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Kim S, Kim G, Cho SH, Oh R, Kim JY, Lee YB, Jin SM, Hur KY, Kim JH. Increased risk of incident mental disorders in adults with new-onset type 1 diabetes diagnosed after the age of 19: A nationwide cohort study. DIABETES & METABOLISM 2024; 50:101505. [PMID: 38103865 DOI: 10.1016/j.diabet.2023.101505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/10/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
AIM This population-based study aimed to investigate the risk of mental disorders in adults with new-onset type 1 diabetes mellitus compared to the general population without diabetes. METHODS We selected 10,391 adults with new-onset type 1 diabetes and 51,995 adults in the general population without diabetes with a median follow-up of 7.94 years using the National Health Insurance Database in South Korea between January 2009 and December 2020. The adjusted hazard ratios (aHRs) were estimated for the occurrence of mental disorders. RESULTS The incidence of mental disorders was more than twice as high in patients with new-onset type 1 diabetes (66 per 1000 person-years) than in those without diabetes (29 per 1000 person-years). The aHR [95 % confidence interval] comparing adults with new-onset type 1 diabetes with those without diabetes were 2.20 [2.12.2.29] for mental disorders, 3.16 [2.99.3.35], for depression, 2.55 [2.32.2.80] for mood disorders, 1.89 [1.80.1.97] for anxiety and stress related disorders, 2.50 [1.48.4.22] for eating disorders, 2.62 [1.45.4.73] for personality and behavior disorders and 4.39 [3.55.5.43] for alcohol and drug misuse disorders. When new-onset type 1 diabetes occurred at the age of 41 to 50, the aHR of developing mental illness was 2.43 [2.19.2.70], compared to those without diabetes. CONCLUSIONS In this nationwide prospective study, new-onset type 1 diabetes in adulthood was significantly associated with a higher risk of mental disorders than in the general population without diabetes.
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Affiliation(s)
- Seohyun Kim
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - So Hyun Cho
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Rosa Oh
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Ji Yoon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Jae Hyeon Kim
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06355, Republic of Korea; Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
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Marks KP, Pouwer F, Jensen MB, Ibfelt EH, Kristensen LJ, Thastum M, Birkebæk NH. Responses to the Strengths and Difficulties Questionnaire predict HbA1c trajectories in children and adolescents with type 1 diabetes: a population-based study. BMJ Open Diabetes Res Care 2023; 11:e003479. [PMID: 37914346 PMCID: PMC10626890 DOI: 10.1136/bmjdrc-2023-003479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/30/2023] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION We aimed to determine whether caregiver responses to the Strengths and Difficulties Questionnaire (SDQ) are predictive of HbA1c trajectory membership in children and adolescents with type 1 diabetes, when adjusting for covariates. RESEARCH DESIGN AND METHODS For a Danish 2009 national cohort of children and adolescents with type 1 diabetes, we analyzed yearly HbA1c follow-up data during 2010-2020 including sociodemographic data from Danish national registries. Using group-based trajectory modeling and multinomial logistic regression, we tested whether caregiver SDQ scores predicted HbA1c trajectory membership when adjusting for sex, age at diabetes diagnosis, diabetes duration, family structure, and caregiver education. RESULTS In total, 835 children and adolescents (52% females) with a mean (SD) age of 12.5 (3.3) years, and a mean diabetes duration of 5.2 (3.1) years, were included. Based on 7247 HbA1c observations, four HbA1c trajectories were identified: (1) 'on target, gradual decrease' (26%), (2) 'above target, mild increase then decrease' (41%), (3) 'above target, moderate increase then decrease' (24%), and (4) 'well above target, large increase then decrease' (9%). Higher SDQ total difficulties scores predicted trajectories 3 and 4 (p=0.0002 and p<0.0001, respectively). Regarding the SDQ subscale scores, emotional symptoms predicted trajectories 3 and 4, and conduct problems and hyperactivity/inattention predicted trajectories 2, 3, and 4. Single-parent family and low caregiver education level both predicted trajectories 3 and 4. CONCLUSIONS Caregiver SDQ responses and sociodemographic information may help detect children and adolescents with type 1 diabetes, who need intensive multidisciplinary medical and psychological interventions.
