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Núñez-Baila MÁ, Gómez-Aragón A, González-López JR. Sociodemographic and Clinical Determinants on Health-Related Quality of Life in Emerging Andalusian Adults with Type 1 Diabetes: A Cross-Sectional Study. J Clin Med 2023; 13:240. [PMID: 38202247 PMCID: PMC10779847 DOI: 10.3390/jcm13010240] [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: 11/30/2023] [Revised: 12/16/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: Having type 1 diabetes during emerging adulthood can impact quality of life due to the challenge of balancing optimal glycemic blood levels with a period of transition and exploration. The purpose of this study was to characterize the quality of life of emerging adults aged 18 to 29 years with type 1 diabetes and to determine the associations between dimensions of Health-Related Quality of Life in type 1 diabetes and sociodemographic and diabetes-related variables. (2) Methods: This cross-sectional descriptive study was conducted in Andalusia, Spain, from October 2021 to July 2022. A total of 362 emerging adults with type 1 diabetes (67.4% women, mean age 22.8 ± 3.4 years) participated. Data were gathered via sociodemographic information form and the ViDa1 scale. Statistical evaluations, encompassing descriptive analyses, t-tests, ANOVA, Pearson correlations, and logistic regression, were conducted using SPSSv26, adhering to STROBE guidelines. (3) Results: Among the participants, 52.1% have a glycosylated hemoglobin level over 7%. Interference with Life is correlated with sex, age, and age at diagnosis, with age being the only predictor. Self-Care is correlated with and predicted by glycosylated hemoglobin levels. Well-being is correlated with and predicted by sex, Body Mass Index, and glycosylated hemoglobin levels. Concern about the Condition is correlated with and predicted by sex and glycosylated hemoglobin levels. (4) Conclusions: Despite concerns about their disease, participants generally maintain optimal levels of Health-Related Quality of Life in type 1 diabetes. Predictive factors for Health-Related Quality of Life in type 1 diabetes in this group include sex, age, Body Mass Index, and glycosylated hemoglobin.
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Affiliation(s)
| | - Anjhara Gómez-Aragón
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain; (M.-Á.N.-B.); (J.R.G.-L.)
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2
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Campbell MS, Gray A, Wiebe DJ, Berg CA. Understanding the Roles of Romantic Partners and Parents in the Management of Type 1 Diabetes in Emerging Adults. Diabetes Spectr 2022; 35:66-75. [PMID: 35308157 PMCID: PMC8914585 DOI: 10.2337/ds21-0011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
During the emerging adulthood of people with type 1 diabetes, long-term romantic partners may be involved in diabetes management in ways that supplant parental involvement. We examined the perspectives of involvement in diabetes management of the parents and romantic partners of 29 emerging adults with type 1 diabetes, using qualitative interviews and an online survey. When the individuals with diabetes were in long-term romantic relationships, their partners were heavily involved in managing diabetes and providing support; however, when the individuals with diabetes were in short-term relationships or not in a relationship, their parents were described as having the biggest positive impact on their diabetes management. Emerging adults described the involvement of their parents and romantic partners in both positive and negative ways. Romantic relationship status is an important but understudied variable in understanding social involvement and its effects on type 1 diabetes management during emerging adulthood.
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Affiliation(s)
| | - Avia Gray
- Department of Psychology, University of California, Merced, Merced, CA
| | - Deborah J. Wiebe
- Department of Psychology, University of California, Merced, Merced, CA
| | - Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT
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3
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Commissariat PV, Wentzell K, Tanenbaum ML. Competing Demands of Young Adulthood and Diabetes: A Discussion of Major Life Changes and Strategies for Health Care Providers to Promote Successful Balance. Diabetes Spectr 2021; 34:328-335. [PMID: 34866865 PMCID: PMC8603129 DOI: 10.2337/dsi21-0009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Young adults (YAs) are often faced with many new transitions and major milestones specific to their life stage. For YAs with diabetes, it can be particularly difficult to balance diabetes management with the age-typical demands of young adulthood. Clinicians can play an important role in helping YAs navigate major life changes and find balance in the competing demands of young adulthood, while protecting their health and well-being.
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Carreon SA, Duran B, Tang TS, Streisand R, Anderson BJ, Lyons SK, McKay S, Hilliard ME. Here for You: A Review of Social Support Research in Young Adults With Diabetes. Diabetes Spectr 2021; 34:363-370. [PMID: 34866869 PMCID: PMC8603130 DOI: 10.2337/dsi21-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Living with and managing diabetes is challenging during young adulthood, and social support may help relieve or minimize the burdens young adults with diabetes experience. This article reviews the types and sources of support young adults with diabetes receive and their associations with behavioral, psychosocial, and glycemic outcomes. Intervention research integrating social support and future directions for care are discussed.
