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ElSayed NA, McCoy RG, Aleppo G, Balapattabi K, Beverly EA, Briggs Early K, Bruemmer D, Echouffo-Tcheugui JB, Eichorst B, Ekhlaspour L, Garg R, Hassanein M, Khunti K, Lal R, Lingvay I, Matfin G, Middelbeek RJ, Pandya N, Pekas EJ, Pilla SJ, Polsky S, Segal AR, Seley JJ, Stanton RC, Tanenbaum ML, Urbanski P, Bannuru RR. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2025. Diabetes Care 2025; 48:S86-S127. [PMID: 39651983 PMCID: PMC11635047 DOI: 10.2337/dc25-s005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2024]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Dandamrongrak C, Rechenberg K, Granger J, Johnson A, Yan K, Kue J. The association between depressive symptoms and executive function in type 1 diabetes population: A scoping review. Prim Care Diabetes 2024; 18:299-307. [PMID: 38653620 DOI: 10.1016/j.pcd.2024.04.001] [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: 10/18/2023] [Revised: 02/13/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The purpose of this study was to explore the existing literature on the relationship between depressive symptoms and executive function in patients with type 1 diabetes (T1DM) across the lifespan. METHODS The scoping review followed the PRISMA protocol by using three databases: PubMed, CINAHL, and PsycINFO on May 14, 2023. Primary research that included reported executive function and the association with depressive symptoms was included in the review. RESULTS Of 1470 de-duplicated publications identified, nine articles were included in the review. Five studies evaluated the T1DM population, while four studies evaluated T1DM and type 2 diabetes (T2DM) as an aggregate result. Three studies indicated an association between depressive symptoms and executive function in adults with T1DM, and four studies indicated an association between depressive symptoms and executive function in adults with either T1DM or T2DM. In general, participants who reported depressive symptoms also exhibited poor executive function. However, two studies did not find an association between depressive symptoms and executive function. CONCLUSION In summary, the seven studies in this review suggest that individuals with T1DM who report depressive symptoms are at a higher risk of poor executive function; a clear association between depressive symptoms and executive function in individuals with T1DM remains inconclusive. There is a need to explore this relationship in the future.
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Affiliation(s)
- Chawisa Dandamrongrak
- College of Nursing, University of South Florida, USA; Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
| | | | - Jumpee Granger
- Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand
| | | | - Kailei Yan
- College of Nursing, University of South Florida, USA
| | - Jennifer Kue
- College of Nursing, University of South Florida, USA
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Ji X, Zou W, Fan L, Zhou Z, Zhu X, Li X. Insulin resistance-related features are associated with cognitive decline: a cross-sectional study in adult patients with type 1 diabetes. Diabetol Metab Syndr 2024; 16:13. [PMID: 38212850 PMCID: PMC10782534 DOI: 10.1186/s13098-023-01249-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/29/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND To investigate the associations between insulin resistance (IR)-related features and cognitive function in type 1 diabetes (T1D). METHODS A total of 117 adult patients with T1D were recruited in this cross-sectional study. IR-related features include overweight/obesity/central obesity, hypertension, atherogenic dyslipidemia, and decreased estimated insulin sensitivity (eIS). The Wechsler Memory Scale-Chinese Revision, Wisconsin Card Sorting Test, and Sustained Attention to Response Task was used to assess memory, executive function and sustained attention, respectively. A z-score was generated from each test, and a composite measure of global cognitive performance was calculated by averaging the z-scores of all tests. Cognitive differences were measured between T1D patients with and without IR-related features. The associations between IR-related features and and cognitive performance were analyzed using: logistic regression, partial correlation, and multivariate linear regression analysis. RESULTS A total of 53 (45.3%) T1D patients were defined as having IR-related features. Individuals with IR-related features displayed worse overall cognitive scores compared to those without and had a 4-fold increase in the risk for having global cognitive z-score < 0. Among the IR-related features, higher triglyceride (TG) and lower eIS showed linear correlation with lower global cognitive performance. And the subsequent regression analysis identified eIS as the factor independently associated with global cognitive performance. CONCLUSIONS We have provided evidence linking IR-related features to deteriorated cognitive function in adult patients with T1D. And eIS showed an independent positive correlation with global cognitive performance. Although no causal relationship can be drawn, IR emerges as an important factor reflecting cognitive function. TRIAL REGISTRATION ClinicalTrials.gov NCT03610984.
