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Stocker R, Gupta A, Taylor GS, Shaw JA, West DJ. Adapting to compromised routines: Parental perspectives on physical activity and health for children and adolescents with type 1 diabetes in the UK during COVID-19 lockdown. J Pediatr Nurs 2024; 77:e242-e250. [PMID: 38658303 DOI: 10.1016/j.pedn.2024.04.035] [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: 12/14/2023] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To determine how COVID-19 lockdown impacted physical activity (PA) levels, wellbeing, and diabetes management in children (aged 0-17 years) with type 1 diabetes (T1D), from the perspectives of their parent/guardian. DESIGN AND METHODS This qualitative descriptive study is part of a larger, parallel mixed-methods design study, which incorporated a cross-sectional survey and semi-structured one-to-one interviews. Interviewees were recruited from the survey, which was distributed to parents of children/adolescents with T1D in the UK. Interviews explored diabetes management, mental and physical wellbeing, changes in PA levels, sleep quality before/during lockdown, and the effects of lockdown on the individual and their family. The interviews were transcribed and the data were analysed thematically. RESULTS 14 interviews were conducted with parents. Thematic analysis generated a central theme of routine disruption, with four further themes on diabetes management routines, harnessing the opportunities of lockdown, weighing up risk, and variable impact on wellbeing. CONCLUSIONS Maintaining or increasing PA during COVID-19 lockdown was associated with better diabetes management, sleep, and wellbeing for children/adolescents with T1D, despite significant disruption to established routines. Use of technology during the pandemic contributed positively to wellbeing. PRACTICE IMPLICATIONS It is crucial to emphasize the significance of maintaining a well-structured routine when treating patients with type 1 diabetes. A consistent routine, incorporating regular physical exercise and good sleep hygiene, will help with managing overall diabetes control.
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Affiliation(s)
- Rachel Stocker
- School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
| | - Alisha Gupta
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom; University Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-On-Tees TS19 8PE, United Kingdom.
| | - Guy S Taylor
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
| | - James A Shaw
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Daniel J West
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
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ElSayed NA, Aleppo G, Bannuru RR, Bruemmer D, Collins BS, Cusi K, Ekhlaspour L, Fleming TK, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Napoli N, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Verduzco-Gutierrez M, Younossi ZM, Gabbay RA. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S52-S76. [PMID: 38078591 PMCID: PMC10725809 DOI: 10.2337/dc24-s004] [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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Sylvetsky AC, Moore HR, Zhu X, Kaidbey JH, Kang L, Saeed A, Khattak S, Grilo MF, Vallone N, Kuttamperoor J, Cogen FR, Elmi A, Walter PJ, Cai H, DiPietro L, Goran MI, Streisand R. Effects of Low-Calorie Sweetener Restriction on Glycemic Variability and Cardiometabolic Health in Children with Type 1 Diabetes: Findings of a Pilot and Feasibility Study. Nutrients 2023; 15:3867. [PMID: 37764650 PMCID: PMC10534616 DOI: 10.3390/nu15183867] [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: 08/03/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Low-calorie sweeteners (LCS) are commonly consumed by children with type 1 diabetes (T1D), yet their role in cardiometabolic health is unclear. This study examined the feasibility, acceptability, and preliminary effects of 12 weeks of LCS restriction among children with T1D. Children (n = 31) with T1D completed a two-week run-in (n = 28) and were randomly assigned to avoid LCS (LCS restriction, n = 15) or continue their usual LCS intake (n = 13). Feasibility was assessed using recruitment, retention, and adherence rates percentages. Acceptability was assessed through parents completing a qualitative interview (subset, n = 15) and a satisfaction survey at follow-up. Preliminary outcomes were between-group differences in change in average daily time-in-range (TIR) over 12 weeks (primary), and other measures of glycemic variability, lipids, inflammatory biomarkers, visceral adiposity, and dietary intake (secondary). Linear regression, unadjusted and adjusted for age, sex, race, and change in BMI, was used to compare mean changes in all outcomes between groups. LCS restriction was feasible and acceptable. No between-group differences in change in TIR or other measures of glycemic variability were observed. However, significant decreases in TNF-alpha (-0.23 ± 0.08 pg/mL) and improvements in cholesterol (-0.31 ± 0.18 mmol/L) and LDL (-0.60 ± 0.39 mmol/L) were observed with usual LCS intake, compared with LCS restriction. Those randomized to LCS restriction did not report increases in total or added sugar intake, and lower energy intake was reported in both groups (-190.8 ± 106.40 kcal LCS restriction, -245.3 ± 112.90 kcal usual LCS intake group). Decreases in percent energy from carbohydrates (-8.5 ± 2.61) and increases in percent energy from protein (3.2 ± 1.16) and fat (5.2 ± 2.02) were reported with usual LCS intake compared with LCS restriction. Twelve weeks of LCS restriction did not compromise glycemic variability or cardiometabolic outcomes in this small sample of youth with T1D. Further examination of LCS restriction among children with T1D is warranted.
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Affiliation(s)
- Allison C. Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA; (J.H.K.); (A.S.); (S.K.); (M.F.G.); (N.V.); (J.K.); (L.D.)
| | - Hailey R. Moore
- Division of Psychology & Behavioral Health, Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, USA; (H.R.M.); (L.K.); (R.S.)
| | - Xinyu Zhu
- Nutrition and Health Sciences Program, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA;
| | - Jasmine H. Kaidbey
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA; (J.H.K.); (A.S.); (S.K.); (M.F.G.); (N.V.); (J.K.); (L.D.)
| | - Leyi Kang
- Division of Psychology & Behavioral Health, Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, USA; (H.R.M.); (L.K.); (R.S.)
| | - Abbas Saeed
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA; (J.H.K.); (A.S.); (S.K.); (M.F.G.); (N.V.); (J.K.); (L.D.)
| | - Shazmeena Khattak
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA; (J.H.K.); (A.S.); (S.K.); (M.F.G.); (N.V.); (J.K.); (L.D.)
| | - Mariana F. Grilo
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA; (J.H.K.); (A.S.); (S.K.); (M.F.G.); (N.V.); (J.K.); (L.D.)
| | - Natalie Vallone
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA; (J.H.K.); (A.S.); (S.K.); (M.F.G.); (N.V.); (J.K.); (L.D.)
| | - Janae Kuttamperoor
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA; (J.H.K.); (A.S.); (S.K.); (M.F.G.); (N.V.); (J.K.); (L.D.)
| | - Fran R. Cogen
- Division of Endocrinology, Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, USA;
- School of Medicine and Health Sciences, The George Washington University, 2300 I St. NW, Washington, DC 20052, USA
| | - Angelo Elmi
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA;
| | - Peter J. Walter
- Clinical Mass Spectrometry Lab, National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 9000 Rockville Pike, Bethesda, MD 20892, USA; (P.J.W.); (H.C.)
| | - Hongyi Cai
- Clinical Mass Spectrometry Lab, National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 9000 Rockville Pike, Bethesda, MD 20892, USA; (P.J.W.); (H.C.)
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA; (J.H.K.); (A.S.); (S.K.); (M.F.G.); (N.V.); (J.K.); (L.D.)
| | - Michael I. Goran
- Department of Pediatrics, The Saban Research Institute, Children’s Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA;
| | - Randi Streisand
- Division of Psychology & Behavioral Health, Children’s National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, USA; (H.R.M.); (L.K.); (R.S.)
- School of Medicine and Health Sciences, The George Washington University, 2300 I St. NW, Washington, DC 20052, USA
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