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Girgin BA, Göl İ, Gözen D, Çarikçi F, Kirmizibekmez H. Effects of applications manual pressure and shotblocker to reduce needle-related pain and fear in children with type 1 diabetes mellitus. J Pediatr Nurs 2023; 73:84-90. [PMID: 37651942 DOI: 10.1016/j.pedn.2023.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/05/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Pain and fear associated with insulin injections can cause children with type 1 diabetes mellitus to avoid insulin injections and skip doses. OBJECTIVE To evaluate and compare pain and fear levels in children aged 6-12 years receiving subcutaneous insulin injection using the manual pressure and ShotBlocker methods. METHODS A randomized controlled study was conducted with 90 children with type 1 diabetes who were allocated using block randomization to the manual pressure, ShotBlocker, and control groups (n = 30 in each group). Fear and pain levels were rated by the children, their parents, and a member of the study team immediately before and after insulin injection using the Children's Fear Scale and Wong-Baker Faces Pain Rating Scale, respectively. RESULTS All groups had similar self-, parent-, and researcher-reported levels of preprocedural pain and fear (p > 0.05). However, pain and fear scores were lower in the manual pressure and ShotBlocker groups than in the control group after injection (p = 0.0001). There was no significant difference in pain and fear scores between the two intervention groups (p > 0.05). CONCLUSION Manual pressure and the ShotBlocker both reduced fear and pain associated with insulin injection in 6- to 12-year-old children with type 1 diabetes. IMPLICATIONS FOR PRACTICE Both the manual pressure and ShotBlocker methods can easily be applied in children receiving insulin injections. As manual pressure is completely cost- and equipment-free, it is a useful option to reduce pain and fear related to insulin injection. CLINICAL TRIAL REGISTRATION NUMBER National Institutes of Health (NIH), ClinicalTrials.gov, NCT05789810.
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Affiliation(s)
- Burcu Aykanat Girgin
- University of Health Sciences, Hamidiye Faculty of Nursing, Department of Pediatric Nursing, Tıbbiye Cad. No:38 Haydarpaşa, Üsküdar, Istanbul, Turkey.
| | - İlknur Göl
- Çankırı Karatekin University, Faculty of Health Sciences, Nursing Department of Public Health Nursing, Uluyazı, Çankırı, Turkey
| | - Duygu Gözen
- İstanbul University-Cerrahpaşa, Florence Nightingale Faculty of Nursing, Pediatric Nursing Department, Turkey
| | - Fatma Çarikçi
- İstanbul Yeni Yüzyıl University, Vocational School of Health Sciences, İstanbul, Turkey
| | - Heves Kirmizibekmez
- İstanbul Ümraniye Research and Training Hospital, Pediatric Endocrinology Service, Ümraniye, Turkey
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Jiang R, Ta X, Xu M, Luo Z, Du Y, Zhong X, Pan T, Cao X. Mediating Role of Depression Between Diabetes Management Self-Efficacy and Diabetes Self-Care Behavior Among Elderly Type 2 Diabetes Mellitus Patients in China. Psychol Res Behav Manag 2023; 16:1545-1555. [PMID: 37143902 PMCID: PMC10153400 DOI: 10.2147/prbm.s396916] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/05/2023] [Indexed: 05/06/2023] Open
Abstract
Objective To investigate the current status of diabetes self-care behavior and the association between depression, self-efficacy and self-care in a sample of Chinese elderly type 2 diabetes mellitus (T2DM) patients. Methods A cross-sectional study with a convenient sample including 240 elderly T2DM patients collected the data of demographic characteristics, diabetes self-care behavior, self-efficacy and depression status. The difference of self-care behavior in different sample characteristics was compared by independent t-test. The Personal correlation analysis was employed to examine the correlation of study variables. The method of bootstrap was used to analyze mediating role of depression. Results Only 22.5% of patients reported better diabetes self-care behavior and depression partly mediated the association between self-efficacy and self-care behavior. The significant coefficient of path a (B = -0.052, p < 0.001) and path b (B = -0.423, p < 0.05) indicated negative associations of self-efficacy on depression, and depression on self-care behavior. The indirect effect (Path a × b) between self-efficacy and self-care behavior through depression was significant (B = 0.022, p < 0.05), the 95% bias-corrected bootstrap confidence interval was 0.004 to 0.006. Meanwhile, the mediating role of depression was not found significant among the participants reported 60-74 years old (B = 0.104, p < 0.001). But depression completely mediated this association among the participants reported 75-89 years old (B = 0.034, p > 0.05). Conclusion The level of diabetes self-care behavior among the elderly T2DM patients in Dahu community of Anqing city was hardly optimistic. The self-efficacy focused intervention could be encouraged for community and clinicians to improve diabetes self-care behavior. Moreover, the prevalence of depression and T2DM is increasing in younger population. More work is needed to confirm these findings, especially conducting cohort studies on different populations.