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Affiliation(s)
- Xiaolin Ji
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
| | - Wenjing Zou
- National Clinical Research Center for Mental Disorders, Medical Psychological Center, Medical Psychological Institute of Central South University, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
- Department of Radiology, The First Affiliated Hospital of Zhejiang University School of Medicine, 310000, Hangzhou, China
| | - Li Fan
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
| | - Zhiguang Zhou
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
| | - Xiongzhao Zhu
- National Clinical Research Center for Mental Disorders, Medical Psychological Center, Medical Psychological Institute of Central South University, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.
| | - Xia Li
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.
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ElSayed NA, Aleppo G, Bannuru RR, Beverly EA, Bruemmer D, Collins BS, Darville A, Ekhlaspour L, Hassanein M, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S77-S110. [PMID: 38078584 PMCID: PMC10725816 DOI: 10.2337/dc24-s005] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Wijk I, Amsberg S, Johansson UB, Livheim F, Toft E, Anderbro T. Impact of an Acceptance and Commitment Therapy programme on HbA1c, self-management and psychosocial factors in adults with type 1 diabetes and elevated HbA1c levels: a randomised controlled trial. BMJ Open 2023; 13:e072061. [PMID: 38101850 PMCID: PMC10729111 DOI: 10.1136/bmjopen-2023-072061] [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: 01/21/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE To evaluate the impact of an Acceptance and Commitment Therapy (ACT) programme, tailored for people living with type 1 diabetes, on glycated haemoglobin (HbA1c), self-management and psychosocial factors among individuals with HbA1c>60 mmol/mol compared with treatment as usual (TAU). SETTING An endocrinologic clinic in Sweden. PARTICIPANTS In this randomised controlled trial, 81 individuals with type 1 diabetes, aged 18-70 years with HbA1c>60 mmol/mol, were randomly assigned to either an ACT group intervention or TAU. Exclusion criteria were: unable to speak Swedish, untreated or severe psychiatric disease, cortisone treatment, untreated thyroid disease and newly started insulin pump therapy. At the 2-year follow-up, HbA1c was measured in 26 individuals. INTERVENTION The ACT programme comprised seven 2-hour sessions held over 14 weeks and focused on acceptance of stressful thoughts and emotions, and to promote value-based committed action. OUTCOMES The primary outcome was HbA1c, and the secondary outcomes were measures of depression, anxiety, general stress, fear of hypoglycaemia, diabetes distress, self-care activities, psychological flexibility (general and related to diabetes) and quality of life. The primary endpoint was HbA1c 2 years after the intervention programme. Linear mixed models were used to test for an interaction effect between measurement time and group. RESULTS Likelihood ratio test of nested models demonstrated no statistically significant interaction effect (χ2=0.49, p=0.485) between measurement time and group regarding HbA1c. However, a statistically significant interaction effect (likelihood ratio test χ2=12.63, p<0.001) was observed with improved scores on The Acceptance and Action Questionnaire in the intervention group after 1 and 2 years. CONCLUSIONS No statistically significant difference was found between the groups regarding the primary outcome measure, HbA1c. However, the ACT programme showed a persistent beneficial impact on psychological flexibility in the intervention group. The dropout rate was higher than expected, which may indicate a challenge in this type of study. TRIAL REGISTRATION NUMBER NCT02914496.