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Affiliation(s)
- Kevin P Marks
- Department of Clinical Medicine - Paediatrics, Aarhus Universitet, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense, Denmark
- Department of Medical Psychology, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Else H Ibfelt
- Danish Clinical Quality Program-National Clinical Registries (RKKP), Frederiksberg, Denmark
- Steno Diabetes Center Copenhagen, The Capital Region, Denmark
| | - Lene J Kristensen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Mikael Thastum
- Department of Psychology, Centre for Psychological Treatment of Children and Adolescents, Aarhus University, Aarhus, Denmark
| | - Niels H Birkebæk
- Department of Clinical Medicine - Paediatrics, Aarhus Universitet, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Paediatric and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
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Roberts AJ, Carlin K, Yi-Frazier JP, Moss A, Gupta M, Malik FS. Longitudinal Associations of Mental Health Comorbidities With A1C Among Adolescents and Young Adults With Type 1 Diabetes. Diabetes Spectr 2023; 36:403-407. [PMID: 37982068 PMCID: PMC10654116 DOI: 10.2337/ds22-0076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Alissa J. Roberts
- Department of Pediatrics, University of Washington, Seattle, WA
- Seattle Children’s Research Institute, Seattle, WA
| | | | | | - Ashley Moss
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | - Meenal Gupta
- Department of Pediatrics, University of Washington, Seattle, WA
- Seattle Children’s Research Institute, Seattle, WA
| | - Faisal S. Malik
- Department of Pediatrics, University of Washington, Seattle, WA
- Seattle Children’s Research Institute, Seattle, WA
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Sawyer B, Hilliard E, Hackney KJ, Stastny S. Barriers and Strategies for Type 1 Diabetes Management Among Emerging Adults: A Qualitative Study. Clin Med Insights Endocrinol Diabetes 2022; 15:11795514221098389. [PMID: 35615101 PMCID: PMC9125103 DOI: 10.1177/11795514221098389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 04/08/2022] [Indexed: 11/15/2022] Open
Abstract
Purpose: Individuals in the emerging adult age group (18-30 years) with type 1 diabetes (T1DM) have unique medical and social needs. The purpose of this study was to observe barriers and strategies for diabetes management among emerging adults with T1DM. Methods: A qualitative grounded theory model was utilized. An open-ended approach with a telephone interview was designed to allow a deeper understanding of the T1DM experience. The participants were from a larger survey-volunteer participant group and were asked to complete 1 interview in spring 2020 (n = 21, diagnosed age: mean 15.00 ± 8.00, females, n = 19). The data were analyzed for cohesive themes using grounded theory. Results: Participants indicated three main barrier themes (physiology, environment, and insurance) and 3 barrier subthemes (mental health, lack of social support, and weather). Three main strategy themes to diabetes management were recognized (medical technology, access to social support, and physical activity). There were 2 strategy subthemes (social media and social accountability). Conclusions: Regular use of social media can be a key tool for social accountability while lack of social support and physiological shifts can be barriers to management of T1DM. Physical activity should be considered as part of an individualized plan for management of diabetes.