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Affiliation(s)
- Ruobing Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Xin Ta
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Min Xu
- Department of Endocrinology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Zhihua Luo
- Department of Pediatrics, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Yijun Du
- Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Xing Zhong
- Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Tianrong Pan
- Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
- Tianrong Pan, Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email
| | - Xiujing Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
- Correspondence: Xiujing Cao, Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email
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辛 美, 吴 敬, 王 小, 韩 蕾. [Changes in the disease spectrum in the pediatric intensive care units within 2 years before and after the outbreak of coronavirus disease 2019]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:1098-1103. [PMID: 36305109 PMCID: PMC9627991 DOI: 10.7499/j.issn.1008-8830.2205074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/02/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To investigate the changes in the disease spectrum among hospitalized children in the pediatric intensive care units (PICU) within 2 years before and after the outbreak of coronavirus disease 2019 (COVID-19). METHODS The related data on disease diagnosis were collected from all children who were hospitalized in the PICU of Affiliated Hospital of Jining Medical College from January 2018 to December 2019 (pre-COVID-19 group) and from January 2020 to December 2021 (post-COVID-19 group). A statistical analysis was performed for the disease spectrum of the two groups. RESULTS There were 2 368 children in the pre-COVID-19 group and 1 653 children in the post-COVID-19 group. The number of children in the post-COVID-19 group was reduced by 30.19% compared with that in the pre-COVID-19 group. There was a significant difference in age composition between the two groups (P<0.05). The top 10 diseases in the pre-COVID-19 group by number of cases were respiratory diseases, neurological diseases, sepsis, critical illness, circulatory system diseases, severe neurosurgical diseases, digestive system diseases, unintentional injuries, endocrine system diseases, and tumors. The top 10 diseases in the post-COVID-19 group by number of cases were respiratory diseases, neurological diseases, sepsis, circulatory system diseases, unintentional injuries, endocrine system diseases, severe neurosurgical diseases, acute abdomen, trauma surgical diseases, and digestive system diseases. The proportions of respiratory diseases, critical illness and severe neurosurgical diseases in the post-COVID-19 group were lower than those in the pre-COVID-19 group (P<0.05), while the proportions of unintentional injuries, acute abdomen, endocrine system diseases, trauma surgical diseases and sepsis were higher than those in the pre-COVID-19 group (P<0.05). CONCLUSIONS COVID-19 epidemic has led to a significant reduction in the number of children admitted to the PICU, and there are significant changes in the disease spectrum within 2 years before and after the outbreak of COVID-19. Relevant prevention and control measures taken during the COVID-19 epidemic can reduce the incidence of respiratory diseases, neurological diseases, and other critical illness in children, but it is necessary to strengthen the prevention of unintentional injuries and chronic disease management during the epidemic.
