores ≥13 indicated clinical elevation. The change in depressive symptoms and the association between CDI score and hemoglobin A1c (HbA1c) level were assessed over 1 year. RESULTS The new-onset group (n = 54) had an HbA1c level of 11.4% ± 2.5%. The pump group (n = 42) had a diabetes duration of 4.1 ± 3.4 years and an HbA1c level of 8.3% ± 1.3%. The baseline median CDI was 5.0 in both groups and remained low over time (ranging from 2.0 to 3.5). Most youth (new onset 72%, pump 81%) scored <13 at all times. Those with a CDI score of ≥13 in month 1 had 9-fold (95% confidence interval: 3-28) and 11-fold (95% confidence interval: 3-38) higher risks of CDI score of ≥13 at 6 and 12 months, respectively, than those with a CDI score of <13. New-onset youth with a CDI score of ≥13 in month 1 had a higher HbA1c level at 6 months (8.3% ± 1.7%) than new-onset youth with a CDI score of <13 (7.2% ± 1.6%, p = .04). CONCLUSIONS CDI scores over 1 year were similar in the new-onset and pump groups. Youth with elevated CDI in the first month after diagnosis or pump start were significantly more likely to have a CDI score of ≥13 at 6 or 12 months, supporting recommendations to screen for depressive symptoms because of persistence over time. Those with new-onset diabetes and depressive symptoms in the first month had higher HbA1c at 6 months; confirmatory research is needed.
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Affiliation(s)
- Dayna E. McGill
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Lisa K. Volkening
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - David M. Pober
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Andrew B. Muir
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA
| | | | - Lori M. Laffel
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
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89
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Haneda M, Noda M, Origasa H, Noto H, Yabe D, Fujita Y, Goto A, Kondo T, Araki E. Japanese Clinical Practice Guideline for Diabetes 2016. Diabetol Int 2018; 9:1-45. [PMID: 30603347 PMCID: PMC6224875 DOI: 10.1007/s13340-018-0345-3] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Indexed: 01/09/2023]
Affiliation(s)
| | | | | | | | - Daisuke Yabe
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Atsushi Goto
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Tatsuya Kondo
- Department of Metabolic Medicine, Kumamoto University, Kumamoto, Japan
| | - Eiichi Araki
- Department of Metabolic Medicine, Kumamoto University, Kumamoto, Japan
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90
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Husárová D, Kostičová M, Kočišová D, Schusterová I, Gecková AM. Do Adolescents with T1DM Differ from Their Peers in Health, Eating Habits and Social Support? Cent Eur J Public Health 2018; 25:307-312. [PMID: 29346855 DOI: 10.21101/cejph.a4876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The aim of this study was to analyse differences in health, eating habits and social support in adolescents with type 1 diabetes mellitus (T1DM) in comparison to peers with another long-term illness or without any medical condition. METHODS We used self-reported data from the cross-sectional Health Behaviour in School-aged Children study collected in 2014 among Slovak adolescents as well as data from adolescents with T1DM collected in outpatient settings (11 to 15 years old, N=8,910, 50.3% of boys). Logistic regression models and general linear models were used to analyse differences between adolescents with T1DM and their peers with and without long-term illness in self-rated health, life satisfaction, health complaints, regular breakfast, sweets and soft drink consumption, and perceived support from family, teachers and classmates. RESULTS Adolescents with T1DM reported worse self-rated health and suffer from more health complaints, but they have lower chance of having breakfast irregularly in comparison to their peers with another long-term illness or without any medical condition. Moreover, compared with their peers, adolescents with T1DM perceived stronger support from teachers and classmates, but weaker support from their family. We did not confirm any differences in life satisfaction, sweets and soft drink consumption between adolescents with T1DM and their peers. CONCLUSIONS Adolescents with T1DM reported more regular eating habits, no difference in life satisfaction and more social support outside the family in comparison to their peers. However, their worse self-rated health, more health complaints and weaker support from family should be considered in interventions targeting psychosocial adjustment of adolescents with T1DM.