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Affiliation(s)
| | - Brenda Duran
- Baylor College of Medicine & Texas Children’s Hospital, Houston, TX
| | - Tricia S. Tang
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Randi Streisand
- Children’s National Hospital, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | | | - Sarah K. Lyons
- Baylor College of Medicine & Texas Children’s Hospital, Houston, TX
| | - Siripoom McKay
- Baylor College of Medicine & Texas Children’s Hospital, Houston, TX
| | - Marisa E. Hilliard
- Baylor College of Medicine & Texas Children’s Hospital, Houston, TX
- Corresponding author: Marisa E. Hilliard,
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5
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Hickling A, Dingle GA, Barrett HL, Cobham VE. Systematic Review: Diabetes Family Conflict in Young People With Type 1 Diabetes. J Pediatr Psychol 2021; 46:1091-1109. [PMID: 34313769 DOI: 10.1093/jpepsy/jsab052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the relationships between diabetes-specific family conflict and health outcomes of young people with type 1 diabetes (T1D). METHODS A systematic review was performed according to the PRISMA statement (registration number: CRD42020164988). PubMed, Embase, PsycNET, reference lists of included studies, and other relevant reviews were searched (1990-2020). Two independent reviewers screened titles, abstracts, and full-texts. Studies were included if they sampled young people with T1D (mean age between 14 and 25 years) and examined the relationship between diabetes-specific family conflict and the following outcomes: glycated hemoglobin (HbA1c), treatment adherence, blood glucose monitoring, depression, anxiety, quality of life, and/or well-being. RESULTS A total of 20 studies met the predetermined inclusion criteria. Greater diabetes-specific family conflict was significantly related to higher HbA1c values in 17 studies. Seven studies reported a significant association between greater diabetes family conflict and suboptimal treatment adherence and/or less frequent blood glucose monitoring. However, significant relationships between conflict and HbA1c and/or treatment adherence were not found in four studies. Seven studies in total reported that greater diabetes family conflict was significantly related to poorer quality of life or well-being and greater depressive and/or anxiety symptoms in young people. CONCLUSIONS Diabetes-specific family conflict is associated with some adverse health outcomes for young people with T1D. However, more longitudinal studies of young people aged older than 16 years are needed. Screening for and addressing diabetes-specific family conflict is recommended, given the growing number of studies linking family conflict to various adverse health outcomes in young people with T1D.
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Affiliation(s)
- Anna Hickling
- School of Psychology, The University of Queensland.,Mater Research Institute, The University of Queensland.,Children's Hospital Foundation (Queensland)
| | | | - Helen L Barrett
- Mater Research Institute, The University of Queensland.,Department of Endocrinology, Mater Health Services, Mater Hospital
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland.,Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service
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6
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Ness MM, Saylor JL, Ji X, Bell A, Habermann B. Challenges Experienced by Parents of Emerging Young Adults With Type 1 Diabetes Mellitus During the Transition to College. DIABETES EDUCATOR 2020; 46:435-443. [PMID: 32734833 DOI: 10.1177/0145721720943120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study is to gain a deeper understanding of the challenges experienced by parents of emerging young adults (EYAs) with type 1 diabetes mellitus (T1DM) who completed their freshman or sophomore year of college. METHODS Using a descriptive, qualitative design, 16 parents participated in semistructured interviews that explored factors impacting the college transition for parents of college freshmen and sophomores with T1DM. Participants were recruited from local endocrinology clinics as well as the College Diabetes Network (CDN) Parent Facebook page, the CDN Facebook page, the CDN Twitter feed, and the Delaware Chapter of the JDRF (formerly Juvenile Diabetes Research Foundation). Researchers used a thematic analysis to analyze the data and develop categories. Interviews were conducted and recorded via video conferencing from July 2019 to September 2019. RESULTS Results represent data from 16 interviews comprising 15 (94%) mothers and 1 father. Thematic analysis resulted in the emergence of 3 themes: managing parental concerns, changes in the parental role, and identifying sources of parental support. Parents identified several challenges including the EYAs' ability to manage T1DM at college, communication with the EYA, and the availability of support for parents. CONCLUSION Parents experience several challenges during their EYA's transition to college with T1DM. Supporting the needs of parents and EYAs during this time may serve to reduce diabetes-related complications for EYAs and increase overall quality of life for both members of the dyad.