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Affiliation(s)
- Ingrid Wijk
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
| | - Susanne Amsberg
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Unn-Britt Johansson
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Livheim
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Eva Toft
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine, Ersta Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Therese Anderbro
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Eaton CK, Comer M, Pruette CS, Riekert KA. Medication adherence in youths with CKD: habits for success. Pediatr Nephrol 2023; 38:3791-3802. [PMID: 37306720 PMCID: PMC11587169 DOI: 10.1007/s00467-023-05976-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Poor adherence habits are key contributors to nonadherence but there are few clinically feasible methods for evaluating adherence habits, particularly for youths with chronic kidney disease (CKD). This study investigated how participants' qualitative responses to three interview questions about adherence habits mapped to primary principles of habit formation and objectively measured medication adherence in youths with CKD. METHODS Participants (ages 11-21 years) were recruited from a pediatric nephrology clinic as part of a larger study. Participants' daily objective antihypertensive medication adherence was measured with an electronic pill bottle over a 4-week baseline period. Qualitative interviews about adherence habits and routines were conducted with a subset of participants (N = 18). RESULTS Clear qualitative differences emerged in how participants with high-medium adherence (80-100%) discussed adherence habits compared to participants with low adherence (0-79%). Participants with high-medium adherence discussed situational cues for taking medicine, including locations that cue adherence, step-by-step events leading up to taking medicine, and people who cue adherence. Participants with high-medium adherence regularly described taking medicine as "automatic," "second nature," and a "habit." Participants with low adherence rarely discussed these habit features nor did they explicitly acknowledge currently missing doses. Participants with low adherence tended to discuss challenges with organization and routines for taking medicine. CONCLUSIONS Evaluating patient responses to questions about adherence habits may uncover challenges with adherence habit formation, provide direction for habit-strengthening intervention focused on developing automatic cues for taking medication, and support adherence successes for youths with CKD. CLINICAL TRIAL REGISTRATION NUMBER NCT03651596. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Cyd K Eaton
- Johns Hopkins University School of Medicine, 4200 Eastern Avenue, Baltimore, MD, 21224, USA.
| | - Margaret Comer
- Johns Hopkins University School of Medicine, 4200 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Cozumel S Pruette
- Johns Hopkins University School of Medicine, 4200 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Kristin A Riekert
- Johns Hopkins University School of Medicine, 4200 Eastern Avenue, Baltimore, MD, 21224, USA
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Wiebe DJ, Berg CA, Munion AK, Loyola MDR, Mello D, Butner JE, Suchy Y, Marino JA. Executive Functioning, Daily Self-Regulation, and Diabetes Management while Transitioning into Emerging Adulthood. Ann Behav Med 2023; 57:676-686. [PMID: 37163736 PMCID: PMC10354839 DOI: 10.1093/abm/kaad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Executive functioning (EF) predicts better Type 1 diabetes (T1D) management in the high-risk years after high school, but the daily self-regulation processes involved are unclear. PURPOSE To examine whether EF is associated with daily self-regulation that minimizes one's exposure or buffers adverse reactions to daily diabetes problems, and to determine whether these patterns become stronger during the transition out of high school. METHODS A measurement burst design with convenience sampling was used. Seniors in high school with T1D (N = 207; 66% female) completed self-report (i.e., Behavioral Rating Inventory of Executive Functioning) and performance measures of EF (i.e., Delis-Kaplan Executive Function System). A 14-day daily diary assessing self-regulation failures, diabetes problems, affect, and indicators of diabetes management was completed at baseline and 1 year later. RESULTS Correlations and multilevel modeling were conducted. Lower self-reported EF problems were associated with lower average levels of daily self-regulation failures, and these variables were associated with fewer daily diabetes problems. In contrast, better EF performance was unrelated to average daily self-regulation failures, and was unexpectedly associated with more frequent diabetes problems in year 2. Equally across years, on days participants reported lower than their average levels of daily self-regulation failures, they had fewer diabetes problems, regardless of EF. On days with lower than average diabetes problems, participants reported better diabetes management indicators. EF generally did not buffer daily associations in either year. CONCLUSIONS Regardless of EF, promoting daily self-regulation may prevent diabetes problems and promote T1D management in daily life at this high-risk transitional time.