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Affiliation(s)
- Daniela Husárová
- Department of Health Psychology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
| | - Michaela Kostičová
- Institute of Social Medicine and Medical Ethics, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Denisa Kočišová
- Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
| | - Ingrid Schusterová
- Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
| | - Andrea Madarasová Gecková
- Department of Health Psychology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic.,Olomouc University Social Health Institute, Palacký University Olomouc, Olomouc, Czech Republic
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91
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Due-Christensen M, Zoffmann V, Willaing I, Hopkins D, Forbes A. The Process of Adaptation Following a New Diagnosis of Type 1 Diabetes in Adulthood: A Meta-Synthesis. QUALITATIVE HEALTH RESEARCH 2018; 28:245-258. [PMID: 29235942 DOI: 10.1177/1049732317745100] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
While Type 1 diabetes (T1D) is generally associated with childhood, half of all cases occur in adulthood. The adaptive strategies individuals employ during the initial adaptive phase may have an important impact on their risk of future diabetes complications and their psychosocial well-being. We conducted a systematic review of six databases and included nine qualitative studies in a meta-synthesis, the aims of which were to develop a better understanding of how adults newly diagnosed with T1D experience the diagnosis and the phenomena associated with the early process of adaptation to life with diabetes. The meta-synthesis identified five constructs that shaped and influenced the early adaptive process: disruption, constructing a personal view of diabetes, reconstructing a view of self, learning to live with diabetes, and behavioral adaptations. The adaptive processes of adults to a diabetes diagnosis are highly referenced to prior life experiences, social habitus, and psychological orientation.
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Affiliation(s)
| | - Vibeke Zoffmann
- 2 Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - David Hopkins
- 4 King's College Hospital NHS Foundation Trust, Denmark Hill, London, United Kingdom
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92
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Alvar CM, Coddington JA, Foli KJ, Ahmed AH. Depression in the School-Aged Child With Type 1 Diabetes: Implications for Pediatric Primary Care Providers. J Pediatr Health Care 2018; 32:43-52. [PMID: 28870495 DOI: 10.1016/j.pedhc.2017.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/09/2017] [Accepted: 07/13/2017] [Indexed: 01/09/2023]
Abstract
Depression is a common comorbid condition experienced by children with type 1 diabetes that, if undiagnosed, can lead to deterioration in glycemic control and other serious health complications. Although it is documented that children with type 1 diabetes experience high rates of depression, a comprehensive clinical guide does not exist to help direct the pediatric provider on how to best care for these children. The purpose of this article is to synthesize current evidence to aid the pediatric primary care provider in the detection and management of depression in the school-aged child with type 1 diabetes.
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93
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94
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Abualula NA, Rodan MF, Milligan RA, Jacobsen KH. Self-rated health among American adolescents with type 1 diabetes in the T1D Exchange Clinic Registry. J Diabetes Complications 2018; 32:83-88. [PMID: 29092790 DOI: 10.1016/j.jdiacomp.2017.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 08/28/2017] [Accepted: 09/20/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND The goal of this study was to examine the self-rated health (SRH) of adolescents with type 1 diabetes (T1D). METHODS A logistic regression analysis of baseline data from adolescents in the United States included in the T1D Exchange Clinic Registry in 2010-2012 was conducted. Participants were 13-18years old at the time of enrollment in the registry and had been diagnosed with T1D at least one year before enrollment (n=5799). RESULTS Half (49.0%) of the participants were female, 46.3% were ages 16-18years, 22.5% were non-white, 35.7% did not have private/military health insurance, and 78.8% had HbA1c levels >7.5%, indicating poor T1D management, 20.7% reported having diabetes-related stress often or very often, and 46.4% used insulin injections or pens rather than a pump. In total, 10.3% (n=600) of the participants rated their health as poor or fair and 59.3% (n=3439) rated their health as very good or excellent. Participants with poor or fair SRH were more likely than those with very good or excellent SRH to be female (adjusted OR=1.7(1.4, 2.1)), 16 to 18years old (OR=2.1(1.7, 2.5)), and non-white (OR=2.7(2.2, 3.4)), to be without private or military insurance (OR=2.4(2.1, 3.0)), to have HbA1c levels >7.5% (OR=3.3(2.4, 4.7)), to report having diabetes-related stress often or very often (OR=6.1(5.1, 7.2)), and to use an injection or pen rather than a pump (OR=2.1(1.6, 2.4)). CONCLUSIONS Because adolescents with T1D who report lower SRH are more likely to have uncontrolled blood glucose and frequent diabetes-related stress, use of pumps and stress-reduction strategies may improve SRH among adolescents with T1D.
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Affiliation(s)
- Nada A Abualula
- College of Nursing, Taibah University, Universities Road, Medina, Saudi Arabia; School of Nursing, George Mason University, Fairfax, VA 22030, USA.
| | - Margaret F Rodan
- School of Nursing, George Mason University, Fairfax, VA 22030, USA.
| | - Renee A Milligan
- School of Nursing, George Mason University, Fairfax, VA 22030, USA.
| | - Kathryn H Jacobsen
- Department of Global & Community Health, George Mason University, Fairfax, VA 22030, USA.