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Affiliation(s)
| | | | - Xiaopeng Ji
- School of Nursing, University of Delaware, Newark, Delaware
| | - Ann Bell
- School of Nursing, University of Delaware, Newark, Delaware
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7
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Campbell MS, Wang J, Cheng Y, Cogen FR, Streisand R, Monaghan M. Diabetes-specific family conflict and responsibility among emerging adults with type 1 diabetes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2019; 33:788-796. [PMID: 31021129 PMCID: PMC6776682 DOI: 10.1037/fam0000537] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Emerging adulthood is a transitional period for type 1 diabetes management, and aspects of family functioning such as family conflict and responsibility for diabetes management likely change following high school graduation. This study examined changes in diabetes-specific family conflict, family responsibility for diabetes management tasks, and associations with glycemic control up to 1 year after high school. Seventy-nine emerging adults with type 1 diabetes (M age = 18.09 ± .43 years; 51% female; 71% Caucasian) and their parents (73% female) completed self-report measures on diabetes-specific family conflict and family responsibility at 3 consecutive clinic visits, beginning in the spring of their senior year of high school. Hemoglobin A1c (HbA1c) was obtained from medical records. Diabetes-specific family conflict was relatively low; scores did not significantly change from baseline to Time 3. Parent responsibility for diabetes care decreased from baseline to Time 3. Higher parent- and emerging adult-reported family conflict and higher parent responsibility for diabetes care were associated with worse glycemic control (ps < .05). Parent-reported family conflict and the interaction between parent-reported family conflict and responsibility predicted HbA1c 1 year after high school. Conversely, HbA1c did not predict diabetes-specific family conflict or responsibility 1 year after high school. Findings indicate that diabetes-specific family conflict is associated with glycemic control after high school, even when emerging adults assume greater responsibility for diabetes self-care. Diabetes-specific family conflict levels were generally low and did not change over time despite this transitional period. If diabetes-specific conflict is present, it should be an important avenue for potential intervention for emerging adults with type 1 diabetes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Jichuan Wang
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | - Yao Cheng
- Children’s National Health System, Washington, DC
| | - Fran R. Cogen
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | - Randi Streisand
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
| | - Maureen Monaghan
- Children’s National Health System, Washington, DC
- George Washington University School of Medicine, Washington, DC
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8
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Kelly CS, Berg CA, Lansing AH, Turner SL, Munion AK, Tracy EL, Wiebe DJ. Keeping parents connected in early emerging adulthood: Diabetes-related disclosure and solicitation. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2019; 33:809-818. [PMID: 31355650 PMCID: PMC6776686 DOI: 10.1037/fam0000565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Emerging adults with Type 1 diabetes benefit when parents remain knowledgeable of their self-management. Yet how early emerging adults remain connected with parents while they experience normative declines in involvement and move out of the parental home is unclear. The present study examined how disclosure to, and solicitation from, parents may (a) be a way that emerging adults and parents remain connected, (b) occur with different methods of contact (i.e., face-to-face; non-face-to-face), and (c) associate with diabetes management differently for those living in versus outside of the parental home. Early emerging adults with Type 1 diabetes (N = 202; Mage = 18.81 years; 66% female) completed measures of their methods of contact with parents; diabetes-related disclosure to, and solicitation from, parents; and diabetes management as part of a 14-day daily diary. General linear models found that face-to-face contact was associated with greater disclosure to parents, for both those living in and out of the parental home. Individuals who lived outside the parental home used more non-face-to-face contact (e.g., texting) than those in the parental home. Multilevel models revealed that higher disclosure to mothers on a daily basis (within-persons) and to mothers and fathers overall (between-persons) was associated with better diabetes management similarly for those living in versus out of the parental home. Results suggest that face-to-face contact may be most effective for keeping parents "in the know" about diabetes management. Moreover, disclosure and solicitation continue to support diabetes management even as individuals move out of the parental home. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | - Deborah J. Wiebe
- University of California, Merced, Psychological Sciences
and Health Sciences Research Institute
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Berg CA, Wiebe DJ, Lee Tracy E, Kelly CS, Mello D, Turner SL, Butner JE, Munion AK, Mansfield JH, White PC, Murray M, Suchy Y. Parental Involvement and Executive Function in Emerging Adults with Type 1 Diabetes. J Pediatr Psychol 2019; 44:970-979. [PMID: 31095317 PMCID: PMC6736420 DOI: 10.1093/jpepsy/jsz025] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine (a) changes in parental involvement across early emerging adulthood, (b) whether yearly fluctuations in parental involvement were associated with adherence and glycated hemoglobin (HbA1c) over time, and (c) whether higher involvement was more beneficial for those with poorer executive function (EF). METHODS A total of 228 high school seniors (M age = 17.76) with type 1 diabetes reported on mothers' and fathers' acceptance, knowledge of diabetes activities, disclosure to mothers and fathers regarding diabetes, and adherence at four yearly time points. At baseline, participants completed performance-based measures of EF. HbA1c was collected from assay kits. RESULTS Growth curve models revealed significant declines in disclosure to fathers and mothers' and fathers' knowledge of diabetes activities; no changes were found in mothers' or fathers' acceptance nor disclosure to mothers. Multilevel models indicated significant between-person effects for nearly all aspects of parental involvement with more acceptance, knowledge, and disclosure associated with better HbA1c and adherence. Within-person effects for disclosure to fathers, and mothers' and fathers' knowledge indicated that in years when emerging adults perceived higher amounts of these types of involvement (compared with their own average), HbA1c was lower. Within-person effects were found for acceptance to mothers, disclosure to mothers and fathers, and mothers' diabetes knowledge for adherence. Disclosure to fathers and mothers' knowledge of diabetes activities were especially beneficial for HbA1c for those with poorer EF performance. CONCLUSIONS Parental involvement in diabetes management remains important during the high-risk time of emerging adulthood, especially for those with poorer EF.
