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Hildebrandt BA, Mikhail ME, Gearhardt AN, Culbert KM, Burt SA, Neale MC, Keel PK, Katzman DK, Klump KL. Self-reported food liking and wanting: A factor analytic study of ratings across 49 consecutive days. Appetite 2024; 201:107601. [PMID: 38986815 PMCID: PMC11330718 DOI: 10.1016/j.appet.2024.107601] [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] [Received: 04/02/2024] [Revised: 06/28/2024] [Accepted: 07/08/2024] [Indexed: 07/12/2024]
Abstract
Reward responses to food are thought to play an important role in highly palatable food overconsumption. In animal models, food reward responses can be decoupled into unique "liking" (in the moment enjoyment) and "wanting" (motivation/craving) components. However, research on liking and wanting has been hampered by uncertainty regarding whether liking and wanting can be reliably separated in humans. We used factor analysis to test whether ratings of liking and wanting could be empirically separated in women assessed across 49 consecutive days. Female participants (N = 688; ages 15-30) from the Michigan State University Twin Registry reported liking and wanting of foods consumed that day, and wanting of foods not consumed that day, separately for sweets (e.g., cookies), fast food (e.g., French fries), carbohydrates (e.g., bread), and whole foods (fruit, plain chicken) each evening for 49 consecutive days. We examined both average levels and daily levels of liking/wanting across the 49-day period that captured individual differences in liking/wanting over time. Across both types of analyses, liking and wanting for foods that were eaten formed a single factor rather than separate, dissociable factors, while wanting of foods not eaten formed an independent factor. At the daily level, a liking/wanting factor emerged for each individual food category (e.g., liking/wanting sweets), whereas in average analyses, a single factor emerged that collapsed across all food types (i.e., liking/wanting of all foods). Results suggest individuals have difficulty distinguishing between liking and wanting of foods they have eaten on that day but may be able to more reliably separate wanting of foods they have not consumed.
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Affiliation(s)
- Britny A Hildebrandt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Megan E Mikhail
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | | | - Kristen M Culbert
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Michael C Neale
- Departments of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Debra K Katzman
- Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA.
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Leung W, Vo K, Clough M, Frias R. The use of wearable devices on physical activity levels among individuals living with diabetes: 2017 BRFSS. Prim Care Diabetes 2024; 18:466-469. [PMID: 38825422 DOI: 10.1016/j.pcd.2024.05.004] [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: 11/09/2023] [Revised: 03/08/2024] [Accepted: 05/27/2024] [Indexed: 06/04/2024]
Abstract
AIM This study aims to examine the association between wearing wearable devices and physical activity levels among people living with diabetes. METHODS 1298 wearable device users and nonusers living with diabetes from eight states of the 2017 Behavioral Risk Factors Surveillance System were included in the analysis. Unadjusted and adjusted linear regression was performed to determine the association between self-reported physical activity per week (min) and wearable device usage (users and nonusers) among people living with diabetes using survey analysis. RESULTS 84.97 % (95 % CI [80.39, 88.89]) of participants were nonusers of wearable devices, while 15.03 % (95 % CI [11.11, 19.61]) were users. Across the sample, the average weekly physical activity was 427.39 mins (95 % Cl [356.43, 498.35]). Nonusers had a higher physical activity per week with 433.83 mins (95 % CI [353.59, 514.07]), while users only had 392.59 mins (95 % CI [253.48, 531.69]) of physical activity per week. However, the differences between the two groups were non-statistically significant (p=.61). In both adjusted and unadjusted linear regressions between physical activity per week and wearable device usage, statistically significant associations were not found (unadjusted: β=-41.24, p=.62; adjusted: β=-56.41, p=.59). CONCLUSION Further research is needed to determine the effectiveness of wearable devices in promoting physical activity among people with diabetes. Additionally, there is a need to determine how people with diabetes use wearable devices that could promote physical activity levels.
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Affiliation(s)
- Willie Leung
- Department of Health Sciences and Human Performance Department, College of Natural and Health Sciences, The University of Tampa, Tamp, FL, USA.
| | - Kim Vo
- Department of Health Sciences and Human Performance Department, College of Natural and Health Sciences, The University of Tampa, Tamp, FL, USA
| | - McKenzie Clough
- Department of Health Sciences and Human Performance Department, College of Natural and Health Sciences, The University of Tampa, Tamp, FL, USA
| | - Rachel Frias
- Department of Health Sciences and Human Performance Department, College of Natural and Health Sciences, The University of Tampa, Tamp, FL, USA
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Mangoulia P, Milionis C, Vlachou E, Ilias I. The Interrelationship between Diabetes Mellitus and Emotional Well-Being: Current Concepts and Future Prospects. Healthcare (Basel) 2024; 12:1457. [PMID: 39057600 PMCID: PMC11276337 DOI: 10.3390/healthcare12141457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/19/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
Diabetes mellitus is a lifelong metabolic disorder that impacts people's well-being and biopsychosocial status. Psychiatric problems and diabetes mellitus have a complex, reciprocal interaction in which one condition affects the other. In this narrative review, we provide an overview of the literature on the psychological effects of diabetes, expound on the evaluation of emotional disorders in the setting of diabetes, and suggest interventions aimed at enhancing both mental and physical health. Diabetes can make daily life complicated and stressful. Frequent blood glucose testing, taking medications on a regular basis, adhering to a tight diet plan, and exercising are some examples of the suggested daily routine of subjects with diabetes. Furthermore, comorbid diseases and typical diabetic complications can have a detrimental impact on quality of life. When mental health conditions coexist with diabetes mellitus, there is a greater likelihood of medication noncompliance, a decreased commitment to diabetes-related self-care, increased functional impairment, inadequate glycemic control, a higher risk of complications, and overall higher healthcare expenses. Thus, evaluation of the mental health status of patients with diabetes is crucial. When treating psychological issues and psychiatric disorders, a comprehensive biopsychosocial approach should be taken, and where appropriate, psychopharmacological therapies or psychotherapy should be applied. The goal of continuous education and assistance for self-care is to give individuals with the disease the information and abilities they need to control their condition over time.
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Affiliation(s)
- Polyxeni Mangoulia
- Faculty of Nursing, National and Kapodistrian University of Athens, GR-11527 Athens, Greece;
| | - Charalampos Milionis
- Department of Endocrinology, Diabetes, and Metabolism, Elena Venizelou General Hospital, GR-11521 Athens, Greece;
| | - Eugenia Vlachou
- Department of Nursing, University of West Attica, GR-12243 Athens, Greece;
| | - Ioannis Ilias
- Department of Endocrinology, Hippokration General Hospital, GR-11527 Athens, Greece
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Grinberg K, Yisaschar-Mekuzas Y. Assessing Mental Health Conditions in Women with Gestational Diabetes Compared to Healthy Pregnant Women. Healthcare (Basel) 2024; 12:1438. [PMID: 39057581 PMCID: PMC11276048 DOI: 10.3390/healthcare12141438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION Pregnant women with gestational diabetes mellitus (GDM) experience higher psychological stress levels than healthy pregnant women. The objectives of the current study were to examine (1) the differences in anxiety, depression, stress, and somatization levels between women diagnosed with GDM and healthy pregnant women, and (2) the differences in anxiety, depression, stress, and somatization levels among women with well-controlled blood sugar levels compared to those who are not well controlled. METHODS A quantitative cross-sectional study was conducted, involving 103 women who had been pregnant at least once, including 40 women diagnosed with GDM and 63 healthy pregnant women. An online questionnaire was distributed that included three parts: socio-demographic parameters, the DASS-21 questionnaire assessing anxiety, depression, and stress, and the Brief Symptom Inventory (BSI) questionnaire assessing somatization. RESULTS Differences in the anxiety (t = 14.470, <0.001), depression (t = 8.17, <0.001), stress (t = 16.354, <0.001), and somatization (t = 13.679, <0.001) levels between women diagnosed with GDM and healthy pregnant women were found. Women diagnosed with GDM reported higher levels of anxiety, depression, stress, and somatization compared to those without GDM. Additionally, women with better blood sugar control, as indicated by lower glycated hemoglobin (HbA1c) levels had lower anxiety (t (38) = -2.04, p < 0.05), depression (t(38) = -2.88, p < 0.01), stress (t(38) = -1.88, p < 0.05), and somatization (t(38) = -1.88, p < 0.05) levels compared to women with poorer blood sugar control. CONCLUSIONS Pregnant women diagnosed with GDM report higher levels of negative mental health conditions such as anxiety, depression, stress, and somatization compared to healthy pregnant women.
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Affiliation(s)
- Keren Grinberg
- Department of Nursing Sciences, Faculty of Social and Community Sciences, Ruppin Academic Center, Emek Hefer 402500, Israel;
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Nazarpour S, Simbar M, Kiani Z, Khalaji N, Khorrami Khargh M, Naeiji Z. The relationship between quality of life and some mental problems in women with gestational diabetes mellitus (GDM): a cross-sectional study. BMC Psychiatry 2024; 24:511. [PMID: 39026253 PMCID: PMC11256570 DOI: 10.1186/s12888-024-05960-4] [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: 04/09/2024] [Accepted: 07/12/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Women with medical problems during pregnancy, including women with Gestational Diabetes Mellitus (GDM), experience an increased prevalence of mental health disorders which can affect their quality of life. This study aimed to assess the relationship between GDM-related quality of life and depression, anxiety, and stress. METHODS This analytical cross-sectional study was performed on 150 women with GDM. The participants were selected using a multi-stage sampling including quota and then randomized method from maternal care centers affiliated with Shahid Beheshti University of Medical Sciences, Tehran-Iran. The data were collected using a personal information questionnaire, the GDM-related quality of life questionnaire (GDMQoL-36), and the depression, anxiety, and stress scale (DASS). The data were analyzed using SPSS-23 software and statistical tests of coefficient Spearman's correlation, t-test, analysis of variance, and multiple linear regression. RESULTS The mean ± SD score for the GDM-related quality of life and the DASS scale were 55.51 ± 8.87 and 27.12 ± 19.43%, respectively. Different degrees of depression, anxiety, and stress were present in 40, 61.3, and 42% of women, respectively. The total score of GDM-related quality of life had a significant negative correlation with the total score of DASS and the scores of the subscales including depression, anxiety, and stress (P < 0.001). There were significant correlations between the total score of GDM-related quality of life with age, BMI, length of marriage, educational level of the woman and her spouse, the occupation of the woman and her spouse, income, and economic class of the family. Multiple linear regression revealed that depression, education, and job are predictive factors for GDM-related quality of life. CONCLUSION GDM-related quality of life is related to some mental disorders. Therefore, it is important to consider the mental health promotion of pregnant women with GDM in future prenatal health programs to improve their quality of life. This also shows the importance of integrating mental health promotion strategies to enhance the quality of life of pregnant women with GDM.
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Affiliation(s)
- Soheila Nazarpour
- Department of Midwifery, Chalous Branch, Islamic Azad University, Chalous, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zahra Kiani
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Khalaji
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mobina Khorrami Khargh
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Naeiji
- Department of Obstetrics and Gynecology, School of Medicine, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tschirhart H, Landeen J, Yost J, Nerenberg KA, Sherifali D. The Examination and Exploration of Diabetes Distress in Pre-existing Diabetes in Pregnancy: A Mixed-methods Study. Can J Diabetes 2024; 48:281-289.e2. [PMID: 38492737 DOI: 10.1016/j.jcjd.2024.03.001] [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: 09/07/2023] [Revised: 01/15/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES Diabetes distress (DD) has been understudied in the pregnancy population. Pregnancy is known to be a complex, highly stressful time for women with diabetes because of medical risks and the high burden of diabetes management. Our aim in this study was to explain and understand DD in women with pre-existing diabetes in pregnancy. METHODS An explanatory, sequential mixed-methods study was undertaken. The first strand consisted of a cross-sectional study of 76 women with type 1 and type 2 diabetes. A nested sampling approach was used to re-recruit 18 women back into the second strand for qualitative interviews using an interpretive description approach. RESULTS DD was measured by the validated Problem Area in Diabetes (PAID) scale. A PAID score of ≥40 was positive for distress. DD prevalence was 22.4% in the cross-sectional cohort and the average PAID score was 27.75 (standard deviation 16.08). In the qualitative strand, women with a range of PAID scores (10.0 to 60.0) were sampled for interviews. The majority of these participants described themes of DD in their interviews. Of the 15 women who described DD thematically, only 6 had positive PAID scores. CONCLUSIONS Integration of the mixed-methods data underscores important meta-inferences about DD in pregnancy, namely that DD was present to a greater degree than the PAID tool is sensitive to. DD was present qualitatively in most of the qualitative sample, despite interviewing women with a range of PAID scores. Future research on a pregnancy-specific DD scale is needed.