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95
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Mozzillo E, Zito E, Maffeis C, De Nitto E, Maltoni G, Marigliano M, Zucchini S, Franzese A, Valerio G. Unhealthy lifestyle habits and diabetes-specific health-related quality of life in youths with type 1 diabetes. Acta Diabetol 2017; 54:1073-1080. [PMID: 28914364 DOI: 10.1007/s00592-017-1051-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/06/2017] [Indexed: 02/05/2023]
Abstract
AIMS Management of type 1 diabetes mellitus (T1DM) influences several aspects of life, such as adherence to healthy lifestyle habits and health-related quality of life (HRQoL). Our aim was to evaluate the association between unhealthy lifestyle habits and HRQoL in adolescents and young adults with T1DM. METHODS Two hundred and forty-two Caucasian patients (13-19 years) consecutively enrolled over a 12-month period in three Regional Pediatric Diabetes Centers in Italy. Demographics, clinical, and laboratory parameters, adherence to lifestyle habits (Mediterranean Diet assessed by KIDMED, Physical Activity levels and sedentary behavior by questionnaire) considered either separately or in cluster, and HRQoL by Pediatric Quality of Life Inventory Diabetes Module (PedsQL 3.0 DM) were collected. Metabolic control was determined by HbA1cmean of previous year. RESULTS Only 15 (6.2%) patients fulfilled the cluster of three healthy lifestyle habits without gender differences (p = 0.353); 62 (25.6%) had 1 unhealthy lifestyle habit, and 165 (68.2%) had ≥2. Adolescents meeting physical activity recommendations had better PedsQL scores than those who did not meet. PedsQL total score and specific sub-scales decreased in patients with unhealthy lifestyle habits. High PedsQL was significantly associated with being male, living in South Italy, having lower HbA1c mean levels, and reporting lower adherence to unhealthy lifestyle habits. CONCLUSIONS The clustering of unhealthy lifestyle habits is associated with reduced HRQoL in adolescents and young adults with T1DM. Promoting multiple behavior changes may be a useful approach to improve the health status and the HRQoL in youths with T1DM.
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Affiliation(s)
- Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center for Pediatric Diabetes, University of Naples Federico II, Naples, Italy
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, via Medina 40, 80133, Naples, Italy
| | - Eugenio Zito
- Department of Translational Medical Science, Section of Pediatrics, Regional Center for Pediatric Diabetes, University of Naples Federico II, Naples, Italy
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University City Hospital of Verona, Verona, Italy
| | - Elena De Nitto
- Department of Translational Medical Science, Section of Pediatrics, Regional Center for Pediatric Diabetes, University of Naples Federico II, Naples, Italy
| | - Giulio Maltoni
- Endocrine Unit, Department of Pediatrics, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Marco Marigliano
- Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University City Hospital of Verona, Verona, Italy
| | - Stefano Zucchini
- Endocrine Unit, Department of Pediatrics, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Adriana Franzese
- Department of Translational Medical Science, Section of Pediatrics, Regional Center for Pediatric Diabetes, University of Naples Federico II, Naples, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, via Medina 40, 80133, Naples, Italy.
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96
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Forsander G, Bøgelund M, Haas J, Samuelsson U. Adolescent life with diabetes-Gender matters for level of distress. Experiences from the national TODS study. Pediatr Diabetes 2017; 18:651-659. [PMID: 28004484 DOI: 10.1111/pedi.12478] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/18/2016] [Accepted: 10/21/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To examine the relationship between diabetes distress and gender, and the association with glycemic control, social support, health behaviors, and socio-economic status. METHODS All adolescents, aged 15 to 18 years, in the national, pediatric diabetes registry SWEDIABKIDS with type 1 diabetes were invited to complete an online questionnaire. A total of 2112 teenagers were identified. RESULTS 453 complete responses were valid for analyses. Young women scored significantly higher on the distress-screening instrument DDS-2. Almost half of the female respondents exhibited moderate to severe diabetes distress-more than twice the proportion than among male respondents (44% vs 19%). Females reported twice as high scores on the fear of hypoglycemia scale (P < 0.0001) and had a higher HbA1c value than males (P < 0.0001). Gender was highly correlated with distress level even when controlling for multiple factors that may affect distress (parameterfemale = 0.4, P = 0.0003). Particular social problems were highly significant, that is, those who trust that their parents can handle their diabetes when necessary were significantly less distressed than others (P = 0.018). Higher HbA1c levels were associated with higher distress scores (P = 0.0005 [female], P = 0.0487 [male]). CONCLUSIONS Diabetes-related distress is a great burden for adolescents living with diabetes. Actively involved family and friends may reduce diabetes distress, but female adolescents appear to be particularly vulnerable and may need extra focus and support. Our findings indicate that pediatric diabetes teams working with teenagers must intensify the care during this vulnerable period of life in order to reduce the risk of both psychological and vascular complications in young adults.