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Affiliation(s)
| | - Deborah J Wiebe
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
- University of Texas Southwestern Medical Center
| | | | | | - Daniel Mello
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
| | | | | | | | | | | | - Mary Murray
- Department of Pediatrics, University of Utah Medical School
| | - Yana Suchy
- Department of Psychology, University of Utah
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10
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Berg CA, Wiebe DJ, Suchy Y, Turner SL, Butner J, Munion A, Lansing AH, White PC, Murray M. Executive Function Predicting Longitudinal Change in Type 1 Diabetes Management During the Transition to Emerging Adulthood. Diabetes Care 2018; 41:2281-2288. [PMID: 30131398 PMCID: PMC6196825 DOI: 10.2337/dc18-0351] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/19/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this study was to examine 1) whether teens' glycemic control and adherence to type 1 diabetes treatment regimen worsen during the transition from late adolescence to emerging adulthood, and 2) whether teens' executive function (EF), as measured by performance and self-reported problems with EF, is predictive of these changes (after controlling for general intelligence). RESEARCH DESIGN AND METHODS High school seniors with type 1 diabetes (N = 236; mean age 17.74 years) were assessed at three yearly time points. At baseline, during the senior year of high school, participants completed a self-report measure of problems with EF and performance-based measures of EF and general intelligence (IQ). Glycemic control was determined on the basis of results collected from HbA1c assay kits, and teens reported their adherence at all three time points. RESULTS HbA1c increased significantly across the three time points and adherence declined. EF performance was not associated with adherence or HbA1c at baseline, nor with changes in adherence over time. However, better EF performance predicted slower increases in HbA1c over time (i.e., slope) while controlling for IQ. Teens' self-reported problems with EF were associated with worse glycemic control and poorer adherence at baseline (i.e., intercept), but they did not predict changes in either HbA1c or adherence over time (i.e., slope). CONCLUSIONS Abilities involved in performance on EF tests may be one resource for maintaining better glycemic control during the transition to emerging adulthood. Assessment of such EF abilities may allow for the identification of individuals who are most at risk for deterioration of glycemic control during this transition.
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Affiliation(s)
- Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Deborah J Wiebe
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, CA
- The University of Texas Southwestern Medical Center, Dallas, TX
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Sara L Turner
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Jonathan Butner
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Ascher Munion
- Department of Psychology, University of Utah, Salt Lake City, UT
| | | | - Perrin C White
- The University of Texas Southwestern Medical Center, Dallas, TX
| | - Mary Murray
- Department of Pediatrics, University of Utah Medical School, Salt Lake City, UT
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Holtz BE, Mitchell KM, Hershey DD, Cotten SR, Holmstrom AJ, Richman J, Dunneback JK, Wood MA. Using an mHealth App to Transition Care of Type 1 Diabetes from Parents to Teens: Protocol for a Pilot Study. JMIR Res Protoc 2018; 7:e10803. [PMID: 30377142 PMCID: PMC6234347 DOI: 10.2196/10803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/20/2018] [Accepted: 08/14/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) afflicts approximately 154,000 people under the age of 20 in the United States. Most people with T1DM are diagnosed at a young age, and parents have to take on the responsibility of T1DM management. Eventually, the child must begin to transition to self-management. Adolescents often struggle to take on responsibility for all the necessary tasks to successfully self-manage their T1DM. In fact, approximately three-quarters of adolescents are not achieving American Diabetes Association-recommended glycated hemoglobin (HbA1c) targets. This lack of adherence can lead to negative health outcomes. OBJECTIVE The goals of this interdisciplinary proposal are as follows: (1) to develop a unique and theory-driven technology using a mobile phone app to promote self-management behaviors for adolescents aged 10-15 years with T1DM and their parents and (2) to explore the feasibility and impact of the self-management mobile app. METHODS This study has two phases: app development and pilot testing. In the app development phase, the app will be conceptualized and a prototype will be tested. In Phase 2, the mobile app will undergo pilot testing to determine its feasibility and impact on diabetes self-management. RESULTS The pilot test was launched in September 2017. Data collection for the final pilot test is underway, and results are forthcoming. CONCLUSIONS Adolescents with T1DM and their parents can have a difficult time managing the transition of diabetes care. It is hoped that this app can help. The focus groups and prototype testing have indicated promising outcomes of app use. TRIAL REGISTRATION ClinicalTrials.gov NCT03436628; https://clinicaltrials.gov/ct2/show/NCT03436628 (Archived by WebCite at http://www.webcitation.org/72tHXTE2Z). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/10803.