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Affiliation(s)
- Holly Tschirhart
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Janet Landeen
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Yost
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States
| | - Kara A Nerenberg
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Diana Sherifali
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Wiens K, Bai L, Hwang SW, Ronksley PE, Austin PC, Booth GL, Spackman E, Campbell DJT. Disparities in diabetes processes of care among people experiencing homelessness: An opportunity for intervention. Diabetes Res Clin Pract 2024; 213:111748. [PMID: 38885743 DOI: 10.1016/j.diabres.2024.111748] [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: 03/23/2024] [Revised: 05/23/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
AIMS To compare processes of diabetes care by homeless status. METHODS A population-based propensity matched cohort study was conducted in Ontario, Canada. People with diabetes were identified in administrative healthcare data between April 2006 and March 2019. Those with a documented history of homelessness were matched to non-homeless controls. Data on processes of care measures included glucose monitoring tests, screening for microvascular complications, and physician follow-up. Differences in processes of care were compared by homeless status using proportions, risk ratios, and rate ratios. RESULTS Of the 1,076,437 people with diabetes, 5219 matched pairs were identified. Homelessness was associated with fewer tests for glycated hemoglobin (RR = 0.63; 95 %CI: 0.60-0.67), LDL cholesterol (RR = 0.80; 95 %CI: 0.78-0.82), serum creatinine (RR = 0.94; 95 %CI: 0.92-0.97), urine protein quantification (RR = 0.62; 95 %CI: 0.59-0.66), and eye examinations (RR = 0.74; 95 %CI: 0.71-0.77). People with a history of homelessness were less likely to use primary care for diabetes management (RR = 0.62; 95 %CI: 0.59-0.66) or specialist care (RR = 0.87; 95 %CI: 0.83-0.91) compared to non-homeless controls. CONCLUSIONS Disparities in diabetes care are evident for people with a history of homelessness and contribute to excess morbidity in this population. These data provide an impetus for investment in tailored interventions to improve healthcare equity and prevent long-term complications.
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Affiliation(s)
- Kathryn Wiens
- Temerty Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON M5S 1A8, Canada.
| | - Li Bai
- ICES Central, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada.
| | - Stephen W Hwang
- Temerty Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON M5S 1A8, Canada; ICES Central, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada; MAP Centre for Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
| | - Paul E Ronksley
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada.
| | - Peter C Austin
- ICES Central, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada.
| | - Gillian L Booth
- Temerty Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON M5S 1A8, Canada; ICES Central, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada; MAP Centre for Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
| | - Eldon Spackman
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada.
| | - David J T Campbell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada; Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive, NW, Calgary, AB T2N 4N1, Canada.
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James O, Abbou-Abbas L, Vijayasingham L. Living with and managing type 1 diabetes in humanitarian settings: A qualitative synthesis of lived experience and stakeholder tacit knowledge. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003027. [PMID: 38905318 PMCID: PMC11192347 DOI: 10.1371/journal.pgph.0003027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/28/2024] [Indexed: 06/23/2024]
Abstract
Humanitarian health actors are beginning to better consider and manage non-communicable diseases, such as diabetes, in emergency and protracted crisis settings. However, a focus on the more globally prevalent type 2 diabetes (T2D) dominates. Blind spots prevail in the unmet needs for type 1 diabetes (T1D), a chronic autoimmune condition where individuals are unable to produce insulin, thereby dependent on lifelong insulin therapy and blood glucose management. Although some T1D management requirements overlap with those of T2D, the immediate risk of fatal complications following insulin therapy disruption, the earlier age of onset during childhood, adolescence or young adulthood, and its lower prevalence compared to T2D within communities and local health systems mean that T1D requires nuanced consideration and targeted interventions. Intending to inform program and policy design for people with T1D (PWT1D), we synthesized themes of lived experience from PLWT1D and their caregivers, and the tacit working knowledge of health providers and policymakers in the context of local humanitarian operations. Through a strategic search of health databases (up to July 2023), we identified 11 articles that include interview excerpts from PWT1D, caregivers, healthcare providers and policymakers about T1D management in humanitarian settings. We used reflexive thematic analysis to guide data extraction, coding, and synthesis, resulting in the identification of four overarching themes: food and insulin security, family relations, knowledge translation, and response to diagnosis. The narratives highlight harsh trade-offs made by PWT1D and their families in the face of insulin and food insecurity, as well as the damaging impact of low T1D education in families, communities and health systems. Targeted family and community-based solutions are urgently required, alongside systemic reforms and international collaboration to enable better T1D coping and management in humanitarian settings.
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Affiliation(s)
- Oria James
- MSc Public Health Graduate Class of 2023, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Linda Abbou-Abbas
- International Committee of the Red Cross, Beirut Delegation, Lebanon
- INSPECT-LB (Institut de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban), Beirut, Lebanon
| | - Lavanya Vijayasingham
- NCD in Humanitarian Settings Research Group and Centre for Global Chronic Conditions, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Bugge SJ, Henriksen DP, Damkier P, Rahbek MT, Schousboe K, Rothmann MJ, Poulsen MK, Hansen C, Nagarajah S, Jensen PB, Johansson SL, Panou V, Schneider IR, Pedersen CG, Andersen JD, Hangaard J, Zwisler ADO. Network of doctors for multimorbidity and diabetes - the NOMAD intervention: protocol for feasibility trial of multidisciplinary team conferences for people with diabetes and multimorbidity. Pilot Feasibility Stud 2024; 10:91. [PMID: 38879561 PMCID: PMC11179232 DOI: 10.1186/s40814-024-01517-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 06/06/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND The prevalence of diabetes and coexisting multimorbidity rises worldwide. Treatment of this patient group can be complex. Providing an evidence-based, coherent, and patient-centred treatment of patients with multimorbidity poses a challenge in healthcare systems, which are typically designed to deliver disease-specific care. We propose an intervention comprising multidisciplinary team conferences (MDTs) to address this issue. The MDT consists of medical specialists in five different specialities meeting to discuss multimorbid diabetes patients. This protocol describes a feasibility test of MDTs designed to coordinate care and improve quality of life for people with diabetes and multimorbidity. METHODS A mixed-methods one-arm feasibility test of the MDT. Feasibility will be assessed through prospectively collected data. We will explore patient perspectives through patient-reported outcomes (PROs) and assess the feasibility of electronic questionnaires. Feasibility outcomes are recruitment, PRO completion, technical difficulties, impact of MDT, and doctor preparation time. During 17 months, up to 112 participants will be recruited. We will report results narratively and by the use of descriptive statistics. The collected data will form the basis for a future large-scale randomised trial. DISCUSSION A multidisciplinary approach focusing on better management of diabetic patients suffering from multimorbidity may improve functional status, quality of life, and health outcomes. Multimorbidity and diabetes are highly prevalent in our healthcare system, but we lack a solid evidence-based approach to patient-centred care for these patients. This study represents the initial steps towards building such evidence. The concept can be efficiency tested in a randomised setting, if found feasible to intervention providers and receivers. If not, we will have gained experience on how to manage diabetes and multimorbidity as well as organisational aspects, which together may generate hypotheses for research on how to handle multimorbidity in the future. ADMINISTRATIVE INFORMATION Protocol version: 01 TRIAL REGISTRATION: NCT05913726 - registration date: 21 June 2023.
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Affiliation(s)
- Stine Jorstad Bugge
- Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark.
- Department of Pharmacology, Odense University Hospital, Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Daniel Pilsgaard Henriksen
- Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark
- Department of Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Per Damkier
- Department of Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Martin Torp Rahbek
- Department of Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Karoline Schousboe
- Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mette Juel Rothmann
- Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marianne Kjær Poulsen
- Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Camilla Hansen
- Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark
| | - Subagini Nagarajah
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nephrology, Odense University Hospital, Odense, Denmark
| | - Per Bruno Jensen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nephrology, Odense University Hospital, Odense, Denmark
| | - Sofie Lock Johansson
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - Vasiliki Panou
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - Ida Ransby Schneider
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Charlotte Gjørup Pedersen
- Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jonas Dahl Andersen
- Steno Diabetes Centre Northern Jutland, Aalborg University Hospital, Aalborg, Denmark
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Jørgen Hangaard
- Steno Diabetes Centre Odense, Odense University Hospital, 5000, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ann-Dorthe Olsen Zwisler
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
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Beaudin J, Chouinard MC, Hudon É, Hudon C. Integrated self-management support provided by primary care nurses to persons with chronic diseases and common mental disorders: a qualitative study. BMC PRIMARY CARE 2024; 25:212. [PMID: 38867162 PMCID: PMC11167744 DOI: 10.1186/s12875-024-02464-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND More and more people suffer from concomitant chronic physical diseases and common mental disorders, calling for integrated self-management support in primary care. However, self-management support of chronic physical diseases and common mental disorders is not clearly operationalized by guidelines and is still conducted in silos by primary care nurses, especially in favour of chronic diseases. This study aims to better understand primary care nurses' experience of integrated self-management support for people with physical chronic diseases and common mental disorders. METHODS An interpretive descriptive qualitative approach was conducted with 23 primary care nurses from family medicine groups in Quebec (Canada). They were selected through purposive and snowball sampling methods to participate in an individual interview. Data were analysed using an iterative inductive and deductive analysis (Rainbow Model of Integrated Care and the Practical Reviews in Self-Management Support (PRISMS) taxonomy). RESULTS Nurses' experience of integrated self-management support for people with CD and CMD was structured around: (1) elements of the approach; (2) clinical integration through prevention and health promotion; and (3) operationalization of integrated self-management support. Several elements deemed essential to integrated self-management support were identified. Nurses offered integrated self-management support through prevention of risk factors and promotion of a healthy lifestyle for physical chronic diseases and common mental disorders. Nurses' self-management support activities included education, action plans, monitoring, and many practical, psychological, and social support strategies. A model of integrated self-management support for primary care nursing is proposed to better understand its clinical integration. CONCLUSION This study presents clinical integration of self-management support and activities for people with physical chronic diseases and common mental disorders in primary care settings. Understanding integrated self-management support will help implement future interventions.
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Affiliation(s)
- Jérémie Beaudin
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada.
- Module des sciences infirmières, Université du Québec à Chicoutimi, 555 Bd de l'Université, Chicoutimi, Québec, G7H 2B1, Canada.
| | - Maud-Christine Chouinard
- Faculté des sciences infirmières, Université de Montréal, Pavillon Marguerite-d'Youville, C.P. 6128 succ. Centre-ville, Montréal, Québec, Canada, H3C 3J7
| | - Émilie Hudon
- Module des sciences infirmières, Université du Québec à Chicoutimi, 555 Bd de l'Université, Chicoutimi, Québec, G7H 2B1, Canada
| | - Catherine Hudon
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada
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Anderson MN, Gallo CA, Passalugo SW, Nimeh JM, Edgar R, Yengo-Kahn AM, Neitz K, Terry DP, Zuckerman SL, Broglio SP, McCrea M, McAllister T, Pasquina P, Buckley TA. Collegiate Athletes With Diabetes: Baseline Medical Comorbidities and Preseason Concussion Testing Performance. J Athl Train 2024; 59:297-303. [PMID: 37655803 DOI: 10.4085/1062-6050-0202.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
CONTEXT People with diabetes mellitus (DM) are at increased risk for adverse health events and complications throughout their lifetime. Whether DM significantly affects collegiate athletes' concussion baseline testing performance remains unclear. OBJECTIVES To (1) describe the prevalence of DM and associated comorbidities and (2) compare concussion baseline testing performance between student-athletes with DM and student-athletes without DM (NoDM). DESIGN Retrospective, cross-sectional study. SETTING University. PATIENTS OR OTHER PARTICIPANTS Using the Concussion, Assessment, Research and Education (CARE) Consortium research database, we matched athletes with self-reported DM (N = 229) by institution, sex, age, sport, position, testing year, and concussion history to athletes with NoDM (N = 229; total sample mean age = 19.6 ± 1.4 years, women = 42%). MAIN OUTCOME MEASURE(S) Descriptive statistics and χ2 tests of independence with subsequent odds ratios were calculated. Independent-samples t tests compared baseline symptoms, neurocognitive testing, and balance performance between athletes with DM and athletes with NoDM. Effect sizes were determined for significant group differences. RESULTS At baseline, athletes with DM had higher rates of self-reported pre-existing balance disorders, sleep disorders, seizure disorders, motion sickness, learning disorders, vision and hearing problems, psychiatric disorders, depression, bipolar disorder, nonmigraine headaches, and meningitis than athletes with NoDM (P values < .05). We found balance differences between groups (P = .032, Cohen d = 0.17) such that, on average, athletes with DM had 1 additional error on the Balance Error Scoring System (DM = 13.4 ± 6.5; NoDM = 12.1 ± 5.9). No other comparisons yielded significant results. CONCLUSIONS Although athletes with DM had high rates of self-reported balance disorders, sleep disorders, seizures, and meningitis, their baseline neurocognitive testing results were largely identical to those of athletes with NoDM. Our findings suggested that nonclinically meaningful differences were present in concussion baseline balance testing but no significant differences were noted in cognitive testing; however, the effect of DM on concussion recovery remains unknown.