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Affiliation(s)
- Bailee Sawyer
- Department of Medical Laboratory Sciences, Public Health, and Nutrition Science, Tarleton State University, Stephenville, TX USA
| | - Elizabeth Hilliard
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Sherri Stastny
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
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Baechle C, Stahl-Pehe A, Castillo K, Holl RW, Rosenbauer J. Family Structure is Associated with Mental Health and Attention Deficit (Hyperactivity) Disorders in Adolescents with Type 1 Diabetes. Exp Clin Endocrinol Diabetes 2022; 130:604-613. [PMID: 35359008 DOI: 10.1055/a-1729-7972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To analyze the cross-sectional associations of family structure with mental health and attention deficit (hyperactivity) disorders (AD(H)D) in 11- to 17-year-old adolescents with early-onset type 1 diabetes participating in one of three baseline surveys as part of an ongoing cohort study. METHODS Parents (n=1,631) completed the Strengths and Difficulties Questionnaire to screen for their child's mental health and answered questions about their child's diagnosis of AD(H)D. Associations between mental health or AD(H)D and family structure were analyzed using multivariable logistic regression analyses adjusted for various personal and diabetes-related variables. RESULTS Compared to adolescents living with both parents, adolescents living with one parent and his/her partner had 2.35 (95% confidence interval 1.32; 4.21) higher odds of abnormal screening result and 2.08 (1.09; 3.95) higher odds of a borderline screening result while adolescents living with a single parent had 1.84 (1.07; 3.17)/1.08 (0.53; 2.21) higher odds of abnormal/borderline screening results. The odds ratios for diagnosed attention deficit (hyperactivity) disorder were 2.17 (0.98; 4.84) for adolescents living with one parent and his/her partner and 1.27 (0.54; 3.01) for those living with a single parent vs. both parents. CONCLUSIONS Our results indicate higher odds of mental health problems and AD(H)D in adolescents with type 1 diabetes who do not live with both parents; this finding was most pronounced in individuals living with one parent and his/her partner vs. both parents. Longitudinal studies are needed to verify our results and elucidate the underlying mechanisms.
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Affiliation(s)
- Christina Baechle
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Anna Stahl-Pehe
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Katty Castillo
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Reinhard W Holl
- University of Ulm, Institute of Epidemiology and Medical Biometry, Ulm, Germany.,German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Joachim Rosenbauer
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
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6
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Garey CJ, Clements MA, McAuliffe-Fogarty AH, Obrynba KS, Weinstock RS, Majidi S, Ross CS, Rioles NA. The association between depression symptom endorsement and glycemic outcomes in adolescents with type 1 diabetes. Pediatr Diabetes 2022; 23:248-257. [PMID: 34779100 DOI: 10.1111/pedi.13290] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The prevalence of depression among adolescents with type 1 diabetes is estimated to be 2-3 times higher than in the general population. In adults with type 1 diabetes and depression, short-term outcomes are worse compared to individuals just diagnosed with type 1 diabetes. This study aims to determine if depressive symptom endorsement is associated with glycemic outcomes and short-term complications in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS Analysis was conducted using electronic medical records from the T1D Exchange Quality Improvement Collaborative. Adolescents with type 1 diabetes, aged 12-18, receiving treatment in a diabetes clinic who had been screened for depression with the PHQ-9 between 2016 and 2018 were eligible for inclusion. Individuals must have also had HbA1c data available from the day of depression screening and from 10 to 24 weeks after screening; the final sample size was 1714. RESULTS Almost 30% of adolescents endorsed mild or greater (PHQ-9 ≥ 5) depressive symptoms. Endorsement of mild or greater depressive symptoms was associated with an 18% increased risk of an HbA1c ≥7.5% and a 42% increased risk of an HbA1c ≥9.0% on the day of screener administration. Depressive symptom endorsement was also associated with an 82% increased risk for DKA. CONCLUSIONS This study suggests that depression symptoms are associated with an increased risk for elevated HbA1c and short-term complications. With the rising incidence of type 1 diabetes in youth, routine screening, and appropriate management of depression is needed.