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Affiliation(s)
- Bree E Holtz
- Department of Advertising and Public Relations, Michigan State University, East Lansing, MI, United States
| | - Katharine M Mitchell
- Department of Advertising and Public Relations, Michigan State University, East Lansing, MI, United States
| | - Denise D Hershey
- College of Nursing, Michigan State University, East Lansing, MI, United States
| | - Shelia R Cotten
- Department of Media and Information, Michigan State University, East Lansing, MI, United States
| | - Amanda J Holmstrom
- Department of Communication, Michigan State University, East Lansing, MI, United States
| | - Joshua Richman
- Department of Surgery, University of Alabama-Birmingham, Birmingham, AL, United States
| | - Julie K Dunneback
- Department of Pediatric Endocrinology, Sparrow Health System, Lansing, MI, United States
| | - Michael A Wood
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
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12
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Kelly CS, Berg CA. Close relationships and diabetes management across the lifespan: The good, the bad, and autonomy. J Health Psychol 2018; 26:226-237. [PMID: 30318922 DOI: 10.1177/1359105318805815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Relationships are linked with positive and negative self-management and illness outcomes for individuals with type 1 diabetes. Explanations for these mixed associations have remained separated in psychosocial research in type 1 diabetes by relationship type (e.g. parent vs spouse) and individual's age (e.g. adolescence vs older adulthood). In this conceptual review, we present a novel perspective that close relationships across the lifespan may be beneficial for illness self-management when they support individuals' sense of autonomy, defined from a Basic Psychological Needs perspective. Processes of autonomy support are crucial for promoting illness management across all ages and relationship types.
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Wiebe DJ, Berg CA, Mello D, Kelly CS. Self- and Social-Regulation in Type 1 Diabetes Management During Late Adolescence and Emerging Adulthood. Curr Diab Rep 2018; 18:23. [PMID: 29564640 DOI: 10.1007/s11892-018-0995-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW This paper aims to examine how self-regulation (i.e., cognition, emotion) and social-regulation (i.e., parents, friends, romantic partners) are interrelated risk and protective factors for type 1 diabetes management during late adolescence and emerging adulthood. RECENT FINDINGS Problems in cognitive (e.g., executive function) and emotional (e.g., depressive symptoms) self-regulation are associated with poorer management, both at the between- and within-person levels. Better management occurs when parents are supportive and when individuals actively regulate the involvement of others (e.g., seek help, minimize interference). Friends both help and hinder self-regulation, while research on romantic partners is limited. Facets of self- and social-regulation are important risk and protective factors for diabetes management during emerging adulthood. At this time when relationships are changing, the social context of diabetes may need to be regulated to support diabetes management. Interventions targeting those with self-regulation problems and facilitating self- and social-regulation in daily life may be useful.
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Affiliation(s)
- Deborah J Wiebe
- Psychological Sciences and the Health Sciences Research Institute, University of California, Merced, 5200 N. Lake Road, Merced, CA, 95343, USA.
| | - Cynthia A Berg
- Department of Psychology, University of Utah, 380 South 1530 East, Salt Lake City, UT, 84112, USA
| | - Daniel Mello
- Psychological Sciences and the Health Sciences Research Institute, University of California, Merced, 5200 N. Lake Road, Merced, CA, 95343, USA
| | - Caitlin S Kelly
- Department of Psychology, University of Utah, 380 South 1530 East, Salt Lake City, UT, 84112, USA
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14
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Ness MM, Saylor J, Selekman J. Maternal Experiences of Transitioning Their Emerging Adult With Type 1 Diabetes to College. DIABETES EDUCATOR 2018; 44:178-187. [PMID: 29482437 DOI: 10.1177/0145721718759980] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose The purpose of this study was to gain a deeper understanding about mothers' experiences of transitioning their emerging adult with type 1 diabetes mellitus to college. Methods A descriptive, qualitative study was conducted with 9 mothers of high school seniors with type 1 diabetes (T1DM) using semi-structured questions via recorded telephone interviews. Results Among the 9 participants, 8 had daughters, and 1 had a son. The thematic analysis resulted in 4 themes: (1) concern for health and safety at college, (2) evolving roles of the parent and emerging adult dyad, (3) communication dynamics, and (4) social support systems. Conclusions Results indicate that mothers of emerging adults with T1DM experience heightened levels of concern during the college transition. These concerns are above and beyond those that are experienced by mothers of emerging adults without T1DM. Findings indicated that increasing levels of support for both parents as well as emerging adults with T1DM during the college transition may serve to decrease maternal stress and enhance the development of preparedness for diabetes self-management. Recommendations for diabetes educators in clinical practice include a family-centered approach focusing on the transition before the late adolescent period, interventions from colleges to promote a smooth transition, and interventions that address concerns of both the emerging adult with T1DM and the parent. Further research is necessary to identify barriers and facilitators to support parent/emerging adult dyads during the college transition period.