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Affiliation(s)
| | - Caitlin A Gallo
- Kinesiology and Applied Physiology, University of Delaware, Newark
| | | | - Jake M Nimeh
- Department of Biological Sciences, University of Delaware, Newark
| | | | | | | | | | | | | | | | | | - Paul Pasquina
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Thomas A Buckley
- Kinesiology and Applied Physiology, University of Delaware, Newark
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12
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Lyu X, Zeng J, Lin J, Song Y, Yang T, Hou W. Validation of the Chinese version of the diabetes health profile to predict the impact of mobile health education on quality of life in type 2 diabetes patients. Front Public Health 2024; 12:1330154. [PMID: 38450133 PMCID: PMC10915233 DOI: 10.3389/fpubh.2024.1330154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Purpose The Diabetes Health Profile (DHP18), initially created in the United Kingdom, currently lacks a Chinese version. This study endeavors to authenticate the Chinese adaptation of the DHP18 and assess the influence of mobile health (mHealth) education intervention on the quality of life of individuals living with diabetes. Patients and methods The study included 470 Type 2 diabetes Mellitus (T2DM) patients (204 men, 266 women), spanning an age range of 19-79 years, with an average age of 54 ± 12.40 years. Data analysis employed Jamovie and Mplus software. Moreover, test-retest reliability was evaluated in 52 hospitalized T2DM patients through two repeated measurements taken 4 weeks apart. Results The Chinese version DHP18 scale exhibited high reliability, evidenced by a Cronbach's alpha of 0.88, and coefficient of test-retest reliability of 0.84. Individual subscales also demonstrated strong reliability, ranging from 0.76 to 0.84, with test-retest reliability spanning from 0.71 to 0.74. Confirmatory Factor Analysis (CFA) employing a three-factor structure (χ2 = 294.69, GFI = 0.92, TLI = 0.91, RMSEA = 0.05, SRMR = 0.06) validated the scale's construct validity. Notably, there was a statistically significant difference (p < 0.05) in the quality of life between Type 2 diabetes patients using mHealth education intervention and those without mHealth education intervention. Mediation analysis revealed that Appraisal of Diabetes (ADS) and Self-Management Efficacy (SED) mediated the effects of Psychological Distress (PD) and Behavior Adherence (BA) on quality of life, both significant direct and indirect effects (p < 0.001). In addition, Dietary Abstinence (DE) displayed significant overall impact (β = -0.13, p < 0.001) and indirect influence (β = -0.10, p < 0.01) on diabetic patients' quality of life, though lacking a significant direct effect (β = -0.03, p = 0.38). Conclusion The Chinese version of the Diabetes Health Profile Scale meets stringent psychometric standards and stands as an appropriate measurement tool for Chinese T2DM patients, maintaining comparable results to the original scale's structure. The mHealth education intervention yielded a notably positive impact on the quality of life among T2DM patients. Mediation analysis revealed that the three dimensions of the DHP were mediated by Appraisal of Diabetes and Diabetes Self-Management Efficacy, partially mediated by Psychological Distress and Behavior Adherence, and fully mediated by Dietary Abstinence, providing insight into the positive effects of the mHealth model on the quality of life of diabetic patients.
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Affiliation(s)
- Xiaokang Lyu
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Jinmei Zeng
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Jingna Lin
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Yixuan Song
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Tingting Yang
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Wenjing Hou
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
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Mahmoud M, Mahmood R. Differences in mental health status between individuals living with diabetes, and pre-diabetes in Qatar: A cross-sectional study. Heliyon 2024; 10:e23515. [PMID: 38187308 PMCID: PMC10770440 DOI: 10.1016/j.heliyon.2023.e23515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 10/03/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Aims The aims of this study was to determine the prevalence and to compare depression and anxiety screening scores by type of diabetes: type 2 diabetes mellitus (T2DM), type 1 diabetes mellitus (T1DM), and pre-diabetes. The secondary aim was to examine sex differences in screening scores by type of diabetes. Methods This cross-sectional study was conducted in Doha, Qatar using primary data collection (N = 150), and stratified random sampling at a diabetes primary healthcare center. The study tool collected demographic information and used validated mental health screening tools for depressive symptoms "Patient Health Questionnaire-9 (PHQ-9)", and for anxiety symptoms "Generalized Anxiety Disorder 7 (GAD-7)". Results The prevalence of moderate to severe depressive and anxiety scores was highest in the prediabetes group (20 % and 14 % respectively). There were increased PHQ-9 scores in the pre-diabetes group compared to T2DM (p-value <0.05). No statistically significant differences in depressive symptom scores were found when comparing the pre-diabetes group with T1DM, and T1DM with T2DM. When looking at sex differences, there were no statistically significant differences between T1DM and pre-diabetes males and females, however PHQ-9 and GAD-7 scores in T2DM females were poorer compared to T2DM males. Conclusion The results of our study found patients living with pre-diabetes, and females with T2DM are vulnerable populations who should be screened for mental health disorders. Early screening for mental health disorders for individuals diagnosed with prediabetes, T1DM, and T2DM should be routinely conducted to potentially improve health outcomes.
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Affiliation(s)
- Montaha Mahmoud
- College of Health Sciences, University of Doha for Science and Technology, Doha, Qatar
| | - Razi Mahmood
- College of Health Sciences, University of Doha for Science and Technology, Doha, Qatar
- AFG College with the University of Aberdeen, Doha, Qatar
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14
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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: 0] [Impact Index Per Article: 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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15
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Eseadi C, Amedu AN, Aloh HE. Significance of fostering the mental health of patients with diabetes through critical time intervention. World J Clin Cases 2023; 11:8486-8497. [PMID: 38188207 PMCID: PMC10768517 DOI: 10.12998/wjcc.v11.i36.8486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/23/2023] [Accepted: 12/12/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Critical time intervention (CTI) is an evidence-based model of practice that is time-limited and aims to provide support for most susceptible individuals during a transition period. AIM To examine the significance of fostering the mental health of diabetes patients through CTI using the scoping review methodology. METHODS As part of the scoping review process, we followed the guidelines established by the Joanna Briggs Institute. The search databases were Google Scholar, PubMed, Scopus, PsycINFO, Reference Citation Analysis (https://www.referencecitationanalysis.com/), and Cochrane Library. From these databases, 77 articles were retrieved with the aid of carefully selected search terms. However, 19 studies were selected after two reviewers appraised the full texts to ensure that they are all eligible for inclusion, while 54 papers were excluded. RESULTS This study revealed that diabetic patients who had experienced homelessness were at higher risk of being diagnosed with mental illness and that social support services are impactful in the management of the comorbidity of diabetes and mental health problems. In addition, this review reveals that CTI is impactful in enhancing the mental health of homeless patients during the transitional period from the hospital through social support services. CONCLUSION CTI is a promising intervention for alleviating mental health symptoms in homeless patients. Empirical studies are needed across the globe, involving both hospitalized and community-based patients, to determine how clinically effectively CTI is in managing the mental health of diabetics.
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Affiliation(s)
- Chiedu Eseadi
- Department of Educational Psychology, Faculty of Education, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | - Amos Nnaemeka Amedu
- Department of Educational Psychology, Faculty of Education, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | - Henry Egi Aloh
- Department of Health Services, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 482131, Ebonyi State, Nigeria
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16
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Isfandari S, Roosihermiatie B, Tuminah S, Mihardja LK. The risk associated with psychiatric disturbances in patients with diabetes in Indonesia (2018): a cross-sectional observational study. Osong Public Health Res Perspect 2023; 14:368-378. [PMID: 37920894 PMCID: PMC10626316 DOI: 10.24171/j.phrp.2023.0144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND The global prevalence of psychiatric disturbances is rising, detrimentally affecting the quality of care and treatment outcomes for individuals, particularly those with diabetes.This study investigated the association of risk factors for psychiatric disturbances among productive-age patients with diabetes (ages 30-59 years), considering sociodemographic characteristics and co-existing diseases. The risk factors considered included sociodemographic factors (e.g., residence, age, sex, marital status, education, and occupation) and co-existing diseases (e.g., hypertension, heart disease, stroke, renal failure, rheumatism, asthma, and cancer). METHODS This cross-sectional study utilized data from the 2018 Indonesian National Health Survey (Riskesdas). The study population comprised respondents aged between 30 and 59 years who had diabetes and had completed the 20-question self-reporting questionnaire (SRQ-20). After the exclusion of incomplete SRQ-20 data, the sample included 8,917 respondents. Data were analyzed using logistic regression. RESULTS Approximately 18.29% of individuals with diabetes displayed symptoms indicative of psychiatric disturbances. After adjusting for sociodemographic factors such as age, sex, education level, occupation, marital status, and place of residence, patients with diabetes who had co-existing conditions such as hypertension, heart diseases, rheumatic disorders, asthma, or cancer had a higher risk for developing psychiatric disturbances than those with diabetes alone (adjusted odds ratio, 6.67; 95% confidence interval, 4.481-9.928; p<0.001). CONCLUSION The elevated risk of psychiatric disturbances among patients with diabetes who had comorbidities underscores the importance of addressing mental health issues in the management of diabetes, especially in patients with concurrent disease conditions.
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Affiliation(s)
- Siti Isfandari
- Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency, Bandung, Indonesia
| | - Betty Roosihermiatie
- Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency, Bandung, Indonesia
| | - Sulistyowati Tuminah
- Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency, Bandung, Indonesia
| | - Laurentia Konadi Mihardja
- Research Center for Pre-Clinical and Clinical Medicine, Research Organization for Health, National Research and Innovation Agency, Bandung, Indonesia
- Faculty of Medicine, University of Malahayati, Bandar Lampung, Indonesia
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17
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Narindrarangkura P, Alafaireet PE, Khan U, Kim MS. Association rule mining of real-world data: Uncovering links between race, glycemic control, lipid profiles, and suicide attempts in individuals with diabetes. INFORMATICS IN MEDICINE UNLOCKED 2023; 42:101345. [PMID: 37946845 PMCID: PMC10634724 DOI: 10.1016/j.imu.2023.101345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Aims The increased risk of suicide among individuals with diabetes is a significant public health concern. However, few studies have focused on understanding the relationship between suicide attempts and diabetes. Association rule mining (ARM) is a data mining technique to discover a set of high-risk factors of a given disease. Therefore, this study aimed to utilize ARM to identify a high-risk group of suicide attempts among patients with diabetes using Cerner Real-World Data™ (CRWD). Methods The study analyzed a large multicenter electronic health records data of 3,265,041 patients with diabetes from 2010 to 2020. The Least Absolute Shrinkage and Selection Operator regression with ten-fold cross-validation and the Apriori algorithm with ARM were used to uncover groups of high-risk suicide attempts. Results Of the 52,217,517 unique patients in the CRWD, 3,266,856 were diagnosed with diabetes. There were 7764 (0.2%) patients with diabetes who had a history of suicide attempts. The study revealed that patients with diabetes who were never married and had average blood glucose levels below 150 mg/dl were more likely to attempt suicide. In contrast, patients with diabetes aged 60 and older who had diabetes for less than five years and A1C levels between 6.5 and 8.9% were less likely to attempt suicide. Risk factors were strongly associated with suicide attempts, including never married, White, blood glucose levels below 150 mg/dl, and LDL levels below 100 mg/dl. Conclusions This is the first study utilizing ARM to discover the risk patterns for suicide attempts in individuals with diabetes. ARM showed the potential for knowledge discovery in large multi-center electronic health records data. The results are explainable and could be practically used by providers during outpatient clinic visits. Further studies are needed to validate the results and investigate the cause-and-effect relationship of suicide attempts among individuals with diabetes.
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Affiliation(s)
- Ploypun Narindrarangkura
- Phramongkutklao College of Medicine, 317 Ratchawithi Rd, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Patricia E. Alafaireet
- Department of Health Management and Informatics, University of Missouri, 5 Hospital Drive, Columbia, MO, 65212, USA
| | - Uzma Khan
- Cosmopolitan International Diabetes and Endocrinology Center, USA
- Department of Medicine, University of Missouri, 5 Hospital Drive, Columbia, MO, 65212, USA
| | - Min Soon Kim
- Department of Health Management and Informatics, University of Missouri, 5 Hospital Drive, Columbia, MO, 65212, USA
- University of Missouri Institute for Data Science and Informatics, 5 Hospital Drive, Columbia, MO, 65212, USA
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18
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Anjali M, Khapre M, Kant R, Kumar S, Pandey P. Effectiveness of Diabetes Self-Management Education on Distress and HbA1C among Indian Type 2 Diabetes Mellitus Patients: A Randomized Controlled Trial. Indian J Community Med 2023; 48:702-708. [PMID: 37970160 PMCID: PMC10637610 DOI: 10.4103/ijcm.ijcm_843_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 07/03/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction The interrelationship of diabetes with mental illness has increased in recent years. Diabetes-related distress is the emotional burden, stress, and worries associated with diabetes, which does not reach the threshold for depressive disorder. A diabetes self-management education (DSME) is a structured educational approach to improve glycemic control and diabetes-related distress. This study aimed to assess the effectiveness of DSME in comparison with usual diabetes care in improving glycemic control and diabetes-related distress. Material and Methods This is a single-center, parallel randomized controlled trial. A total of 106 participants were recruited for both intervention and control groups with 53 participants each. The control group received only routine outpatient department (OPD) care. The intervention group received DSME in addition to routine OPD care. Diabetes-related distress and HbA1C were assessed after 3 months. The data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 25. Per-protocol analysis was done. Results Of 127 patients screened, 106 met the eligibility criteria and were randomized. At 3-month follow-up, the reduction in mean HbA1C, fasting blood sugar (FBS), postprandial blood sugar (PPBS), and diabetes distress were significant in the intervention group compared with the control group (p 0.001). The mean HbA1C reduction in the intervention group was significant (mean difference: -1.3, SD: 0.4). The mean DDS had decreased significantly in the intervention group from 2 to 1.2 (mean difference: -0.8, SD: 0.1). Conclusion The DSME was effective in improving the glycemic control, diabetes-related distress, and self-care among type 2 diabetes (T2DM) mellitus patients.