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Luque-Vara T, Fernández-Gómez E, Linares-Manrique M, Navarro-Prado S, Sánchez-Ojeda MA, Enrique-Mirón C. Attitudes and Perceptions of School Teachers in Melilla Regarding the Care Provided to Students with Type 1 Diabetes. CHILDREN 2021; 8:children8121137. [PMID: 34943333 PMCID: PMC8699907 DOI: 10.3390/children8121137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022]
Abstract
The main objective of the study was to assess the perception of non-university teachers in the city of Melilla to help students with type 1 diabetes mellitus (T1DM), as well as their attitudes towards helping these students in diabetic emergencies. This observational, descriptive, cross-sectional study analyzed the answers given by 441 teachers from 25 public institutions in the city of Melilla to a survey on the attitude and perception regarding the capacity of educational institutions (16 questions) to help and manage students with T1DM. Out of 47.6% of teachers who represent having had students with TIDM, only 4.8% acknowledged having been trained in diabetes. The percentage that has experienced a hypoglycaemia episode at the institution was 29.9%. More than half of participants acknowledged that their educational institution is not prepared to manage diabetic emergencies. Only 5.7% stated their institutions have glucagon in their first-aid kit and less than half of participants (44.7%) would be willing to administer it if necessary. Teachers of educational institutions believe they have not been particularly trained in the care of students living with T1DM and point out that their educational institutions are not prepared to help in diabetic emergencies.
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Affiliation(s)
- Trinidad Luque-Vara
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; (T.L.-V.); (E.F.-G.); (S.N.-P.); (M.A.S.-O.)
| | - Elisabet Fernández-Gómez
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; (T.L.-V.); (E.F.-G.); (S.N.-P.); (M.A.S.-O.)
| | - Marta Linares-Manrique
- SEJ-658 Laboratory for Cognition, Department of Nursing, Health, Training and Interaction among Humans, Animals and Machines, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain
- Correspondence: ; Tel.: +34-952698839
| | - Silvia Navarro-Prado
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; (T.L.-V.); (E.F.-G.); (S.N.-P.); (M.A.S.-O.)
| | - María Angustias Sánchez-Ojeda
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; (T.L.-V.); (E.F.-G.); (S.N.-P.); (M.A.S.-O.)
| | - Carmen Enrique-Mirón
- HUM-613 Research Group, Department of Inorganic Chemistry, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain;
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Liu J, Liu L, Han YS, Yi J, Guo C, Zhao HQ, Ling J, Wang YH. The molecular mechanism underlying mitophagy-mediated hippocampal neuron apoptosis in diabetes-related depression. J Cell Mol Med 2021; 25:7342-7353. [PMID: 34213839 PMCID: PMC8335699 DOI: 10.1111/jcmm.16763] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 12/12/2022] Open
Abstract
Diabetes‐related depression (DD) is a major complication of diabetes mellitus. Our previous studies indicated that glutamate (Glu) and hippocampal neuron apoptosis are key signal and direct factor leading to diabetes‐related depression, respectively. However, the accurate pathogenesis remains to be unclear. We hypothesized that diabetes‐related depression might be associated with the mitophagy‐mediated hippocampal neuron apoptosis, triggered by aberrant Glu‐glutamate receptor2 (GluR2)‐Parkin pathway. To testify this hypothesis, here the rat model of DD in vivo and in vitro were both established so as to uncover the potential mechanism of DD based on mitophagy and apoptosis. We found that DD rats exhibit an elevated glutamate levels followed by monoamine neurotransmitter deficiency and depressive‐like behaviour, and DD modelling promoted autophagosome formation and caused mitochondrial impairment, eventually leading to hippocampal neuron apoptosis via aberrant Glu‐GluR2‐Parkin pathway. Further, in vitro study demonstrated that the simulated DD conditions resulted in an abnormal glutamate and monoamine neurotransmitter levels followed by autophagic flux increment, mitochondrial membrane potential reduction and mitochondrial reactive oxygen species and lactic dehydrogenase elevation. Interestingly, both GluR2 and mammalian target of rapamycin (mTOR) receptor blocker aggravated mitophagy‐induced hippocampal neuron apoptosis and abnormal expression of apoptotic protein. In contrast, both GluR2 and mTOR receptor agonist ameliorated those apoptosis in simulated DD conditions. Our findings revealed that mitophagy‐mediated hippocampal neuron apoptosis, triggered by aberrant Glu‐GluR2‐Parkin pathway, is responsible for depressive‐like behaviour and monoamine neurotransmitter deficiency in DD rats. This work provides promising molecular targets and strategy for the treatment of DD.