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Holtz BE, Murray KM, Hershey DD, Richman J, Dunneback JK, Vyas A, Wood MA. The design and development of MyT1DHero: A mobile app for adolescents with type 1 diabetes and their parents. J Telemed Telecare 2017; 25:172-180. [PMID: 29228854 DOI: 10.1177/1357633x17745470] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Type 1 diabetes impacts approximately 1.25 m Americans, many of them young children. As a child grows, there is a transition towards independence and they must learn to manage their diabetes independently. The objective of this study was to design, develop and conduct a prototype test to assess the satisfaction and feasibility of a mobile app for adolescents with type 1 diabetes and their parents to aid in this transition. METHODS Ten parent/adolescent groups used MyT1DHero for four weeks. They were given a pre-test/post-test survey regarding family conflict with three tasks of diabetes management and the general tone of family communication. At post-test they were asked questions regarding their satisfaction and perception of ease of use of the app. They also participated in short interviews regarding the app. Additionally, we used server data to examine actual app usage. RESULTS The parents' perceptions of conflict around the results of the blood sugar tests increased ( t(9) = 2.71, p = .02) as did perceptions of conflict around logging the blood sugar results ( t(9) = 3.67, p = .005). The adolescents perceived increased conflict surrounding the results around logging the blood sugars results ( t(9) = 3.09, p = .01).There was no change in the tone of general family communication. During the prototype testing, we discovered that the app crashed repeatedly and several of the functions were not working properly. In the interview data, three main themes emerged, app-crashing issues, problems with notifications and positive feedback. DISCUSSION Through this process, all of the reported issues were corrected and new features were planned for subsequent versions. A smartphone application has the potential to be a novel intervention for engaging adolescents and their parents in positive communication to support type 1 diabetes management.
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Affiliation(s)
- Bree E Holtz
- 1 Department of Advertising & Public Relations, Michigan State University, MI, USA
| | - Katharine M Murray
- 1 Department of Advertising & Public Relations, Michigan State University, MI, USA
| | | | - Joshua Richman
- 3 Department of Surgery, University of Alabama-Birmingham, MI, USA
| | - Julie K Dunneback
- 4 Department of Paediatric Endocrinology, Sparrow Health System, MI, USA
| | - Arpita Vyas
- 5 Department of Paediatrics, Texas Tech University, MI, USA
| | - Michael A Wood
- 6 Department of Paediatrics, University of Michigan, MI, USA
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16
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Berg CA, Butner J, Wiebe DJ, Lansing AH, Osborn P, King PS, Palmer DL, Butler JM. Developmental model of parent-child coordination for self-regulation across childhood and into emerging adulthood: Type 1 diabetes management as an example. DEVELOPMENTAL REVIEW 2017; 46:1-26. [DOI: 10.1016/j.dr.2017.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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17
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Kelly CS, Berg CA, Ramsey MA, Baker AC, Donaldson DL, Swinyard MT, Lindsay R, Murray M, Wiebe DJ. Relationships and the development of transition readiness skills into early emerging adulthood for individuals with type 1 diabetes. CHILDRENS HEALTH CARE 2017; 47:308-325. [PMID: 30906104 PMCID: PMC6426132 DOI: 10.1080/02739615.2017.1354294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The study examined how 'transition readiness' skills develop from relationship processes with parents, friends, and healthcare providers. During their senior year of high school and one year later, participants (N = 217) with type 1 diabetes completed measures of transition readiness skills (Self-Management; Self-Advocacy), adherence, HbA1c, and relationships with providers (patient-centered communication), parents (monitoring/knowledge), and friends (knowledge/helpfulness) surrounding diabetes. Self-Management skills increased across time. Higher friend knowledge/helpfulness during emerging adulthood was associated with increased Self-Management skills. Adherence improved when relationships with providers and friends matched transition readiness skills, indicating that these relationships may facilitate transition skills in early emerging adulthood.
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Affiliation(s)
- Caitlin S. Kelly
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Meagan A. Ramsey
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Ashley C. Baker
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, CA
| | - David L. Donaldson
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | | | - Rob Lindsay
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - Mary Murray
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - Deborah J. Wiebe
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, CA
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18
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Goethals ER, Oris L, Soenens B, Berg CA, Prikken S, Van Broeck N, Weets I, Casteels K, Luyckx K. Parenting and Treatment Adherence in Type 1 Diabetes Throughout Adolescence and Emerging Adulthood. J Pediatr Psychol 2017; 42:922-932. [DOI: 10.1093/jpepsy/jsx053] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 02/02/2017] [Indexed: 11/14/2022] Open
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19
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Main A, Wiebe DJ, Van Bogart K, Turner SL, Tucker C, Butner JE, Berg CA. Secrecy From Parents and Type 1 Diabetes Management in Late Adolescence. J Pediatr Psychol 2015; 40:1075-84. [PMID: 26136405 DOI: 10.1093/jpepsy/jsv060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 05/28/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study examined (a) associations of parent-adolescent relationship characteristics and adolescent problem behavior with late adolescents' secrecy from parents about type 1 diabetes management, and (b) whether secrecy was associated with diabetes and psychological outcomes independently of these factors. METHODS Adolescents (N = 247, Mage = 17.76 years) completed survey measures of diabetes-related secrecy from parents, disclosure, parental acceptance, parental knowledge, and conduct problems. Mothers and adolescents reported on adolescent adherence to diabetes regimens and adolescents reported their depressive symptoms. Glycemic control was obtained from HbA1c test kits. RESULTS Adolescent-reported disclosure to parents was uniquely negatively associated with secrecy from parents. Controlling for relationship variables, conduct problems, and sociodemographic and illness-related variables, secrecy from mothers was uniquely associated with poorer glycemic control and secrecy from both parents was associated with lower adherence. CONCLUSIONS Secrecy about type 1 diabetes management is uniquely associated with diabetes outcomes independent of other relationship characteristics and problem behaviors.