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Affiliation(s)
- Gun Forsander
- Department of Pediatrics, Institute of Clin Sciences, Sahlgrenska Academy, University of Gothenburg and The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, S-416 85 Gothenburg, Sweden
| | - Mette Bøgelund
- Incentive, Holte Stationsvej, 14, 1., 2840 Holte, Denmark
| | - Josephine Haas
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden
| | - Ulf Samuelsson
- Department of Clinical and Experimental Medicine, Division of Pediatrics, Linköping University, Linköping, Sweden
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97
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Noser AE, Huffhines L, Clements MA, Patton SR. Diabetes conflict outstrips the positive impact of self-efficacy on youth adherence and glycemic control in type 1 diabetes. Pediatr Diabetes 2017; 18:614-618. [PMID: 27859979 PMCID: PMC6233994 DOI: 10.1111/pedi.12471] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/08/2016] [Accepted: 10/12/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To examine whether self-efficacy buffers the deleterious consequences of diabetes-specific family conflict on self-monitoring blood glucose (SMBG) and glycated hemoglobin (HbA1c) in youth with type 1 diabetes mellitus (T1DM). METHODS A total of 129 youth with T1DM (aged 10-16 years) completed measures of diabetes-specific family conflict and self-efficacy for diabetes management, and their blood glucose meter data and HbA1c were extracted from the electronic medical record. We preformed moderation analyses to examine whether self-efficacy moderated the association that diabetes-specific family conflict had with SMBG and HbA1c. We used simple slopes analyses to probe significant interactions. RESULTS Our results indicated that self-efficacy moderated the association that diabetes-specific family conflict had with SMBG and HbA1c. The pattern of these findings showed that high self-efficacy buffered the negative impact of diabetes conflict on HbA1c. However, benefits of high self-efficacy for more frequent SMBG was only apparent in the context of low diabetes-specific family conflict. CONCLUSIONS Study findings highlight the interactive relationship between diabetes-specific family conflict and self-efficacy in relation to SMBG and glycemic control. These findings suggest that family functioning and youth's self-efficacy are promising intervention targets for families having trouble with SMBG and HbA1c.
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Affiliation(s)
- Amy E. Noser
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS 66045
| | - Lindsay Huffhines
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS 66045
| | - Mark A. Clements
- Division of Endocrinology & Diabetes, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri 64108
| | - Susana R. Patton
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas 66103
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98
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Scialla MA, Canter KS, Chen FF, Kolb EA, Sandler E, Wiener L, Kazak AE. Implementing the psychosocial standards in pediatric cancer: Current staffing and services available. Pediatr Blood Cancer 2017; 64:10.1002/pbc.26634. [PMID: 28544310 PMCID: PMC5719337 DOI: 10.1002/pbc.26634] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/14/2017] [Accepted: 04/14/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fifteen evidence-based Standards for Psychosocial Care for Children with Cancer and Their Families (Standards) were published in 2015. The Standards cover a broad range of topics and circumstances and require qualified multidisciplinary staff to be implemented. This paper presents data on the availability of psychosocial staff and existing practices at pediatric oncology programs in the United States, providing data that can be used to advocate for expanded services and prepare for implementation of the Standards. PROCEDURE Up to three healthcare professionals from 144 programs (72% response rate) participated in an online survey conducted June-December 2016. There were 99 pediatric oncologists with clinical leadership responsibility (Medical Director/Clinical Director), 132 psychosocial leaders in pediatric oncology (Director of Psychosocial Services/Manager/most senior staff member), and 58 administrators in pediatric oncology (Administrative Director/Business Administrator/Director of Operations). The primary outcomes were number and type of psychosocial staff, psychosocial practices, and identified challenges in the delivery of psychosocial care. RESULTS Over 90% of programs have social workers and child life specialists who provide care to children with cancer and their families. Fewer programs have psychologists (60%), neuropsychologists (31%), or psychiatrists (19%). Challenges in psychosocial care are primarily based on pragmatic issues related to funding and reimbursement. CONCLUSION Most participating pediatric oncology programs appear to have at least the basic level of staffing necessary to implement of some of the Standards. However, the lack of a more comprehensive multidisciplinary team is a likely barrier in the implementation of the full set of Standards.