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Affiliation(s)
- Jian Liu
- The First Hospital, Hunan University of Chinese Medicine, Hunan Province, Changsha, China
| | - Lin Liu
- The First Hospital, Hunan University of Chinese Medicine, Hunan Province, Changsha, China
| | - Yuan-Shan Han
- The First Hospital, Hunan University of Chinese Medicine, Hunan Province, Changsha, China
| | - Jian Yi
- The First Hospital, Hunan University of Chinese Medicine, Hunan Province, Changsha, China
| | - Chun Guo
- The First Hospital, Hunan University of Chinese Medicine, Hunan Province, Changsha, China
| | - Hong-Qing Zhao
- Institute of Innovation and Applied Research, Hunan University of Chinese Medicine, Hunan Province, Changsha, China.,Key Laboratory of Chinese Material Medical Power and Innovation Drugs Established by Provincial and Ministry, Hunan University of Chinese Medicine, Hunan Province, Changsha, China
| | - Jia Ling
- Institute of Innovation and Applied Research, Hunan University of Chinese Medicine, Hunan Province, Changsha, China.,Key Laboratory of Chinese Material Medical Power and Innovation Drugs Established by Provincial and Ministry, Hunan University of Chinese Medicine, Hunan Province, Changsha, China
| | - Yu-Hong Wang
- Institute of Innovation and Applied Research, Hunan University of Chinese Medicine, Hunan Province, Changsha, China.,Key Laboratory of Chinese Material Medical Power and Innovation Drugs Established by Provincial and Ministry, Hunan University of Chinese Medicine, Hunan Province, Changsha, China
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Hasan RA, Hamid K, Dubre D, Nolan B, Sharman M. The Two-bag System for Intravenous Fluid Management of Children with Diabetic Ketoacidosis: Experience from a Community-Based Hospital. Glob Pediatr Health 2021; 8:2333794X21991532. [PMID: 33614853 PMCID: PMC7841651 DOI: 10.1177/2333794x21991532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 12/28/2020] [Accepted: 01/09/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: Intravenous fluid (IVF) administration using the two-bag system compared with the one-bag system in children with diabetic ketoacidosis (DKA) admitted between January 1, 2015 and December 31, 2016. Design: Retrospective cohort study. Setting: Community-based hospital. Results: A total of 109 patients were enrolled with a mean age of 13.24 years. The 2 groups had comparable demographics. Initial laboratory results were similar except for initial PH and Sodium. The two bag system had significantly less number of calls compared to one bag system (25.2 vs 5.2 P = .0001). One bag system had fewer hypoglycemia <60 mg/dl (4 vs 12 P = .049). No statistically significant observations noted in regards to glucose drop rate, number of intravenous fluid bags used, amount of fluid boluses given, hospital stay and Pediatric ICU stay. Conclusions: The two-bag system has less resource utilization and slower blood glucose drop rate, but higher hypoglycemic events
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Affiliation(s)
| | - Kewan Hamid
- Saint Peter's University Hospital, New Brunswick, NJ, USA
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Wu R, Zhu Z, Zhou D. VEGF, apelin and HO-1 in diabetic patients with retinopathy: a correlation analysis. BMC Ophthalmol 2020; 20:326. [PMID: 32770964 PMCID: PMC7414684 DOI: 10.1186/s12886-020-01593-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It's necessary to analyze the role of VEGF, apelin, and HO-1 in patients with type 2 diabetes (T2DM), and to evaluate its relevance to diabetic retinopathy (DR). METHODS T2DM patients who were treated in our hospital from December 1, 2018 to November 30, 2019 were included. T2DM patients were divided into non-DR (NDR) group, non-proliferative DR (NPDR) group, and proliferative DR (PDR) group. and healthy participants were selected as the control group. The value of VEGF, apelin, and HO1 in predicting PDR were analyzed by receiver operating characteristic (ROC) curve, and the relations of VEGF, apelin, HO-1 and clinical factors in PDR patients were analyzed by Pearson correlation analysis. RESULTS A total of 295 participants were included. The level of FPG and HbAlc in PDR group were significantly higher than that of other groups (all p < 0.05); the level of VEGF and apelin in PDR group were significantly higher than that of other groups (all p < 0.05), but the level of HO-1 in PDR group were significantly less than that of other groups(p = 0.017); the AUC of VEGF, apelin, HO-1 and combined use was 0.806(95%CI: 0.779-0.861), 0.819(95%CI: 0.765-0.878), 0.808(95%CI: 0.733-0.869) and 0.902(95%CI: 0.822-0.958) respectively, the AUC, sensitivity, specificity of the three combined use was significantly higher than that of single VEGF, apelin, HO-1 use(all p < 0.05). The cutoff values of serum VEGF, apelin, and HO-1 levels for predicting PDR were 163.85 pg/ml, 8.27 ng/ml, and 26.06 mmol/L respectively. Serum VEGF, apelin, and HO-1 in patients with PDR was related to the time course of DM, FPG and HbAlc (all p < 0.05). CONCLUSIONS VEGF, apelin and HO-1 are related to the progress of DR, and the combined use of VEGF, apelin and HO-1 is beneficial to the diagnosis and treatment of PDR.