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Affiliation(s)
- M Anjali
- Department of Community and Family Medicine, AIIMS Rishikesh, Uttarakhand, India
| | - Meenakshi Khapre
- Department of Community and Family Medicine, AIIMS Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Internal Medicine, AIIMS Rishikesh, Uttarakhand, India
| | - Santosh Kumar
- Department of Community and Family Medicine, AIIMS Rishikesh, Uttarakhand, India
| | - Pragya Pandey
- Department of Community and Family Medicine, AIIMS Rishikesh, Uttarakhand, India
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Yang YL, Im EO, Kim Y. Association between type 2 diabetes mellitus and depression among Korean midlife women: a cross-sectional analysis study. BMC Nurs 2023; 22:237. [PMID: 37430288 DOI: 10.1186/s12912-023-01385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/17/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The prevalence of depression is higher among midlife women, and they have less control over their diabetes during the menopausal transition. However, there is limited evidence on the association between type 2 diabetes mellitus and depression among Korean women in their midlife. This study aimed to examine the association between type 2 diabetes mellitus and depression and explore the levels of awareness and treatment of depression among Korean midlife women with T2DM. METHODS This is a cross-sectional analysis study conducted using data from the Korea National Health and Nutrition Examination Surveys of 2014, 2016, and 2018. Korean women aged 40-64 years who randomly participated in the surveys were included, and 4,063 midlife women were selected as study participants. The diabetes progression status of the participants was classified into diabetes, pre-diabetes, and non-diabetes. Furthermore, the Patient Health Questionnaire-9 was used for screening depression. Participants' awareness rate, treatment rate among incident cases of depression, and treatment rate among awareness cases of depression were also analyzed. For data analysis, the Rao-Scott χ2 test, multiple logistic regression, and linear regression were conducted using SAS 9.4 software program. RESULTS The prevalence of depression significantly differed between diabetes, pre-diabetes, and non-diabetes groups. However, depression awareness, treatment/incident, and treatment/awareness rates did not differ statistically between the diabetes progression status groups. Compared to the non-diabetes group, diabetes group had a higher odds ratio of depression after adjusting for general and health-related factors. Thus, the diabetes group had significantly higher PHQ-9 scores than the non-diabetes group after adjusting for covariates. CONCLUSIONS Women in their midlife who have type 2 diabetes mellitus tend to have higher levels of depressive symptoms and are at risk of depression. However, we found no significant differences between diabetes and non-diabetes regarding the awareness and treatment rates of depression in South Korea. We recommend that future studies focus on developing clinical practice guidelines aimed at additional screening and intervention for depression in midlife women with type 2 diabetes mellitus to ensure prompt treatment and improved outcomes.
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Affiliation(s)
- You Lee Yang
- College of Nursing, Eulji University, 553, Sanseong-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13135, Republic of Korea
| | - Eun-Ok Im
- School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA
| | - Yunmi Kim
- College of Nursing, Eulji University, 553, Sanseong-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13135, Republic of Korea.
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Gaggero A, Gil J, Jiménez-Rubio D, Zucchelli E. Sick and depressed? The causal impact of a diabetes diagnosis on depression. HEALTH ECONOMICS REVIEW 2023; 13:38. [PMID: 37395821 DOI: 10.1186/s13561-023-00451-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/07/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND There is sparse evidence on the impact of health information on mental health as well as on the mechanisms governing this relationship. We estimate the causal impact of health information on mental health via the effect of a diabetes diagnosis on depression. METHODS We employ a fuzzy regression discontinuity design (RDD) exploiting the exogenous cut-off value of a biomarker used to diagnose type-2 diabetes (glycated haemoglobin, HbA1c) and information on psycometrically validated measures of diagnosed clinical depression drawn from rich administrative longitudinal individual-level data from a large municipality in Spain. This approach allows estimating the causal impact of a type-2 diabetes diagnosis on clinica ldepression. RESULTS We find that overall a type-2 diabetes diagnosis increases the probability of becoming depressed, however this effect appears to be driven mostly by women, and in particular those who are relatively younger and obese. Results also appear to differ by changes in lifestyle induced by the diabetes diagnosis: while women who did not lose weight are more likely to develop depression, men who did lose weight present a reduced probability of being depressed. Results are robust to alternative parametric and non-parametric specifications and placebo tests. CONCLUSIONS The study provides novel empirical evidence on the causal impact of health information on mental health, shedding light on gender-based differences in such effects and potential mechanisms through changes in lifestyle behaviours.
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Affiliation(s)
- Alessio Gaggero
- Department of Applied Economics, University of Granada, Granada, Spain
| | - Joan Gil
- Department of Economics and BEAT, Universitat de Barcelona, Diagonal Ave. 696, 08034, Barcelona, Spain.
| | | | - Eugenio Zucchelli
- Madrid Institute for Advanced Study (MIAS) and Department of Economic Analysis, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Lancaster University, Lancaster, UK
- IZA, Bonn, Germany
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21
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Quattrin T, Mastrandrea LD, Walker LSK. Type 1 diabetes. Lancet 2023; 401:2149-2162. [PMID: 37030316 DOI: 10.1016/s0140-6736(23)00223-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 12/03/2022] [Accepted: 01/26/2023] [Indexed: 04/10/2023]
Abstract
Type 1 diabetes is a chronic disease caused by autoimmune destruction of pancreatic β cells. Individuals with type 1 diabetes are reliant on insulin for survival. Despite enhanced knowledge related to the pathophysiology of the disease, including interactions between genetic, immune, and environmental contributions, and major strides in treatment and management, disease burden remains high. Studies aimed at blocking the immune attack on β cells in people at risk or individuals with very early onset type 1 diabetes show promise in preserving endogenous insulin production. This Seminar will review the field of type 1 diabetes, highlighting recent progress within the past 5 years, challenges to clinical care, and future directions in research, including strategies to prevent, manage, and cure the disease.
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Affiliation(s)
- Teresa Quattrin
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA; Diabetes Center, John R Oishei Children's Hospital, Buffalo, NY, USA.
| | - Lucy D Mastrandrea
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA; Diabetes Center, John R Oishei Children's Hospital, Buffalo, NY, USA
| | - Lucy S K Walker
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK
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Robinson DJ. No One Is an Islet: Introducing the 2023 Diabetes and Mental Health Update. Can J Diabetes 2023; 47:307. [PMID: 37068586 DOI: 10.1016/j.jcjd.2023.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/19/2023]
Affiliation(s)
- David J Robinson
- Canadian Mental Health Association, Thames Valley Branch, London, Ontario, Canada.
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23
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Yoo TK, Han KD, Rhee EJ, Lee WY. Impact of mental disorders on the risk of heart failure among Korean patients with diabetes: a cohort study. Cardiovasc Diabetol 2023; 22:115. [PMID: 37208672 DOI: 10.1186/s12933-023-01809-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 03/19/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Few studies have assessed the correlation between coexisting mental disorders in participants with diabetes mellitus (DM) and the risk of heart failure (HF). Herein, we conducted a cohort study to determine the association between the accumulation of mental disorders in participants with DM and the risk of HF. METHODS The Korean National Health Insurance Service records were assessed. 2,447,386 adults with DM who underwent health screening between 2009 and 2012 were analyzed. Participants with major depressive disorder, bipolar disorder, schizophrenia, insomnia, or anxiety disorders were included. In addition, participants were categorized based on the number of coexisting mental disorders. Each participant was followed until December 2018 or until the onset of HF. Cox proportional hazard modelling with confounding factors adjustment was conducted. In addition, a competing risk analysis was conducted. Subgroup analysis assessed the impact of clinical variables on the association between the accumulation of mental disorders and the risk of HF. RESULTS The median follow-up duration was 7.09 years. The accumulation of mental disorders was associated with a risk of HF (zero mental disorder (0), reference; 1 mental disorder, adjusted hazard ratio (aHR): 1.222, 95% confidence intervals (CI): 1.207-1.237; 2 mental disorders, aHR: 1.426, CI: 1.403-1.448; ≥3 mental disorders, aHR: 1.667, CI: 1.632-1.70. In the subgroup analysis, the strength of association was the strongest in the younger age group (< 40 years, 1 mental disorder, aHR 1.301, CI 1.143-1.481; ≥2 mental disorders, aHR 2.683, CI 2.257-3.190; 40-64 years, 1 mental disorder, aHR 1.289, CI 1.265-1.314; ≥2 mental disorders, aHR 1.762, CI 1.724-1.801; ≥65 years, 1 mental disorder, aHR 1.164, CI 1.145-1.183; ≥2 mental disorders, aHR 1.353, CI 1.330-1.377; Pinter<0.001). In addition, income, BMI, hypertension, chronic kidney disease, history of cardiovascular disease, insulin use, and duration of DM showed significant interactions. CONCLUSIONS Comorbid mental disorders in participants with DM are associated with an increased risk of HF. In addition, the association was stronger in a younger age group. Participants with DM and mental disorders should be monitored with increased frequency for signs of HF; for which they have a higher risk than the general population.
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Affiliation(s)
- Tae Kyung Yoo
- Department of Medicine, MetroWest Medical Center, Framingham, MA, USA
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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24
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Chen YH, Wang HN, Lang XE, Zhang XY. Prevalence and clinical correlates of abnormal glucose metabolism in young, first- episode and medication-naïve outpatients with major depressive disorder. Psychiatry Res 2023; 325:115250. [PMID: 37207542 DOI: 10.1016/j.psychres.2023.115250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUNDS The high co-morbidity of abnormal glucose metabolism in depressed patients has been extensively studied, but few studies have explored abnormal glucose metabolism in young patients with major depressive disorder (MDD). This study aimed to examine the prevalence and clinical correlates of abnormal glucose metabolism in young patients with first-episode medication-naïve (FEMN) MDD. METHODS A cross-sectional study was conducted on 1289 young Chinese outpatients with FEMN MDD. All subjects were assessed on the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale, and their sociodemographic information was collected, and blood pressure, blood glucose, lipid and thyroid hormone levels were measured. RESULTS The prevalence of abnormal glucose metabolism was 12.57% in young FEMN MDD outpatients. Thyroid stimulating hormone (TSH) levels and HAMA scale scores were associated with fasting blood glucose levels in patients with FEMN MDD (P<0.05), and TSH could differentiate patients with abnormal normal glucose metabolism from those without abnormal glucose metabolism (Area Under Curve of 0.774). CONCLUSIONS Our study showed a high prevalence of comorbid glucose metabolism abnormalities in young FEMN MDD outpatients. TSH may be a promising biomarker of abnormal glucose metabolism in young patients with FEMN MDD.
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Affiliation(s)
- Yi-Huan Chen
- Department of Psychiatry, Xijing Hospital, Air Force Military Medical University, Xi'an, China
| | - Hua-Ning Wang
- Department of Psychiatry, Xijing Hospital, Air Force Military Medical University, Xi'an, China
| | - Xiao-E Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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25
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Racey M, Whitmore C, Alliston P, Cafazzo JA, Crawford A, Castle D, Dragonetti R, Fitzpatrick-Lewis D, Jovkovic M, Melamed OC, Naeem F, Senior P, Strudwick G, Ramdass S, Vien V, Selby P, Sherifali D. Technology-Supported Integrated Care Innovations to Support Diabetes and Mental Health Care: Scoping Review. JMIR Diabetes 2023; 8:e44652. [PMID: 37159256 DOI: 10.2196/44652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/23/2023] [Accepted: 04/01/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND For individuals living with diabetes and its psychosocial comorbidities (eg, depression, anxiety, and distress), there remains limited access to interprofessional, integrated care that includes mental health support, education, and follow-up. Health technology, broadly defined as the application of organized knowledge or skill as software, devices, and systems to solve health problems and improve quality of life, is emerging as a means of addressing these gaps. There is thus a need to understand how such technologies are being used to support, educate, and help individuals living with co-occurring diabetes and mental health distress or disorder. OBJECTIVE The purpose of this scoping review was to (1) describe the literature on technology-enabled integrated interventions for diabetes and mental health; (2) apply frameworks from the Mental Health Commission of Canada and World Health Organization to elucidate the components, type, processes, and users of technology-enabled integrated interventions for diabetes and mental health; and (3) map the level of integration of interventions for diabetes and mental health. METHODS We searched 6 databases from inception to February 2022 for English-language, peer-reviewed studies of any design or type that used technology to actively support both diabetes and any mental health distress or disorder in succession or concurrently among people with diabetes (type 1 diabetes, type 2 diabetes, and gestational diabetes). Reviewers screened citations and extracted data including study characteristics and details about the technology and integration used. RESULTS We included 24 studies described in 38 publications. These studies were conducted in a range of settings and sites of care including both web-based and in-person settings. Studies were mostly website-based (n=13) and used technology for wellness and prevention (n=16) and intervention and treatment (n=15). The primary users of these technologies were clients and health care providers. All the included intervention studies (n=20) used technology for clinical integration, but only 7 studies also used the technology for professional integration. CONCLUSIONS The findings of this scoping review suggest that there is a growing body of literature on integrated care for diabetes and mental health enabled by technology. However, gaps still exist with how to best equip health care professionals with the knowledge and skills to offer integrated care. Future research is needed to continue to explore the purpose, level, and breadth of technology-enabled integration to facilitate an approach to overcome or address care fragmentation for diabetes and mental health and to understand how health technology can further drive the scale-up of innovative integrated interventions.