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Affiliation(s)
- Colleen J Garey
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Mark A Clements
- Department of Pediatrics, Endocrinology, Children's Mercy Hospital, Kansas City, Missouri, USA
| | | | - Kathryn S Obrynba
- Department of Pediatrics, Endocrinology, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ruth S Weinstock
- Department of Medicine, Endocrinology, Diabetes, and Metabolism Division, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Shideh Majidi
- Barbara Davis Center Pediatric Diabetes Division, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Craig S Ross
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Nicole A Rioles
- Quality Improvement & Population Health, T1D Exchange, Boston, Massachusetts, USA
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Tuomaala AK, Hero M, Tuomisto MT, Lähteenmäki M, Miettinen PJ, Laine T, Wehkalampi K, Kiiveri S, Ahonen P, Ojaniemi M, Kaunisto K, Tossavainen P, Lapatto R, Sarkola T, Pulkkinen MA. Motivational Interviewing and Glycemic Control in Adolescents With Poorly Controlled Type 1 Diabetes: A Randomized Controlled Pilot Trial. Front Endocrinol (Lausanne) 2021; 12:639507. [PMID: 33776935 PMCID: PMC7994365 DOI: 10.3389/fendo.2021.639507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
A multicenter randomized controlled pilot trial investigated whether motivational interviewing (MI) by diabetes physicians improves glycemic control and variability in the context of follow-up for adolescent patients with poorly controlled type 1 diabetes. Patients (n = 47) aged 12 to 15.9 years who showed poor glycemic control (HbA1c >75 mmol/mol/9.0%) were randomized to standard education (SE) only or MI+SE, with study physicians randomized to employ MI+SE (N = 24 patients) or SE only (N = 23). For one year of follow-up, the main outcome measurements were obtained at three-month visits (HbA1c) or six-monthly: time in range (TIR) and glycemic variability (CV). Mean adjusted 12-month change in HbA1c was similar between the MI+SE and SE-only group (-3.6 vs. -1.0 mmol/mol), and no inter-group differences were visible in the mean adjusted 12-month change in TIR (-0.8 vs. 2.6%; P = 0.53) or CV (-0.5 vs. -6.2; P = 0.26). However, the order of entering the study correlated significantly with the 12-month change in HbA1c in the MI+SE group (r = -0.5; P = 0.006) and not in the SE-only group (r = 0.2; P = 0.4). No link was evident between MI and changes in quality of life. The authors conclude that MI's short-term use by diabetes physicians managing adolescents with poorly controlled type 1 diabetes was not superior to SE alone; however, improved skills in applying the MI method at the outpatient clinic may produce greater benefits in glycemic control.
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Affiliation(s)
- Anna-Kaisa Tuomaala
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Matti Hero
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Martti T. Tuomisto
- Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland
| | - Maria Lähteenmäki
- Faculty of Social Sciences (Psychology), Tampere University, Tampere, Finland
| | - Päivi J. Miettinen
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tiina Laine
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Karoliina Wehkalampi
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sanne Kiiveri
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pekka Ahonen
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marja Ojaniemi
- Department of Pediatrics and Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kari Kaunisto
- Department of Pediatrics and Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Päivi Tossavainen
- Department of Pediatrics and Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Risto Lapatto
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Taisto Sarkola
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Mari-Anne Pulkkinen
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- *Correspondence: Mari-Anne Pulkkinen,
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8
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Eriksen TM, Gaulke A, Thingholm PR, Svensson J, Skipper N. Association of type 1 diabetes and school wellbeing: a population-based cohort study of 436,439 Danish schoolchildren. Diabetologia 2020; 63:2339-2348. [PMID: 32815027 DOI: 10.1007/s00125-020-05251-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/04/2020] [Indexed: 01/09/2023]
Abstract
AIMS/HYPOTHESIS We aimed to examine the association of type 1 diabetes with school wellbeing among Danish children. METHODS This is a population-based cohort study involving 436,439 Danish children, of which 1499 had a confirmed diagnosis of type 1 diabetes. The children were enrolled in grade levels 4 to 9 (middle school) in Danish public schools in the years 2014-2017. Questionnaire outcomes from the yearly National Wellbeing Survey related to self-efficacy, perceived competences, peer and teacher support, bullying and somatic symptoms were analysed. Ordered logistic regression was used to compare outcomes of children with and without type 1 diabetes, and to compare subgroups of children with type 1 diabetes by different levels of HbA1c and diabetes duration. Primary outcomes were answers to seven pre-specified questionnaire items (scale, 1 to 5). RESULTS A total of 817,679 questionnaires were initiated, of which n = 2681 were from children with type 1 diabetes. Compared with the background population, children with type 1 diabetes expressed more peer support; adjusted OR 1.17 (95% CI 1.08, 1.27). Children with diabetes also reported more often having a headache; adjusted OR 1.09 (95% CI 1.00, 1.19). Overall, children with poor glycaemic control (HbA1c >70 mmol/mol) had worse outcomes on the wellbeing measures compared with the background population. Even after adjusting for socioeconomic status, they still reported significantly worse perceived competences, less teacher support and more somatic symptoms (stomach ache and headache). CONCLUSIONS/INTERPRETATION In Denmark, children with type 1 diabetes generally feel well supported in school but have more headaches than other children. Poor glycaemic control is associated with worse psychological school-related wellbeing. Graphical abstract.