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Affiliation(s)
- Deborah J Wiebe
- Department of Psychological Sciences and the Health Sciences Research Institute, University of California, Merced, USA
| | - Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, USA
| | - Ascher K Munion
- Department of Psychology, University of Utah, Salt Lake City, USA
- Department of Psychology, East Carolina University, Greenville, USA
| | - Maria D Ramirez Loyola
- Department of Psychological Sciences and the Health Sciences Research Institute, University of California, Merced, USA
| | - Daniel Mello
- Department of Psychological Sciences and the Health Sciences Research Institute, University of California, Merced, USA
| | | | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, USA
| | - Jessica A Marino
- Department of Psychological Sciences and the Health Sciences Research Institute, University of California, Merced, USA
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Iceta S, Sohier L, Bégin C, Brazeau AS, Rabasa-Lhoret R, Gagnon C. Impact of glycemic variability on cognitive impairment, disordered eating behaviors and self-management skills in patients with type 1 diabetes: study protocol for a cross-sectional online study, the Sugar Swing study. BMC Endocr Disord 2022; 22:283. [PMID: 36401237 PMCID: PMC9673316 DOI: 10.1186/s12902-022-01191-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND People living with type 1 diabetes (PWT1D) are at increased risk for impairments in brain function, which may impact on daily life. Cognitive impairments in PWT1D might contribute to increasing eating disorders, reducing self-management skills, and deteriorating glycemic control. Glycemic variability may be a key determinant of disordered eating behaviors, as well as of cognitive impairments. The main objective of this study is to better understand the impact of glycemic variability in disordered eating behaviors and cognitive impairment, and its consequences on self-management skills in PWT1D. METHOD We aim to recruit 150 PWT1D with 50% of men and women in this cross-sectional study. Participants will record their glycemic variability over a 10-day period using a continuous glucose monitoring system (CGMS) and track their dietary intakes using image-assisted food tracking mobile application (2 days). Over four online visits, eating behaviors, diabetes self-management's skills, anxiety disorders, depression disorder, diabetes literacy and numeracy skills, cognitive flexibility, attention deficit, level of interoception, and impulsivity behaviors will be assessed using self-reported questionnaires. Cognitive functions (i.e., attention, executive functions, impulsivity, inhibition and temporal discounting), will be measured. Finally, medical, biological and sociodemographic data will be collected. To further our understanding of the PWT1D experience and factors impacting glycemic self-management, 50 PWT1D will also participate in the qualitative phase of the protocol which consist of individual in-depth face-to-face (virtual) interviews, led by a trained investigator using a semi-structured interview. DISCUSSION This study will contribute to highlighting the consequences of blood sugar fluctuations (i.e., "sugar swings"), in daily life, especially how they disrupt eating behaviors and brain functioning. A better understanding of the mechanisms involved could eventually allow for early detection and management of these problems. Our study will also seek to understand the patients' point of view, which will allow the design of appropriate and meaningful recommendations. TRIAL REGISTRATION ClinicalTrials.gov, NCT05487534. Registered 4 August 2022.
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Affiliation(s)
- Sylvain Iceta
- Research Center of the Quebec Heart and Lung Institute, Québec, QC, Canada.
- Department of Psychiatry and Neurosciences, Laval University, Québec, QC, Canada.
| | - Léonie Sohier
- Research Center of the Quebec Heart and Lung Institute, Québec, QC, Canada
- School of Psychology, Laval University, Québec, QC, Canada
| | - Catherine Bégin
- School of Psychology, Laval University, Québec, QC, Canada
- Centre d'expertise, Poids, Image Et Alimentation (CEPIA), Québec, QC, Canada
| | - Anne-Sophie Brazeau
- School of Human Nutrition, McGill University, Montreal, QC, Canada
- Montreal Institute for Clinical Research, Montreal, QC, Canada
| | - Rémi Rabasa-Lhoret
- Montreal Institute for Clinical Research, Montreal, QC, Canada
- Department of Nutrition, Montreal University, Montreal, QC, Canada
| | - Claudia Gagnon
- CHU de Québec-Université Laval Research Centre, Québec, QC, Canada
- Department of Medicine, Laval University, Québec, QC, Canada