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Affiliation(s)
- Megan Racey
- McMaster Evidence Review and Synthesis Team, McMaster University, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Carly Whitmore
- School of Nursing, McMaster University, Hamilton, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Paige Alliston
- McMaster Evidence Review and Synthesis Team, McMaster University, Hamilton, ON, Canada
| | - Joseph A Cafazzo
- Healthcare Human Factors, University Health Network, Toronto, ON, Canada
- eHealth Innovation, University Health Network, Toronto, ON, Canada
| | - Allison Crawford
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - David Castle
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | | | - Milos Jovkovic
- McMaster Evidence Review and Synthesis Team, McMaster University, Hamilton, ON, Canada
| | - Osnat C Melamed
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Farooq Naeem
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Peter Senior
- Clinical Islet Transplant Program, University of Alberta, Edmonton, AB, Canada
- Department of Medicine, Division of Endocrinology, University of Alberta, Edmonton, AB, Canada
| | - Gillian Strudwick
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Seeta Ramdass
- Diabetes Action Canada, Toronto, ON, Canada
- McGill University, Montreal, QC, Canada
| | - Victor Vien
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Diana Sherifali
- McMaster Evidence Review and Synthesis Team, McMaster University, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
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26
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Sushko K, Strachan P, Butt M, Nerenberg KA, Sherifali D. Understanding the self-management experiences and support needs during pregnancy among women with pre-existing diabetes: a qualitative descriptive study. BMC Pregnancy Childbirth 2023; 23:309. [PMID: 37131168 PMCID: PMC10152436 DOI: 10.1186/s12884-023-05542-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/23/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND With the increasing prevalence of pre-existing type 1 and type 2 diabetes in pregnancy and their associated perinatal risks, there is a need to focus on interventions to achieve optimal maternal glycemia to improve pregnancy outcomes. One strategy focuses on improving diabetes self-management education and support for expectant mothers with diabetes. This study's objective is to describe the experience of managing diabetes during pregnancy and identify the diabetes self-management education and support needs during pregnancy among women with type 1 and type 2 diabetes. METHODS Using a qualitative descriptive study design, we conducted semi-structured interviews with 12 women with pre-existing type 1 or 2 diabetes in pregnancy (type 1 diabetes, n = 6; type 2 diabetes, n = 6). We employed conventional content analyses to derive codes and categories directly from the data. RESULTS Four themes were identified that related to the experiences of managing pre-existing diabetes in pregnancy; four others were related to the self-management support needs in this population. Women with diabetes described their experiences of pregnancy as terrifying, isolating, mentally exhausting and accompanied by a loss of control. Self-management support needs reported included healthcare that is individualized, inclusive of mental health support and support from peers and the healthcare team. CONCLUSIONS Women with diabetes in pregnancy experience feelings of fear, isolation and a loss of control, which may be improved through personalized management protocols that avoid "painting everybody with the same brush" as well as peer support. Further examination of these simple interventions may yield important impacts on women's experience and sense of connection.
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Affiliation(s)
- Katelyn Sushko
- Faculty of Health Sciences, School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - Patricia Strachan
- Faculty of Health Sciences, School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Michelle Butt
- Faculty of Health Sciences, School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Kara A Nerenberg
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Diana Sherifali
- Faculty of Health Sciences, School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
- Diabetes Care and Research Program, Hamilton Health Sciences, Hamilton, ON, Canada
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Rivera-Santiago K, Cumba-Aviles E, Gómez-Rivera D. Recurrent depression relates to worse outcomes than single episode depression among Hispanic adolescents with diabetes. HEALTH PSYCHOLOGY REPORT 2023; 12:1-13. [PMID: 38425888 PMCID: PMC10900980 DOI: 10.5114/hpr/162649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/12/2022] [Accepted: 03/27/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Adolescents with type 1 diabetes (T1D) are at increased risk for depression. A history of recurrent depression (HRD) may relate to worse health outcomes than single-episode depression. However, no study has explored this issue among T1D adolescents. PARTICIPANTS AND PROCEDURE We examined differences in psychosocial and diabetes-related outcomes between T1D adolescents with (G1; n = 33) and without (G2; n = 18) HRD. Participants were 51 youths (aged 12-17 years) enrolled in a depression treatment study. Youths and one caregiver each completed several measures. Using MANOVA, followed by individual ANOVAs, and chi-square tests, we compared groups in continuous and categorical variables, respectively. RESULTS MANOVA results were significant, F(7, 43) = 3.97, p = .002. Adolescents from G1 obtained higher scores than youths in G2 in self-esteem/guilt problems, cognitive alterations, and sadness due to T1D. Their caregivers reported more burden and rated their offspring as having more internalizing problems, facing more barriers to complying with T1D treatment, and using a medical ID less frequently than their counterparts did. A higher percentage of G1 participants presented clinical anxiety and inadequate glycemic control, and reported a history of major depression. According to caregivers, a higher proportion of G1 members had experienced multiple diabetes-related hospitalizations, were non-compliant with insulin treatment, and lived in homes with a conflictive environment. CONCLUSIONS Our study documents important differences in outcomes between T1D youths with vs. without any HRD. Clinicians may need an intensive and integrative approach to treat mental and physical aspects of health among these patients.
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Affiliation(s)
- Keiliany Rivera-Santiago
- Institute for Psychological Research, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico
| | - Eduardo Cumba-Aviles
- Institute for Psychological Research, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico
| | - Demivette Gómez-Rivera
- Institute for Psychological Research, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico
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Yous ML, Ganann R, Ploeg J, Markle-Reid M, Northwood M, Fisher K, Valaitis R, Chambers T, Montelpare W, Légaré F, Beleno R, Gaudet G, Giacometti L, Levely D, Lindsay C, Morrison A, Tang F. Older adults' experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) for diabetes self-management in Canada: a qualitative descriptive study. BMJ Open 2023; 13:e068694. [PMID: 37019487 PMCID: PMC10083734 DOI: 10.1136/bmjopen-2022-068694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVES To assess the experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) from the perspectives of older adults with diabetes and other chronic conditions. The ACHRU-CPP is a complex 6-month self-management evidence-based intervention for community-living older adults aged 65 years or older with type 1 or type 2 diabetes and at least one other chronic condition. It includes home and phone visits, care coordination, system navigation support, caregiver support and group wellness sessions delivered by a nurse, dietitian or nutritionist, and community programme coordinator. DESIGN Qualitative descriptive design embedded within a randomised controlled trial was used. SETTING Six trial sites offering primary care services from three Canadian provinces (ie, Ontario, Quebec and Prince Edward Island) were included. PARTICIPANTS The sample was 45 community-living older adults aged 65 years or older with diabetes and at least one other chronic condition. METHODS Participants completed semistructured postintervention interviews by phone in English or French. The analytical process followed Braun and Clarke's experiential thematic analysis framework. Patient partners informed study design and interpretation. RESULTS The mean age of older adults was 71.7 years, and the mean length of time living with diabetes was 18.8 years. Older adults reported positive experiences with the ACHRU-CPP that supported diabetes self-management, such as improved knowledge in managing diabetes and other chronic conditions, enhanced physical activity and function, improved eating habits, and opportunities for socialisation. They reported being connected to community resources by the intervention team to address social determinants of health and support self-management. CONCLUSIONS Older adults perceived that a 6-month person-centred intervention collaboratively delivered by a team of health and social care providers helped support chronic disease self-management. There is a need for providers to help older adults connect with available health and social services in the community. TRIAL REGISTRATION NUMBER ClinicalTrials.gov ID: NCT03664583; Results.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Rebecca Ganann
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Maureen Markle-Reid
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Melissa Northwood
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Kathryn Fisher
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Ruta Valaitis
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Tracey Chambers
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - William Montelpare
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - France Légaré
- VITAM Centre de recherche en santé durable, Université Laval, Quebec, Quebec, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Ron Beleno
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Gary Gaudet
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Luisa Giacometti
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Deborah Levely
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Craig Lindsay
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Allan Morrison
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Frank Tang
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
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29
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Niu L, Li Y, Hwang WC, Song G, Xie B. Prevalence and management of type 2 diabetes among Chinese Americans. ETHNICITY & HEALTH 2023:1-13. [PMID: 36803178 DOI: 10.1080/13557858.2023.2179020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
AIMS : This study examines: (a) the prevalence rate of type 2 diabetes mellitus (T2DM) in Chinese Americans (CAs); (b) the influence of acculturative status (i.e. generational status and linguistic fluency) on T2DM prevalence; (c) and differences in diabetes management between CAs and Non-Hispanic Whites (NHWs). METHODS : We used 2011-2018 data from the California Health Interview Survey (CHIS) to analyze the prevalence rate and management of diabetes among the CAs. Chi-squares, linear regressions, and logistic regressions were used to analyze the data. RESULTS : After controlling for demographic, socioeconomic, and health behaviors, there were no significant differences in the T2DM prevalence rate between CAs overall or of varying acculturative statuses compared with NHWs. However, there were differences in diabetes management, with first-generation CAs being less likely to exam glucose daily, have medical care plans developed by medical providers, or have confidence in controlling diabetes compared to NHWs. CAs with limited English proficiency (LEP) were less likely to perform self-monitoring of blood glucose or have confidence in managing their diabetes care compared to NHWs. Finally, non-first generation CAs were also more likely to take diabetes medication compared to NHWs. CONCLUSIONS : Although the prevalence rate of T2DM was found to be similar between CAs and NHWs, significant differences were found in diabetes care and management. Specifically, those who were less acculturated (e.g. first generation and those with LEP) were less likely to actively manage and have confidence in managing their T2DM. These results highlight the importance of targeting immigrants with LEP in prevention and intervention efforts.
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Affiliation(s)
- Lijie Niu
- School of Community & Global Health, Claremont Graduate University, Claremont, CA, USA
| | - Yawen Li
- School of Social Work, California State University San Bernardino, San Bernardino, CA, USA
| | - Wei-Chin Hwang
- Department of Psychological Science, Claremont McKenna College, Claremont, CA, USA
| | - Gaole Song
- School of Community & Global Health, Claremont Graduate University, Claremont, CA, USA
| | - Bin Xie
- School of Community & Global Health, Claremont Graduate University, Claremont, CA, USA
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30
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Denche-Zamorano A, Perez-Gomez J, Barrios-Fernandez S, Oliveira R, Adsuar JC, Brito JP. Relationships between Physical Activity Frequency and Self-Perceived Health, Self-Reported Depression, and Depressive Symptoms in Spanish Older Adults with Diabetes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2857. [PMID: 36833555 PMCID: PMC9958756 DOI: 10.3390/ijerph20042857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.
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Affiliation(s)
- Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jorge Perez-Gomez
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Jose C. Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
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31
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Mach C, Bulanadi J, Gucciardi E, Segal P, De Melo M. Exploring the Needs of Adults Living With Type 1 or Type 2 Diabetes Distress Using the Problem Areas in Diabetes 5 Tool. Can J Diabetes 2023; 47:51-57.e1. [PMID: 36154985 DOI: 10.1016/j.jcjd.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/12/2022] [Accepted: 07/28/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES This study investigated the feasibility and acceptability of implementing a screening tool as a part of routine care and the subsequent screening experiences of patients and clinicians. Additionally, potential sources of diabetes distress (DD) were identified in this clinical population. METHODS Our investigation was a cross-sectional, mixed-methods, convenience sample of 203 patients living with type 1 or type 2 diabetes from 2 Canadian tertiary hospital-based clinics. The Problem Areas in Diabetes 5 (PAID5) scale was used to assess DD. Structured telephone interviews of patients with high DD scores and care provider focus group transcriptions were analyzed using a deductive thematic content analysis. RESULTS The prevalence of DD was 45%. Lack of medication coverage (p=0.02) and presence of neuropathy (p=0.04) were approximately 5- and 2-fold more likely to be predictors of high DD, respectively. Patient interviews identified DD screening as an opportunity to share and feel supported but demonstrated their fear of discussing mental health concerns. Patients found discussion about mental health helpful and often did not require a referral to a mental health specialist. Staff focus groups discussed screening as a feasible tool, but also acknowledged barriers and knowledge gaps that preclude DD screening integration in routine clinical practice. Specialized training for clinicians may help increase confidence and improve uptake of DD screening into routine clinical practice. CONCLUSIONS The prevalence of DD in outpatient care settings is high. Findings suggest that integrating the PAID5 screening tool into regular clinical practice is feasible by patients and care providers.
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Affiliation(s)
- Calvin Mach
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jeroselle Bulanadi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Enza Gucciardi
- School of Nutrition, Ryerson University, Toronto, Ontario, Canada
| | - Phillip Segal
- Faculty of Medicine, Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada; Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Margaret De Melo
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
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Claro AE, Palanza C, Mazza M, Corsello A, Rizzi A, Tartaglione L, de Waure C, Marano G, Piciollo S, Muti Schuenemann GEU, Rigoni M, Muti P, Pontecorvi A, Janiri L, Sani G, Pitocco D. Evaluation of the prevalence of the most common psychiatric disorders in patients with type 2 diabetes mellitus using the patient health questionnaire: results of the cross-sectional "DIA2PSI" study. Acta Diabetol 2023; 60:247-255. [PMID: 36342534 PMCID: PMC9640892 DOI: 10.1007/s00592-022-01993-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022]
Abstract
AIMS Common Psychiatric Disorders (CPDs) are associated with the development of overweight and obesity, the strongest risk factors for the onset and maintenance of Type 2 Diabetes mellitus (T2D). To the best of our knowledge, this is the first study to assess the prevalence of CPDs in patients with T2D in Italy. METHODS This is a monocentric cross-sectional study; n = 184 T2D patients were screened for CPDs using the Patient Health Questionnaire (PHQ). Primary outcome was to evaluate the prevalence of CPDs. To assess association between CPDs and risk factors, we have utilized univariable logistic regression models. RESULTS 64.1% were men, median age was 67 (59-64) and median BMI 27 (25-30) kg/m2. The 42.9% tested positive for one or more mental disorders, 25.6% for depression. Patients with higher BMI (p = 0.04) had an increased likelihood of testing positive to the PHQ. Patients who had implemented lifestyle changes (p < 0.01) and were aware that mental health is linked to body health (p = 0.07) had a reduction in the likelihood of testing positive. CONCLUSIONS Prevalence of CPDs in T2D patients is higher than in the general population. Since CPDs favor the onset and subsistence of T2D, integrated diabetic-psychiatric therapy is required for improvement or remission of T2D in patients with comorbid CPDs.