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Affiliation(s)
- Alexandra Main
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
| | - Deborah J Wiebe
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
| | - Karina Van Bogart
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
| | | | - Christy Tucker
- Division of Psychology, University of Texas Southwestern Medical Center
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20
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Hanna KM, Weaver MT, Slaven JE, Stump TE, Shieh C. Weight control behaviors among emerging adults with type 1 diabetes. DIABETES EDUCATOR 2015; 41:444-51. [PMID: 25862681 DOI: 10.1177/0145721715581667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to examine the association of weight control behaviors (WCBs) with living and educational situations among emerging adults with type 1 diabetes during the first year after high school graduation. METHODS Among 184 emerging adults with type 1 diabetes, data were collected every 3 months for 12 months on WCBs, body mass index (BMI), living and educational situations; at baseline and 12 months, on impulse control; and at baseline, on sex, depressive symptoms, and glycemic control. Generalized linear models incorporated repeated measures (0, 3, 6, 9, and 12 months). RESULTS No significant associations existed between WCBs and living or educational situations, when controlling for covariates. More depressive symptoms and higher BMIs were associated with a greater likelihood of involvement in unhealthy WCBs, whereas more depressive symptoms-not higher BMI-were associated with higher odds for involvement in very unhealthy WCBs. Although healthy WCBs were also associated with more depressive symptoms and higher BMIs, they were also associated with greater impulse control. CONCLUSIONS Health care professionals should assess emerging adults with type 1 diabetes for WCBs along with BMI, depressive symptoms, and impulse control.
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Affiliation(s)
- Kathleen M Hanna
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA (Dr Hanna),School of Nursing, Indiana University, Indianapolis, Indiana, USA (Dr Hanna, Dr Weaver, Dr Shieh)
| | - Michael T Weaver
- School of Nursing, Indiana University, Indianapolis, Indiana, USA (Dr Hanna, Dr Weaver, Dr Shieh)
| | - James E Slaven
- Department of Biostatistics, School of Medicine, Indiana University, Indianapolis, IN, USA (Mr Slaven, Mr Stump)
| | - Timothy E Stump
- Department of Biostatistics, School of Medicine, Indiana University, Indianapolis, IN, USA (Mr Slaven, Mr Stump)
| | - Carol Shieh
- School of Nursing, Indiana University, Indianapolis, Indiana, USA (Dr Hanna, Dr Weaver, Dr Shieh)
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21
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Monaghan M, Helgeson V, Wiebe D. Type 1 diabetes in young adulthood. Curr Diabetes Rev 2015; 11:239-50. [PMID: 25901502 PMCID: PMC4526384 DOI: 10.2174/1573399811666150421114957] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/24/2015] [Accepted: 03/09/2015] [Indexed: 02/08/2023]
Abstract
Type 1 diabetes has traditionally been studied as a chronic illness of childhood. However, young adulthood is a critical time for the development and integration of lifelong diabetes management skills, and research is starting to identify unique challenges faced by youth with diabetes as they age into adulthood. Most young adults experience multiple transitions during this unstable developmental period, including changes in lifestyle (e.g., education, occupation, living situation), changes in health care, and shifting relationships with family members, friends, and intimate others. Young adults with type 1 diabetes must navigate these transitions while also assuming increasing responsibility for their diabetes care and overall health. Despite these critical health and psychosocial concerns, there is a notable lack of evidence-based clinical services and supports for young adults with type 1 diabetes. We review relevant evolving concerns for young adults with type 1 diabetes, including lifestyle considerations, health care transitions, psychosocial needs, and changes in supportive networks, and how type 1 diabetes impacts and is impacted by these key developmental considerations. Specific avenues for intervention and future research are offered.