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Rechenberg K, Koerner Ms R. General Anxiety, Diabetes-Specific Anxiety, and Quality of Life in Adolescents With Type 1 Diabetes. Sci Diabetes Self Manag Care 2022; 48:469-475. [PMID: 36125100 DOI: 10.1177/26350106221125689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of the study was to identify the differential associations between general anxiety, diabetes-specific anxiety, and diabetes-specific quality of life (QOL). METHODS A cross-sectional study was conducted of 146 adolescents with type 1 diabetes (T1DM) ages 13 to 17 during the COVID-19 pandemic. Participants completed self-report questionnaires assessing demographic characteristics, general anxiety, diabetes-specific anxiety, depressive symptoms, and diabetes-specific QOL. RESULTS The final sample of 146 adolescents was mostly male, non-Hispanic White, mean age of 14.5 ± 1.27, having diabetes for more than 1 year, and using insulin pumps. Higher diabetes-specific anxiety was associated with poorer general treatment-related QOL, but general anxiety was not. General anxiety, diabetes-specific anxiety, and depressive symptoms were significantly associated with diabetes-specific treatment-related QOL, worry-specific QOL, and poorer communication-related QOL. CONCLUSIONS There may be a differential impact of general anxiety and diabetes-specific anxiety in adolescents with T1DM. Diabetes-specific anxiety may be a more important factor in adolescents reporting poorer general treatment-related QOL, worry-related QOL, and communication-related QOL, while general anxiety and diabetes-specific anxiety appear to similarly impact poorer diabetes-specific treatment-related QOL. Diabetes-specific anxiety may be a more important component of QOL in adolescents. Targeted interventions may be required to effectively improve QOL.
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Rechenberg K, Szalacha L, Bugajski A. A self-report measure of diabetes-specific anxiety symptoms for adolescents. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2047970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Laura Szalacha
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Andrew Bugajski
- Department of Research and Sponsored Studies, Lakeland Regional Health, Lakeland, FL, USA
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Luo D, Wang Y, Cai X, Li R, Li M, Liu H, Xu J. Resilience Among Parents of Adolescents With Type 1 Diabetes: Associated With Fewer Parental Depressive Symptoms and Better Pediatric Glycemic Control. Front Psychiatry 2022; 13:834398. [PMID: 35492685 PMCID: PMC9043445 DOI: 10.3389/fpsyt.2022.834398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although pediatric resilience plays a significant role in resisting negative moods and improving glycaemic control, little research exists regarding resilience among the parents of adolescents with Type 1 diabetes. OBJECTIVE To investigate parental resilience's correlations with parental depressive symptoms, parental diabetes distress, and pediatric glycaemic control. METHODS This cross-sectional study recruited adolescents with Type 1 diabetes and their parents from two hospitals. The parents completed questionnaires. The 10-item Connor-Davidson Resilience Scale measured resilience; the Problem Areas in Diabetes Survey-Parent Revised version measured diabetes distress; the Patient Health Questionnaire-9 measured depressive symptoms. Standard glycated hemoglobin tests were performed on the adolescents. RESULTS Data from 224 parents (77.2% female, Mage = 39.88 [SD = 5.02], age range = 30-56 years) of adolescents (50.9% boys, Mage = 13.54 years [SD = 2.48], age range = 10-19 years) were available. More than half (52.7%) of parents exceeded the criterion score for high resilience. Parental resilience was significantly negatively associated with parental depressive symptoms and diabetes distress. Parents from the high-resilience group reported fewer depressive symptoms than those from the low-resilience group. In multivariate regressions, greater parental resilience is consistently related to better pediatric glycaemic control beyond parental psychological risk factors. CONCLUSIONS This study highlights the importance of parental resilience for parental mental health and glycaemic control among adolescents with Type 1 diabetes. The appropriate resilience support programme might be developed for parents, especially for those existing depressive symptoms and diabetes distress.
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Affiliation(s)
- Dan Luo
- School of Nursing, Nanjing University of Chinese Medicine, Jiangsu, China
| | - Yubing Wang
- Department of Endocrinology, Children's Hospital Affiliated to Nanjing Medical University, Jiangsu, China
| | - Xue Cai
- School of Nursing, Peking University, Beijing, China
| | - Ruxue Li
- School of Nursing, Peking University, Beijing, China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, China
| | - Haiyan Liu
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jingjing Xu
- Department of Endocrinology, The First Affiliated Hospital With Nanjing Medical University (Jiangsu Province Hospital), Jiangsu, China
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