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Affiliation(s)
- Angelo Emilio Claro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
| | - Clelia Palanza
- Istituto Italiano Di Antropologia-ISItA, Piazzale Aldo Moro, 5-00185 Rome, Italy
| | - Marianna Mazza
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
| | - Andrea Corsello
- Diabetes Care Unit, Department of Endocrinology and Diabetes, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
| | - Alessandro Rizzi
- Diabetes Care Unit, Department of Endocrinology and Diabetes, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
| | - Linda Tartaglione
- Diabetes Care Unit, Department of Endocrinology and Diabetes, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Piazza dell’ Università, 1, 06123 Perugia, Italy
| | - Giuseppe Marano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
| | - Simone Piciollo
- Associazione Italiana di Psicologia Giuridica–AIPG, Via Bisagno, 15, 00199 Rome, Italy
| | - Giovanna Elsa Ute Muti Schuenemann
- Health Research Methods, Evidence and Impact Department, McMaster University, McMaster University Medical Centre, 1280 Main Street West 2C Area, Hamilton, ON L8S 4K1 Canada
| | - Marta Rigoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Paola Muti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Alfredo Pontecorvi
- Division of Endocrinology, Department of Endocrine-Metabolic and Dermo-Rheumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
| | - Luigi Janiri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
| | - Gabriele Sani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
| | - Dario Pitocco
- Diabetes Care Unit, Department of Endocrinology and Diabetes, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8-CAP 00168 Rome, Italy
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Gupta N, Crouse DL, Miah P, Takaro T. Individual physical activity, neighbourhood active living environment and mental illness hospitalisation among adults with cardiometabolic disease: a Canadian population-based cohort analysis. BMJ Open 2023; 13:e067736. [PMID: 36725097 PMCID: PMC9896238 DOI: 10.1136/bmjopen-2022-067736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES This population-based observational study explores the associations between individual-level and neighbourhood-level indices of active living with inpatient mental healthcare use among adults with an underlying chronic cardiometabolic condition. DESIGN AND SETTING Data from the 2013-2014 Canadian Community Health Survey were linked longitudinally to hospital records from the 2013/2014‒2017/2018 Discharge Abstract Database and to a geocoded measure of active living environments (ALE). Relationships between individuals' leisure-time physical activity and neighbourhood ALE with risk of hospital admission for mental health disorders were assessed using multivariable Cox regressions. PARTICIPANTS A national cohort was identified from the survey data of 24 960 respondents aged 35 years and above reporting having been diagnosed with diabetes, hypertension and/or heart disease. OUTCOME MEASURE Potentially avoidable hospitalisation for a mood, anxiety or substance use disorder over a 5-year period. RESULTS More than half (52%) of adults aged 35 years and above with a cardiometabolic disease were physically inactive in their daily lives, and one-third (34%) resided in the least activity-friendly neighbourhoods. The rate of being hospitalised at least once for a comorbid mental disorder averaged 8.1 (95% CI: 7.0 to 9.3) per 1000 person-years of exposure. Individuals who were at least moderately active were half as likely to be hospitalised for a comorbid mental health problem compared with those who were inactive (HR: 0.50 (95% CI: 0.38 to 0.65)). No statistically discernible associations between neighbourhood ALE and hospitalisation risks were found after controlling for individuals' behaviours and characteristics, including in separate models stratified by age group and by sex. CONCLUSIONS The evidence base to support prioritisation of interventions focusing on the built environment favouring mental health-promoting physical activity among higher-risk adults at the population level, independently of individual-level behaviours and characteristics, remains limited.
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Affiliation(s)
- Neeru Gupta
- University of New Brunswick, Fredericton, New Brunswick, Canada
| | | | - Pablo Miah
- University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Tim Takaro
- Simon Fraser University, Burnaby, British Columbia, Canada
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Kichler JC. A Paradigm Shift in the Evaluation of Behavioural Interventions for Diabetes: Promotion of Sustained Behaviour Change in Clinical Practice. Can J Diabetes 2023; 47:1-2. [PMID: 36577554 DOI: 10.1016/j.jcjd.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Jessica C Kichler
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada.
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Dowling E, Maidment DW. Assessing depressive symptoms and diabetes distress in Type 1 diabetic adults: A comparison of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) users. J Health Psychol 2023; 28:149-161. [PMID: 35672927 DOI: 10.1177/13591053221098498] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This cross-sectional observational study assesses differences in depressive symptoms and diabetes-distress between adults with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) insulin delivery methods. Two-hundred and seventy-one adults with type 1 diabetes were recruited who used CSII (n = 104) or MDI (n = 167). Results show that, compared to CSII users, scores on the Severity Measure for Depression - Adult questionnaire and Management and Physician subscales on the Type 1 Diabetes Distress Scale were significantly greater in users of MDI. Thus, MDI users may require greater targetted support to improve these aspects of psychological wellbeing.
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Affiliation(s)
- Ella Dowling
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
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36
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Mental health of UK firefighters. Sci Rep 2023; 13:62. [PMID: 36627314 PMCID: PMC9832123 DOI: 10.1038/s41598-022-24834-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/21/2022] [Indexed: 01/12/2023] Open
Abstract
Exposure to trauma, high-stress situations, and disrupted sleep are well known risk factors affecting firefighters' mental health. Little is known about the association between firefighters' exposure to fire contaminants and mental health disorders. The UK Firefighter Contamination Survey assessed firefighters' health and capacity for occupational exposure to contaminants. Participants were invited to anonymously complete its 64 questions online. Logistic regression analyses assessed the associations between self-reported mental health disorders and proxies of contaminant exposure. Results found that firefighters who notice soot in their nose/throat for more than a day after attending fires (Odds Ratio (OR) = 1.8, 1.4-2.4), and those who remain in their personal protective equipment (PPE) for over 4 h after fires (OR = 1.9, 1.2-3.1), were nearly twice as likely to report mental health disorders. Significantly increased odds ratios for all three outcomes of interest (anxiety, depression and/or any mental health disorders) were also found among firefighters who take PPE home to clean. Sleeping problems were reported by 61% of firefighters. These firefighters were 4.2 times more likely to report any mental health disorder (OR = 4.2, 3.7-4.9), 2.9 times more likely to report anxiety (OR = 2.9, 2.4-3.5) and 2.3 times more likely to report depression (OR = 2.3, 1.9-2.8) when compared to firefighters who did not report sleep issues. Effective decontamination measures within UK Fire and Rescue Services, together with firefighters' wellness, may play a crucial role in protecting firefighters' mental health.
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ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Young-Hyman D, Gabbay RA, on behalf of the American Diabetes Association. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2023. Diabetes Care 2023; 46:S68-S96. [PMID: 36507648 PMCID: PMC9810478 DOI: 10.2337/dc23-s005] [Citation(s) in RCA: 139] [Impact Index Per Article: 139.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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, a multidisciplinary 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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Li Q, Douglas JA, Subica AM. Examining neighbourhood-level disparities in Black, Latina/o, Asian, and White physical health, mental health, chronic conditions, and social disadvantage in California. Glob Public Health 2023; 18:2273425. [PMID: 37902041 DOI: 10.1080/17441692.2023.2273425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/16/2023] [Indexed: 10/31/2023]
Abstract
Racial/ethnic minority individuals in the U.S. experience numerous health disparities versus Whites, often due to differences in social determinants. Yet, limited large-scale research has examined these differences at the neighbourhood level. We merged 2021 PLACES Project and 2020 American Community Survey data across 3,211 census tracts (neighbourhoods) defined as majority (>50%) Black, Latina/o, Asian or White. T-tests and hierarchical linear regressions were used to examine differences and associations between neighbourhoods on key health (general health, mental health, obesity, diabetes, cancer, coronary heart disease, chronic obstructive pulmonary disease, stroke), and social outcomes (income, unemployment, age, population density). Results indicated that minority neighbourhoods in California exhibited stark health and social disparities versus White neighbourhoods, displaying worse outcomes on nearly every social and health variable/condition examined; particularly for Black and Latina/o neighbourhoods. Moreover, regression findings revealed that, after considering income, unemployment, and population density, (1) fair/poor mental health and higher percentages of Black, Latina/o and Asian residents in neighbourhoods independently associated with greater neighbourhood fair/poor physical health, and (2) fair/poor mental health significantly associated with greater prevalence of obesity and COPD. This study thus underscores the need to address the profound health and social disparities experienced by minority neighbourhoods for more equitable neighbourhoods.
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Affiliation(s)
- Qiuxi Li
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, CA, USA
| | - Jason A Douglas
- Department of Health, Society, and Behavior, Program in Public Health, Center for Environmental Health Disparities Research, University of California, Irvine, CA, USA
| | - Andrew M Subica
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, CA, USA
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Guo F, Han R, Sun Y, Sun L, Luo T, Zheng L, Gao C. The associations between COVID-19 vaccination and psychological disorders among healthcare workers in China. J Affect Disord 2022; 318:40-47. [PMID: 36031006 PMCID: PMC9420003 DOI: 10.1016/j.jad.2022.08.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/26/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION COVID-19 has caused an unprecedented psychological affection that might impact the nationwide vaccination program in China. This study was to explore the association between COVID-19 vaccination and psychological disorders among healthcare workers. METHODS The study included 1571 healthcare workers from an anonymous online survey. Participants' sociodemographic characteristics, uptake data for the COVID-19 vaccine, and scores of the Depression, Anxiety, and Stress Scale (DASS-21) were collected. Nonparametric tests were conducted to compare the mean scores of DASS-21 between different subgroups. The potential factors related to psychological disorders of healthcare workers were analyzed using logistic regression. RESULTS The vaccination rate was 69.6 %, the incidence of vaccine-related adverse events was 35.13 %, and the prevalence of depression, anxiety, and stress were 24.8 %, 32 %, and 33.4 % in this study, respectively. Compared to vaccinated participants (single-dose and double-dose vaccines), unvaccinated participants got significantly higher mean scores of DASS-21 (p < 0.05 for all). Vaccinated participants who suffered no adverse events scored significantly lower than those who suffered 1-2 or ≥3 adverse events (p < 0.05 for all). Vaccination was negatively associated with higher depression, anxiety, and stress, however, the number of vaccine-related adverse events was positively associated with them. LIMITATIONS As this is a cross-sectional study, we could only speculate on the causality. CONCLUSIONS An obvious impact of the psychological disorders on the COVID-19 vaccine coverage and related adverse events was detected in this study. Public health agencies should attach great importance to the psychological states of our citizens before getting vaccinated.
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Affiliation(s)
- Fei Guo
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Ruili Han
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Yiwei Sun
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Li Sun
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Ting Luo
- Department of Obstetrics and Gynecology, the Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Lanlan Zheng
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Changjun Gao
- Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China.
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Pate R, Caswell N, Gardner KJ, Holyoak L. A structural equation model in adults with type 1 and 2 diabetes: exploring the interplay of psychological states and diabetes outcomes, and the mediating effect of resilience. Acta Diabetol 2022; 59:1575-1587. [PMID: 36038781 PMCID: PMC9581857 DOI: 10.1007/s00592-022-01955-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/04/2022] [Indexed: 11/01/2022]
Abstract
AIMS Type 1 and 2 diabetes mellitus (T1DM and T2DM) can lead to emotional distress and cognitive impairments, often caused by psychological factors such as low mood or anxiety; yet, few studies have explored the theoretical mechanisms underlying these relationships and within one study. This study explored the relationships between psychological states (anxiety/worry, fatigue) and diabetes outcomes (diabetes distress, cognitive dysfunction), and whether resilience mediated the association between these in T1DM and T2DM. METHODS A sample of 307 UK adults with a clinical diagnosis of diabetes (T1DM = 129; T2DM = 178) completed a cross-sectional online survey, composed of six questionnaires. Associations between variables were investigated using Pearson's correlations and Structural Equation Modelling (SEM). RESULTS Psychological states were significantly correlated with diabetes outcomes, and resilience was significantly related to both psychological states and diabetes outcomes. The SEM model achieved an acceptable model fit with a significant mediating effect of resilience between psychological states (anxiety/worry, fatigue) and diabetes outcomes (diabetes distress, cognitive dysfunction), with no significant differences between diabetes type. CONCLUSIONS We propose a new theoretical model of T1DM and T2DM that could be used to provide guidance for those designing interventions. These findings help to understand the complex nature of diabetes management, suggesting resilience could be a key factor in managing psychological states and diabetes outcomes.
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Affiliation(s)
- Rosalind Pate
- School of Psychology, University of Central Lancashire, Preston, UK
| | - Noreen Caswell
- School of Psychology, University of Central Lancashire, Preston, UK
| | | | - Lynda Holyoak
- School of Psychology, University of Central Lancashire, Preston, UK
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Lai TC, McDaniel CC, Chou C. Diabetes management behaviors associated with depression in the U.S. Diabetol Metab Syndr 2022; 14:178. [PMID: 36419073 PMCID: PMC9685969 DOI: 10.1186/s13098-022-00953-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There is a lack of nationally representative evidence from the U.S. investigating the relationships between depression and diabetes management behaviors. Our study aimed to assess the associations between diabetes management behaviors and depression status, and to compare U.S. population-level percentages of diabetes management behaviors among patients with and without depression. METHODS A cross-sectional study was conducted using population-based survey data to assess patient-reported variables retrospectively. We used the Behavioral Risk Factor Surveillance System (BRFSS) data and included states in the U.S. that continuously adopted the diabetes optional modules in 2013, 2015, 2017, and 2019. We included U.S. adults (≥ 18 years old) with self-reported diabetes in our analysis. Main outcomes were diabetes management behaviors (i.e., self-check for blood glucose and feet sores/irritation, regular diabetes clinical visit, HbA1c check, professional feet check, and dilated eye examination) and lifestyle behaviors (i.e., exercise, smoking, and alcohol consumption). RESULTS Among the 74,011 respondents with diabetes, patients with depression had a higher likelihood of performing routine HbA1c checks (adjusted odds ratio (AOR) = 1.12; 95% CI 1.01-1.23) but had a lower likelihood to perform regular self-check for blood glucose (AOR = 0.91; 95% CI 0.84-0.99), receive professional feet checks (AOR = 0.87; 95% CI 0.79-0.95), and receive a dilated eye examination (AOR = 0.89; 95% CI 0.82-0.98). For lifestyle behaviors, patients with depression were more likely to smoke (No smoking (AOR) = 0.65; 95% CI = 0.59-0.72) and less likely to engage in sufficient exercise time (AOR = 0.69; 95% CI 0.63-0.75). There were no significant associations between depression and other behaviors, including self-check for feet sores/irritation (AOR = 0.99; 95% CI 0.92-1.08), regular diabetes clinical visit (AOR = 1.03, 95% CI 0.94-1.13), and alcohol consumption (AOR = 1.01, 95% CI 0.92-1.10). CONCLUSIONS The association between depression status and diabetes management behaviors varied. People with depression were positively associated with HbA1c checks. However, less uptake of other behaviors may indicate the needs for improvement in diabetes management.