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Hanna KM, Stupiansky NW, Weaver MT, Slaven JE, Stump TE. Alcohol use trajectories after high school graduation among emerging adults with type 1 diabetes. J Adolesc Health 2014; 55:201-8. [PMID: 24661736 PMCID: PMC4108540 DOI: 10.1016/j.jadohealth.2014.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 02/03/2014] [Accepted: 02/04/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore alcohol involvement trajectories and associated factors during the year post-high school (HS) graduation among emerging adults with type 1 diabetes. METHODS Youth (N = 181) self-reported alcohol use at baseline and every 3 months for 1 year post-HS graduation. Data were also collected on parent-youth conflict, diabetes self-efficacy, major life events, living and educational situations, diabetes management, marijuana use, cigarette smoking, and glycemic control. Trajectories of alcohol use were modeled using latent class growth analysis. Associations between trajectory class and specific salient variables were examined using analysis of variance, chi square, or generalized linear mixed model, as appropriate. RESULTS Identified alcohol involvement trajectory classes were labeled as (1) consistent involvement group (n = 25, 13.8%) with stable, high use relative to other groups over the 12 months; (2) growing involvement group (n = 55, 30.4%) with increasing use throughout the 12 months; and (3) minimal involvement group (n = 101, 55.8%) with essentially no involvement until the ninth month. Those with minimal involvement had the best diabetes management and better diabetes self-efficacy than those with consistent involvement. In comparison with those minimally involved, those with growing involvement were more likely to live independently of parents; those consistently involved had more major life events; and both the growing and consistent involvement groups were more likely to have tried marijuana and cigarettes. CONCLUSIONS This sample of emerging adults with type 1 diabetes has three unique patterns of alcohol use during the first year after HS.
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Affiliation(s)
- Kathleen M Hanna
- Science of Nursing Care Department, Indiana University School of Nursing, Indianapolis, Indiana.
| | - Nathan W Stupiansky
- Department of Pediatrics, Adolescent Section, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael T Weaver
- Science of Nursing Care Department, Indiana University School of Nursing, Indianapolis, Indiana
| | - James E Slaven
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Timothy E Stump
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
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Hanna KM, Weaver MT, Stump TE, Fortenberry JD, DiMeglio LA. The Relationship of Worry About Hypoglycemia With Diabetes-specific and Typical Youth Behavior Among Emerging Adults With Type 1 Diabetes. DIABETES EDUCATOR 2014; 40:533-542. [PMID: 24676275 DOI: 10.1177/0145721714528997] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE Little is known about the relationship of worry about hypoglycemia with diabetes-specific and typical youth behaviors among emerging adults with type 1 diabetes. This study's purpose was to examine the relationship among worry about hypoglycemia, diabetes management, and glycemic control within the context of alcohol use, hypoglycemia-related weight control behaviors, depressive symptoms, and impulse control among emerging adults with type 1 diabetes. RESEARCH DESIGN AND METHODS The sample was 181 emerging adults with type 1 diabetes who were part of a larger study. Path analysis was used to test associations among worry about hypoglycemia, diabetes management, hypoglycemia-related weight control behaviors (WCB), alcohol use, impulse control, depressive symptoms, and glycemic control. RESULTS Path model fit and modification indices suggested that a feedback loop between worry about hypoglycemia and diabetes management should be incorporated into the original model. Youth with fewer depressive symptoms reported fewer hypoglycemia-related WCB and less worry about hypoglycemia; those with higher impulse control had less alcohol use and better diabetes management; those with lower alcohol use had more worry about hypoglycemia; and better glycemic control was associated with better diabetes management. CONCLUSIONS Health care professionals need to understand how multiple factors related to worry about hypoglycemia and diabetes management interact in emerging adults. In the context of depressive symptoms, impulse control, alcohol use, and hypoglycemia-related WCB, the path model results suggest several potential avenues for intervening to improve glycemic control in emerging adults.
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Affiliation(s)
- Kathleen M Hanna
- Indiana University School of Nursing, Indianapolis, Indiana (Dr Hanna, Dr Weaver) .,Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (Mr Stump) .,Indiana University School of Medicine, Indianapolis, Indiana (Dr Fortenberry, Dr DiMeglio)
| | - Michael T Weaver
- Indiana University School of Nursing, Indianapolis, Indiana (Dr Hanna, Dr Weaver).,Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (Mr Stump).,Indiana University School of Medicine, Indianapolis, Indiana (Dr Fortenberry, Dr DiMeglio)
| | - Timothy E Stump
- Indiana University School of Nursing, Indianapolis, Indiana (Dr Hanna, Dr Weaver).,Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (Mr Stump).,Indiana University School of Medicine, Indianapolis, Indiana (Dr Fortenberry, Dr DiMeglio)
| | - J Dennis Fortenberry
- Indiana University School of Nursing, Indianapolis, Indiana (Dr Hanna, Dr Weaver).,Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (Mr Stump).,Indiana University School of Medicine, Indianapolis, Indiana (Dr Fortenberry, Dr DiMeglio)
| | - Linda A DiMeglio
- Indiana University School of Nursing, Indianapolis, Indiana (Dr Hanna, Dr Weaver).,Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (Mr Stump).,Indiana University School of Medicine, Indianapolis, Indiana (Dr Fortenberry, Dr DiMeglio)
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