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Affiliation(s)
| | | | | | | | | | - Lori Wiener
- Sidney Kimmel Medical College of Thomas Jefferson University
| | - Anne E. Kazak
- Nemours Children’s Health System,Sidney Kimmel Medical College of Thomas Jefferson University
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99
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Sundberg F, Barnard K, Cato A, de Beaufort C, DiMeglio LA, Dooley G, Hershey T, Hitchcock J, Jain V, Weissberg-Benchell J, Rami-Merhar B, Smart CE, Hanas R. ISPAD Guidelines. Managing diabetes in preschool children. Pediatr Diabetes 2017; 18:499-517. [PMID: 28726299 DOI: 10.1111/pedi.12554] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 05/14/2017] [Accepted: 05/31/2017] [Indexed: 01/09/2023] Open
Affiliation(s)
- Frida Sundberg
- The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Katharine Barnard
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Allison Cato
- Neurology Division, Nemours Children's Health System, Jacksonville, Florida
| | - Carine de Beaufort
- Clinique Pediatrique, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg.,Department of Pediatrics, UZ Brussels, Jette, Belgium
| | - Linda A DiMeglio
- Department of Pediatrics, Section of Pediatric Endocrinology/Diabetology, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Tamara Hershey
- Psychiatry Department, Washington University School of Medicine, St. Louis, Missouri.,Radiology Department, Washington University School of Medicine, St. Louis, Missouri
| | | | - Vandana Jain
- Pediatric Endocrinology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jill Weissberg-Benchell
- Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Birgit Rami-Merhar
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Carmel E Smart
- Department of Endocrinology, John Hunter Children's Hospital and University of Newcastle, Newcastle, Australia
| | - Ragnar Hanas
- Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Department of Pediatrics, NU Hospital Group, Uddevalla, Sweden
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100
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Duca LM, Wang B, Rewers M, Rewers A. Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes Predicts Poor Long-term Glycemic Control. Diabetes Care 2017; 40:1249-1255. [PMID: 28667128 DOI: 10.2337/dc17-0558] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 06/05/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study tested the hypothesis that diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in children predicts poor long-term glycemic control independently of established risk factors. RESEARCH DESIGN AND METHODS This was a prospective cohort study of 3,364 Colorado residents diagnosed with type 1 diabetes before 18 years of age, in 1998-2012, and monitored for up to 15 years. Of those, 1,297 (39%) had DKA at diagnosis (blood glucose >250 mg/dL, and venous pH <7.3 or bicarbonate <15 mEq/L). Severity of DKA was further classified as mild/moderate (pH 7.10-7.29 or bicarbonate 5-14 mEq/L) or severe (pH <7.10 or bicarbonate <5 mEq/L). HbA1c levels were measured an average of 2.8 times/year (median 20 HbA1c values/patient). A linear mixed model was used to examine the effect of DKA on long-term HbA1c levels, adjusting for age, race/ethnicity, sex, family history of diabetes, health insurance, and insulin pump use. RESULTS DKA at diagnosis predicted persistently elevated HbA1c levels. Compared with children without DKA, HbA1c tracked 1.4% (15.3 mmol/mol) higher in those with severe DKA (P < 0.0001) and 0.9% (9.8 mmol/mol) higher in those with mild/moderate DKA at diagnosis (P < 0.0001). These effects were independent of ethnic minority status or lack of health insurance at diagnosis that predicted higher HbA1c by 0.5% (5.5 mmol/mol; P < 0.0001) and 0.2% (2.2 mmol/mol; P < 0.0001), respectively. Insulin pump use or having a parent or sibling with type 1 diabetes predicted lower long-term HbA1c by, respectively, 0.4% (4.4 mmol/mol; P < 0.0001) and 0.2% (2.2 mmol/mol; P = 0.01). CONCLUSIONS DKA at diagnosis of type 1 diabetes in children predicts poor long-term glycemic control, independent of demographic and socioeconomic factors.
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Affiliation(s)
- Lindsey M Duca
- Barbara Davis Center for Diabetes, School of Medicine, University of Colorado, Aurora, CO.,Colorado School of Public Health, University of Colorado, Aurora, CO
| | - Bing Wang
- Barbara Davis Center for Diabetes, School of Medicine, University of Colorado, Aurora, CO
| | - Marian Rewers
- Barbara Davis Center for Diabetes, School of Medicine, University of Colorado, Aurora, CO
| | - Arleta Rewers
- Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO
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