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Affiliation(s)
- Tim C Lai
- Department of Health Outcomes Research and Policy, Auburn University Harrison College of Pharmacy, 4306 Walker Building, Auburn, AL, 36849, USA
| | - Cassidi C McDaniel
- Department of Health Outcomes Research and Policy, Auburn University Harrison College of Pharmacy, 4306 Walker Building, Auburn, AL, 36849, USA
| | - Chiahung Chou
- Department of Health Outcomes Research and Policy, Auburn University Harrison College of Pharmacy, 4306 Walker Building, Auburn, AL, 36849, USA.
- Department of Medical Research, China Medical University Hospital, Taichung City, Taiwan.
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Nazu NA, Wikström K, Lamidi ML, Lindström J, Tirkkonen H, Rautiainen P, Laatikainen T. Mode of treatments and achievement of treatment targets among type 2 diabetes patients with different comorbidities - a register-based retrospective cohort study in Finland. BMC PRIMARY CARE 2022; 23:278. [PMID: 36352358 PMCID: PMC9644526 DOI: 10.1186/s12875-022-01889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
AIMS Type 2 diabetes (T2D) is a progressive disease often associated with comorbidities that complicate the management of T2D and affect the achievement of treatment targets. However, adherence to guidelines and individualized treatments can potentially improve treatment outcomes. This study assessed the association between different glucose lowering and lipid lowering medication lines and the achievement of treatment targets with different comorbidities among a T2D cohort in North Karelia, Finland (2011-12 to 2015-16). METHODS The data on all diagnosed T2D patients (n = 10,190) in North Karelia were collated retrospectively from regional electronic health records (EHRs). Analyses were performed considering the age, sex, and comorbidities such as cardiovascular diseases (CVD) and any mental disorders (AMD). We analyzed the trends in using glucose lowering and lipid lowering medications and the effect of changes in medication on the achievement of treatment targets among different patient groups. RESULTS Metformin was the most common treatment in all patient groups. The use of only metformin declined and the use of metformin and/or other non-insulin medications increased during the follow-up. A Combination of insulin and non-insulin medication was mostly used by T2D patients with both cardiovascular diseases and mental disorders (T2D + CVD + AMD), and the use of insulin increased among this group in follow-up. Achievement of the glucose treatment target deteriorated even after the intensification of medication among all patient groups during the follow-up. A considerably higher number of patients with T2D + AMD and T2D + CVD + AMD did not use lipid lowering medication when compared to the T2D + CVD patients both at baseline and follow-up. However, the achievement of the LDL treatment target improved during the follow-up. CONCLUSION Achievement of the glucose target deteriorated even after the intensification of treatment, and especially among patients with multiple diseases. Many T2D patients with AMD and CVD remained without lipid lowering medication, which needs further attention.
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Affiliation(s)
- Nazma Akter Nazu
- Department of Public Health, University of Helsinki,, PO BOX 63, 00014, Helsinki, Finland.
| | - Katja Wikström
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO BOX 1627, 70211, Kuopio, Finland
- Department of Public Health and Social welfare, Finnish Institute for Health and Welfare, PO BOX 30, 00271, Helsinki, Finland
| | - Marja-Leena Lamidi
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO BOX 1627, 70211, Kuopio, Finland
| | - Jaana Lindström
- Department of Public Health, University of Helsinki,, PO BOX 63, 00014, Helsinki, Finland
- Department of Public Health and Social welfare, Finnish Institute for Health and Welfare, PO BOX 30, 00271, Helsinki, Finland
| | - Hilkka Tirkkonen
- Joint municipal authority for North Karelia Social and Health Services (Siun sote), Tikkamäentie 16, 70210, Joensuu, Finland
| | - Päivi Rautiainen
- Joint municipal authority for North Karelia Social and Health Services (Siun sote), Tikkamäentie 16, 70210, Joensuu, Finland
| | - Tiina Laatikainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO BOX 1627, 70211, Kuopio, Finland
- Department of Public Health and Social welfare, Finnish Institute for Health and Welfare, PO BOX 30, 00271, Helsinki, Finland
- Joint municipal authority for North Karelia Social and Health Services (Siun sote), Tikkamäentie 16, 70210, Joensuu, Finland
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Dodd S, Sominsky L, Siskind D, Bortolasci CC, Carvalho AF, Maes M, Walker AJ, Walder K, Yung AR, Williams LJ, Myles H, Watson T, Berk M. The role of metformin as a treatment for neuropsychiatric illness. Eur Neuropsychopharmacol 2022; 64:32-43. [PMID: 36191545 DOI: 10.1016/j.euroneuro.2022.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/04/2022] [Accepted: 09/07/2022] [Indexed: 12/12/2022]
Abstract
Advances in psychopharmacology have been significantly slower to evolve than in other disciplines of medicine and therefore investigation into novel therapeutic approaches is required. Additionally, concurrent metabolic conditions are prevalent among people with mental disorders. Metformin is a widely used hypoglycaemic agent that is now being studied for use beyond diabetes management. Evidence is emerging that metformin has multiple effects on diverse neurobiological pathways and consequently may be repurposed for treating mental illness. Metformin may have beneficial neuroimmunological, neuroplastic, neuro-oxidative and neuro-nitrosative effects across a range of psychiatric and neurodegenerative illnesses. Mechanisms include glucose lowering effects and effects on AMP-activated protein kinase (AMPK) signalling, however the best evidence for clinical benefit is through the glucose lowering effects, with other mechanisms less supported by the current evidence base. This narrative review aims to draw together the existing evidence for use of metformin as a psychopharmaceutical and present the role of metformin in the context of physical and psychiatric ill health, including metabolic, endocrinological and cancer domains. It not only has therapeutic potential in medical comorbidity but may have potential in core illness domains.
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Affiliation(s)
- Seetal Dodd
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, the University of Melbourne, Parkville, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
| | - Luba Sominsky
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Barwon Health Laboratory, University Hospital Geelong, Barwon Health, VIC, Australia
| | - Dan Siskind
- Metro South Addiction and Mental Health Service, MIRT, Level 2, 228 Logan Rd, Woolloongabba, Brisbane, Qld 4102, Australia University of Queensland School of Clinical Medicine, Brisbane, Australia Queensland Centre for Mental Health Research, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Chiara C Bortolasci
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Andre F Carvalho
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Michael Maes
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Adam J Walker
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Ken Walder
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Alison R Yung
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia; School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Lana J Williams
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Hannah Myles
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia; Northern Adelaide Mental Health Service, Salisbury, SA, Australia
| | - Tayler Watson
- Mental Health, Drugs and Alcohol Service, Barwon Health, Geelong VIC, Australia
| | - Michael Berk
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, the University of Melbourne, Parkville, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia; Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
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Mersha AG, Tollosa DN, Bagade T, Eftekhari P. A bidirectional relationship between diabetes mellitus and anxiety: A systematic review and meta-analysis. J Psychosom Res 2022; 162:110991. [PMID: 36081182 DOI: 10.1016/j.jpsychores.2022.110991] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Due to the existence of inconsistencies in the evidence regarding the direction and extent of association between diabetes and anxiety disorders, the anxiety-diabetes comorbidity remains an issue of debate. AIM To estimate the proportion and risk of diabetes among individuals with anxiety disorder and vice versa. METHODS A systematic review was conducted using studies retrieved from databases and grey literature, with the last database search being conducted on April 15, 2021. The methodological rigor of studies was assessed using the National Institute of Health quality assessment tool. Prevalence and effect size (ES) estimates were pooled using a random effect model. Heterogeneity was assessed using the Higgins' I2 statistical test, and subgroup analysis conducted. RESULTS We included 68 studies presenting data from 2,128,029 participants. The prevalence of anxiety disorders in diabetic patients was 28% (95% CI: 26%, 31%); however, subgroup analysis showed significant differences based on type of anxiety assessment scales, study location, and type of diabetes. The prevalence of diabetes among patients with anxiety disorders was 12% (95% CI: 9%, 16%). Patients with anxiety disorders were found to have a 19% higher risk of diabetes (pooled effect size (ES) = 1.19, 95% CI: 1.13, 1.26). Diabetic patients were found to have a 41% higher risk of developing anxiety disorders (ES = 1.41, 95% CI: 1.19, 1.62). CONCLUSIONS There is a higher risk of anxiety disorders in patients with diabetes mellitus and vice versa. It is recommended to screen diabetic patients for anxiety at initial diagnosis and follow-up visits. Similarly, patients with anxiety disorders should have regular screening for diabetes. REVIEW REGISTRATION PROSPERO registration number CRD42021252475.
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Affiliation(s)
- Amanual Getnet Mersha
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia.
| | - Daniel Nigusse Tollosa
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia.
| | - Tanmay Bagade
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia; Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle 2305, NSW, Australia.
| | - Parivash Eftekhari
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia; Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle 2305, NSW, Australia.
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Long-Term Psychosocial Consequences of Whole-Body Magnetic Resonance Imaging and Reporting of Incidental Findings in a Population-Based Cohort Study. Diagnostics (Basel) 2022; 12:diagnostics12102356. [PMID: 36292045 PMCID: PMC9600583 DOI: 10.3390/diagnostics12102356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
Management of radiological incidental findings (IF) is of rising importance; however, psychosocial implications of IF reporting remain unclear. We compared long-term psychosocial effects between individuals who underwent whole-body magnetic resonance imaging (MRI) with and without reported IF, and individuals who did not undergo imaging. We used a longitudinal population-based cohort from Western Europe. Longitudinal analysis included three examinations (exam 1, 6 years prior to MRI; exam 2, MRI; exam 3, 4 years after MRI). Psychosocial outcomes included PHQ-9 (Patient Health Questionnaire), DEEX (Depression and Exhaustion Scale), PSS-10 (Perceived Stress Scale) and a Somatization Scale. Univariate analyses and adjusted linear mixed models were calculated. Among 855 included individuals, 25% (n = 212) underwent MRI and 6% (n = 50) had at least one reported IF. Compared to MRI participants, non-participants had a higher psychosocial burden indicated by PHQ-9 in exam 1 (3.3 ± 3.3 vs. 2.5 ± 2.3) and DEEX (8.6 ± 4.7 vs. 7.7 ± 4.4), Somatization Scale (5.9 ± 4.3 vs. 4.8 ± 3.8) and PSS-10 (14.7 ± 5.7 vs. 13.7 ± 5.3, all p < 0.05) in exam 3. MRI participation without IF reporting was significantly associated with lower values of DEEX, PHQ-9 and Somatization Scale. There were no significant differences at the three timepoints between MRI participants with and without IF. In conclusion, individuals who voluntarily participated in whole-body MRI had less psychosocial burden and imaging and IF reporting were not associated with adverse long-term psychosocial consequences. However, due to the study design we cannot conclude that the MRI exam itself represented a beneficial intervention causing improvement in mental health scores.
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Silva LAD, Menguer LDS, Doyenart R, Boeira D, Milhomens YP, Dieke B, Volpato AM, Thirupathi A, Silveira PC. Effect of aquatic exercise on mental health, functional autonomy, and oxidative damages in diabetes elderly individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2098-2111. [PMID: 34152875 DOI: 10.1080/09603123.2021.1943324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/10/2021] [Indexed: 06/13/2023]
Abstract
This study investigated the effect of aquatic exercise on mental health, functional autonomy, and oxidative dysfunction in elderly with DM2. A total of 104 elderly were included in the longitudinal clinical study and were attributed to the diabetes group (n = 30) and the non-diabetic group (n = 29). Both groups were involved in the aquatic exercise (nine exercises; 3 sets x 1-minute duration each; linear intensity and frequency measured twice a week) for 12 weeks. The assessments of mental health, functional autonomy, and oxidative dysfunction were done. All results were evaluated at baseline and 12 weeks later. The values of the following variable scores decreased in the DM2 group after participation in the aquatic exercise: depression (-56 ± 2 scores; 57%), anxiety (-8.2 ± 2 scores; 41%), stress (-3.1 ± 0.3 scores; 32%), and sleep (-3. 7 ± 1.3 points; 51%); an improvement in Berg scores was observed (+53.1 ± 2 points; 8%), Tug tests (-6.1 ± 0.7 points; 25%), carbonyl groups (-0.048 ± 0.01 nnmol/mg/protein; 49%), and total thiol (+0.33 ± 0.08 nnmol/mg/protein; 83%). We have concluded that a linear intensity aquatic exercise program improves mental health, functional autonomy, and oxidative dysfunction in elderly with DM2.