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Affiliation(s)
- Rensiqin Wu
- Department of Endocrinology, The Affiliated Hospital of Inner Mongolia Medical University, No.1st tunnel north road, Hohhot, 010000 Innermongolia China
| | - Zhifeng Zhu
- Department of Endocrinology, The Affiliated Hospital of Inner Mongolia Medical University, No.1st tunnel north road, Hohhot, 010000 Innermongolia China
| | - Dandan Zhou
- Department of Endocrinology, The Affiliated Hospital of Inner Mongolia Medical University, No.1st tunnel north road, Hohhot, 010000 Innermongolia China
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Mkhwanazi BN, van Heerden FR, Mavondo GA, Mabandla MV, Musabayane CT. Triterpene derivative improves the renal function of streptozotocin-induced diabetic rats: a follow-up study on maslinic acid. Ren Fail 2019; 41:547-554. [PMID: 31234683 PMCID: PMC6598493 DOI: 10.1080/0886022x.2019.1623818] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Introduction: Reports indicate that oral administration of plant-derived maslinic acid (MA) exhibits hypoglycemic and renoprotective effects in streptozotocin (STZ)-induced diabetic rats. Challenges with triterpenes such as MA include low bioavailabilty which affects treatment efficacy in experimental animals. The goal of this study was to synthesize the MA derivative phenylhydrazine (PH-MA) in an effort to improve the efficacy of MA. Methods: Separate groups of non-diabetic and STZ-induced diabetic rats (n = 6) were anesthetized and the jugular vein cannulated for the infusion of 0.077 M NaCl at 9 mL/h. The bladder was catheterized for collection the urine samples every 30 min. After 30.5 h equilibration period, consecutive 30 min urine collections were made over the subsequent 4 h of 1 h control, 1.5 h treatment, and 1.5 h recovery periods. PH-MA (22 µg/h) and MA (90 µg/h) were added during the treatment periods for analysis of proximal tubular Na+ handling, plasma aldosterone and arginine vasopressin in male Sprague-Dawley rats. Results: Intravenous infusion of PH-MA (22 µg/h) and MA (90 µg/h) significantly (p ˂ .05) increased Na+ output, fractional excretion of Na+ (FENa) and lithium (FELi). Interestingly, like MA, PH-MA significantly (p ˂ .05) increased glomerular filtration rate (GFR) over the treatment period and decreased plasma aldosterone levels. Our findings indicate that PH-MA inhibited sodium reabsorption in the proximal and distal tubule as shown by increased FENa and low plasma aldosterone levels, respectively. Conclusions: PH-MA is, therefore, a promising multitarget antidiabetic agent that may ameliorate kidney function of diabetic patients at a dose four times lower than the parent compound (MA).
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Affiliation(s)
- Blessing Nkazimulo Mkhwanazi
- a School of Agricultural, Earth & Environmental Sciences , University of KwaZulu-Natal , Scottsville , South Africa
| | | | - Greanious Alfred Mavondo
- c Faculty of Medicine , National University of Science and Technology (NUST) , Bulawayao , Zimbabwe
| | - Musa Vuyisile Mabandla
- d School of Laboratory Medicine and Medical Sciences , University of KwaZulu-Natal , Durban , South Africa
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