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Affiliation(s)
- Luciano Acordi da Silva
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
- Faculdade de Educação Física, Centro Universitário Barriga Verde, Orleans, brazil
| | - Lorhan da Silva Menguer
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | - Ramiro Doyenart
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | - Daniel Boeira
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | - Yuri Pinheiro Milhomens
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | - Beatriz Dieke
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | - Ana Maria Volpato
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | | | - Paulo Cesar Silveira
- Laboratory of Exercise Psychophysiology, Advanced Aquatic Exercise Research Group, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
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Polhuis KCMM, van Bennekom E, Bot M, Nefs G, Vaandrager L, Habibovic M, Geleijnse JM, Pouwer F, Soedamah-Muthu SS. Flourishing mental health and lifestyle behaviours in adults with Type 1 and Type 2 Diabetes Mellitus: results from the Diabetes MILES - The Netherlands Study. J Psychosom Res 2022; 160:110950. [PMID: 35691119 DOI: 10.1016/j.jpsychores.2022.110950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the associations between mental health and lifestyle in adults with type 1 and type 2 diabetes mellitus (T1DM and T2DM). METHODS Online survey data from the cross-sectional Diabetes MILES - The Netherlands Study was analysed, including 270 adults with T1DM and 325 with T2DM. Mental health status (flourishing, moderate and languishing) in relation to diet, physical activity, alcohol consumption and smoking was analysed with ANCOVA and logistic regressions (adjusted for confounders). RESULTS 47% of T1DM-, and 55% of T2DM participants reported flourishing mental health. Due to an insufficient number, participants with languishing mental health were excluded. In T2DM, participants with flourishing mental health had more optimal diet quality (mean ± SEM: 70 ± 1 vs 68 ± 1 diet quality score, p = 0.015), and physical activity levels (mean ± SEM: 3484 ± 269 vs 2404 ± 273 MET minutes/week, p = 0.001) than those with moderate mental health, but did not differ with respect to alcohol consumption and smoking. In T1DM, no significant associations were found. CONCLUSION Only in T2DM, people with flourishing mental health had more optimal lifestyle behaviours compared to people with moderate mental health. Further research is needed to determine if mental health is more important for specific lifestyle behaviours, and if the mental health effect differs across diabetes types.
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Affiliation(s)
- Kristel C M M Polhuis
- Health and Society, Social Sciences, Wageningen University and Research, Hollandseweg 1, P.O. Box 8130, 6707 KN Wageningen, the Netherlands.
| | - Eline van Bennekom
- Health and Society, Social Sciences, Wageningen University and Research, Hollandseweg 1, P.O. Box 8130, 6707 KN Wageningen, the Netherlands; Department of Medical and Clinical Psychology, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Mariska Bot
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Giesje Nefs
- Department of Medical and Clinical Psychology, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, the Netherlands; Department of Medical Psychology, Radboud university medical center, Radboud Institute for Health Sciences, Huispost 926, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Diabeter, National Treatment and Research Center for Children, Adolescents and Adults With Type 1 Diabetes, Blaak 6, 3011 TA Rotterdam, the Netherlands.
| | - Lenneke Vaandrager
- Health and Society, Social Sciences, Wageningen University and Research, Hollandseweg 1, P.O. Box 8130, 6707 KN Wageningen, the Netherlands.
| | - Mirela Habibovic
- Department of Medical and Clinical Psychology, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, the Netherlands.
| | - Johanna M Geleijnse
- Division of Human Nutrition and Health, Wageningen University and Research, Stippeneng 4, P.O. Box 176700, AA Wageningen, 6708 WE Wageningen, The Netherlands.
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Campusvej 55, Odense M DK-5230, Denmark; Steno Diabetes Center Odense (SDCO), Odense Universitetshospital, Kløvervænget 10, 5000 Odense C, Denmark; School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia.
| | - Sabita S Soedamah-Muthu
- Department of Medical and Clinical Psychology, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, the Netherlands; Institute for Food, Nutrition and Health (IFNH), University of Reading, Whiteknights, Pepper Lane Whiteknights, RG6 6AR Reading, United Kingdom.
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Espasandín C, Rivero S, Bengoa L, Cal K, Romanelli G, Benech JC, Damián JP. CaMKIV/CREB/BDNF signaling pathway expression in prefrontal cortex, amygdala, hippocampus and hypothalamus in streptozotocin-induced diabetic mice with anxious-like behavior. Exp Brain Res 2022; 240:2687-2699. [PMID: 35984483 DOI: 10.1007/s00221-022-06446-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/14/2022] [Indexed: 11/04/2022]
Abstract
Individuals with diabetes mellitus (DM) tend to manifest anxiety and depression, which could be related to changes in the expression of calcium/calmodulin-dependent protein kinase IV (CaMKIV), transcription factor cyclic AMP-responsive element binding protein (CREB), phosphorylated CREB (pCREB) and brain-derived neurotrophic factor (BDNF) in different brain regions. The objective of this study was to determine whether mice with type 1 diabetes (T1DM) induced with streptozotocin show a profile of anxious-type behaviors and alterations in the expression/activity of CaMKIV, CREB, pCREB and BDNF in different regions of the brain (prefrontal cortex, amygdala, hippocampus and hypothalamus) in comparison to non-diabetic mice (NDB). Mice with 3 months of chronic DM showed an anxious-like behavioral profile in two anxiety tests (Open Field and Elevated Plus Maze), when compared to NDB. There were significant differences in the expression of cell signaling proteins: diabetic mice had a lower expression of CaMKIV in the hippocampus, a greater expression of CREB in the amygdala and hypothalamus, as well as a lower pCREB/CREB in hypothalamus than NDB mice (P < 0.05). This is the first study evaluating the expression of CaMKIV in the brain of animals with DM, who presented lower expression of this protein in the hippocampus. In addition, it is the first time that CREB was evaluated in amygdala and hypothalamus of animals with DM, who presented a higher expression. Further research is necessary to determine the possible link between expression of CaMKIV and CREB, and the behavioral profile of anxiety in diabetic animals.
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Affiliation(s)
- Camila Espasandín
- Departamento de Biociencias Veterinarias, Facultad de Veterinaria, Universidad de la República, Lasplaces 1550, 11600, Montevideo, CP, Uruguay
- Laboratorio de Señalización Celular y Nanobiología, Instituto de Investigaciones Biológicas Clemente Estable, Avenida Italia 3318, 11600, Montevideo, CP, Uruguay
| | - Sofía Rivero
- Departamento de Biociencias Veterinarias, Facultad de Veterinaria, Universidad de la República, Lasplaces 1550, 11600, Montevideo, CP, Uruguay
| | - Laura Bengoa
- Departamento de Biociencias Veterinarias, Facultad de Veterinaria, Universidad de la República, Lasplaces 1550, 11600, Montevideo, CP, Uruguay
| | - Karina Cal
- Departamento de Biociencias Veterinarias, Facultad de Veterinaria, Universidad de la República, Lasplaces 1550, 11600, Montevideo, CP, Uruguay
- Laboratorio de Patologías del Metabolismo y el Envejecimiento, Institut Pasteur Montevideo, Mataojo 2020, 11400, Montevideo, CP, Uruguay
| | - Gerardo Romanelli
- Laboratorio de Señalización Celular y Nanobiología, Instituto de Investigaciones Biológicas Clemente Estable, Avenida Italia 3318, 11600, Montevideo, CP, Uruguay
| | - Juan Claudio Benech
- Laboratorio de Señalización Celular y Nanobiología, Instituto de Investigaciones Biológicas Clemente Estable, Avenida Italia 3318, 11600, Montevideo, CP, Uruguay
| | - Juan Pablo Damián
- Departamento de Biociencias Veterinarias, Facultad de Veterinaria, Universidad de la República, Lasplaces 1550, 11600, Montevideo, CP, Uruguay.
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Fukunaga A, Inoue Y, Nakagawa T, Honda T, Yamamoto S, Okazaki H, Yamamoto M, Miyamoto T, Gonmori N, Kochi T, Eguchi M, Shirasaka T, Yamamoto K, Hori A, Tomita K, Konishi M, Katayama N, Kabe I, Dohi S, Mizoue T. Diabetes, prediabetes, and long-term sickness absence due to mental disorders: Japan Epidemiology Collaboration on Occupational Health Study. J Psychosom Res 2022; 158:110925. [PMID: 35569177 DOI: 10.1016/j.jpsychores.2022.110925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/28/2022] [Accepted: 04/22/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To investigate the association of diabetes and prediabetes with long-term sickness absence (LTSA) due to mental disorders or specific mental disorders. METHODS A prospective cohort study was conducted using data from the Japan Epidemiology Collaboration on Occupational Health Study. A total of 62,065 workers who received health check-ups in 2011 (nine companies) or 2014 (two companies) and were followed up to March 31, 2020 were included in this study. Diabetes status was defined based on the American Diabetes Association criteria, and diabetes was differentiated into diabetes with/without anti-diabetic treatment for additional analysis. A Cox proportional hazards regression model was used to investigate these associations. RESULTS During maximum 8-year follow-up period, 1024 participants underwent LTSA due to mental disorders. The adjusted hazard ratio (aHR) and corresponding 95% confidence interval (CI) of LTSA due to all mental disorders were 1.10 (0.88-1.38) and 1.45 (1.07-1.98) for prediabetes and diabetes, respectively. Diabetic individuals with/without treatment were both at a high risk of LTSA due to mental disorders. For specific mental disorders, diabetes was associated with a higher risk of LTSA due to reaction to severe stress and adjustment disorders (aHR = 3.02, 95% CI = 2.01-4.52) while it was marginally associated with LTSA due to depressive episode (aHR = 1.25, 95% CI = 0.98-1.60). Prediabetes was also associated with LTSA due to reaction to severe stress and adjustment disorders (aHR = 1.41, 95% CI = 1.08-1.84). CONCLUSIONS The present study suggests the importance of screening diabetes status and providing psychological support for decreasing the risk of LTSA due to mental disorders within working populations.
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Affiliation(s)
- Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd., Ibaraki, Japan
| | - Toru Honda
- Hitachi Health Care Center, Hitachi, Ltd., Ibaraki, Japan
| | | | | | | | | | - Naoki Gonmori
- East Japan Works (Keihin), JFE Steel Corporation, Kanagawa, Japan
| | | | | | | | - Kenya Yamamoto
- Division of Chemical Information, National Institute of Occupational Safety and Health, Kanagawa, Japan
| | - Ai Hori
- Department of Global Public Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobumi Katayama
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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50
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Ndjaboue R, Ngueta G, Rochefort-Brihay C, Delorme S, Guay D, Ivers N, Shah BR, Straus SE, Yu C, Comeau S, Farhat I, Racine C, Drescher O, Witteman HO. Prediction models of diabetes complications: a scoping review. J Epidemiol Community Health 2022; 76:jech-2021-217793. [PMID: 35772935 DOI: 10.1136/jech-2021-217793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 06/08/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Diabetes often places a large burden on people with diabetes (hereafter 'patients') and the society, that is, in part attributable to its complications. However, evidence from models predicting diabetes complications in patients remains unclear. With the collaboration of patient partners, we aimed to describe existing prediction models of physical and mental health complications of diabetes. METHODS Building on existing frameworks, we systematically searched for studies in Ovid-Medline and Embase. We included studies describing prognostic prediction models that used data from patients with pre-diabetes or any type of diabetes, published between 2000 and 2020. Independent reviewers screened articles, extracted data and narratively synthesised findings using established reporting standards. RESULTS Overall, 78 studies reported 260 risk prediction models of cardiovascular complications (n=42 studies), mortality (n=16), kidney complications (n=14), eye complications (n=10), hypoglycaemia (n=8), nerve complications (n=3), cancer (n=2), fracture (n=2) and dementia (n=1). Prevalent complications deemed important by patients such as amputation and mental health were poorly or not at all represented. Studies primarily analysed data from older people with type 2 diabetes (n=54), with little focus on pre-diabetes (n=0), type 1 diabetes (n=8), younger (n=1) and racialised people (n=10). Per complication, predictors vary substantially between models. Studies with details of calibration and discrimination mostly exhibited good model performance. CONCLUSION This rigorous knowledge synthesis provides evidence of gaps in the landscape of diabetes complication prediction models. Future studies should address unmet needs for analyses of complications n> and among patient groups currently under-represented in the literature and should consistently report relevant statistics. SCOPING REVIEW REGISTRATION: https://osf.io/fjubt/.
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Affiliation(s)
- Ruth Ndjaboue
- Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
- School of social work, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- CIUSSS de l'Estrie, Research Centre on Aging, Sherbrooke, Quebec, Canada
| | - Gérard Ngueta
- Université de Sherbrooke Faculté des Sciences, Sherbrooke, Quebec, Canada
| | | | | | - Daniel Guay
- Diabetes Action Canada, Toronto, Ontario, Canada
| | - Noah Ivers
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Family Medicine and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Baiju R Shah
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Catherine Yu
- Knowledge Translation, St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
| | - Sandrine Comeau
- Université Laval Faculté de médecine, Quebec, Quebec, Canada
| | - Imen Farhat
- Université Laval Faculté de médecine, Quebec, Quebec, Canada
| | - Charles Racine
- Université Laval Faculté de médecine, Quebec, Quebec, Canada
| | - Olivia Drescher
- Université Laval Faculté de médecine, Quebec, Quebec, Canada
| | - Holly O Witteman
- Family and Emergency Medicine, Laval University, Quebec City, Quebec, Canada
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