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Affiliation(s)
- Tine M Eriksen
- VIVE-The Danish Center for Social Science Research, Copenhagen, Denmark
| | - Amanda Gaulke
- Department of Economics, Kansas State University, Manhattan, KS, USA
| | - Peter R Thingholm
- Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | | | - Niels Skipper
- Department of Economics and Business Economics, Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Fuglesangs Allé 4, 8210, Aarhus V., Denmark.
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9
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Ashrafzadeh S, Hamdy O. Patient-Driven Diabetes Care of the Future in the Technology Era. Cell Metab 2019; 29:564-575. [PMID: 30269984 DOI: 10.1016/j.cmet.2018.09.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 08/01/2018] [Accepted: 09/02/2018] [Indexed: 02/07/2023]
Abstract
The growing burden of diabetes is fueled by obesity-inducing lifestyle behaviors including high-calorie diets and lack of physical activity. Challenges in access to diabetes specialists and educators, low adherence to medications, and inadequate motivational support for proper disease self-management contribute to poor glycemic control in patients with diabetes. Simultaneously, high patient volumes and low reimbursement rates limit physicians' time spent on lifestyle behavior counseling. These barriers to efficient diabetes care lead to high rates of diabetes-related complications, driving healthcare costs up and reducing the quality of patients' lives. Considering recent advancements in healthcare delivery technologies such as smartphone applications, telemedicine, m-health, device connectivity, machine-learning technology, and artificial intelligence, there is significant opportunity to achieve better efficiency in diabetes care and increase patient involvement in diabetes self-management, which ultimately may put an end to soaring diabetes-related healthcare expenditures. This review explores the patient-driven diabetes care of the future in the technology era.
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Affiliation(s)
- Sahar Ashrafzadeh
- Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA
| | - Osama Hamdy
- Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA.
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10
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Vasigh A, Abdi A, Borji M, Tarjoman A. The prevalence of neuropathy among type 1 diabetic adolescents in Iran: a systematic review and meta-analysis. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0223/ijamh-2018-0223.xml. [PMID: 30685741 DOI: 10.1515/ijamh-2018-0223] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/28/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Neuropathy is one of the most common complications of diabetes, which causes many problems for diabetic patients. Thus, the aim of the present study was to investigate the prevalence of neuropathy among type 1 diabetic adolescents by systematic review and meta-analysis. MATERIALS AND METHODS This study is a systematic review and meta-analysis, which reviewed articles published from 2001 to September 1, 2018. The search process was carried out in the Google Scholar search engine and domestic and international databases such as Magiran, SID, Iranmedex, IranDoc, Medlib, PubMed, Scopus, Science Direct, Springer, Wiley Online Library, Web of Science, Ebsco and Cochrane using Persian and English keywords based on MESH conformity. All the research steps were carried out by two members of the research team who were familiar with systematic reviews and meta-analysis data, using the software CMA. Analysis of meta-regression and the use of a random effects model were introduced and analyzed. FINDINGS When a systematic search was carried out on the reviewed articles, five of them were included in the meta-analysis phase. The sample size was 484, and the prevalence of diabetic peripheral neuropathy (DPN) in type 1 diabetic patients was 28.2% [confidence interval (CI) = 19.5-39.1]. The findings of the meta-regression analysis showed that the DPN prevalence rate decreased with increasing age (Q = 5.77 p = 0.016), and the results of more recent studies showed an increase in the DPN incidence rate (Q = 20.62, p < 0.001). CONCLUSION The findings of the present study revealed that although the prevalence of neuropathy in diabetic adolescents was not high, the prevalence was significant. Considering the increasing prevalence of diabetes and its impact on the health status of patients, appropriate interventions should be conducted to prevent diabetes and subsequent diabetic neuropathy.
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Affiliation(s)
- Aminolah Vasigh
- Department of Anaesthesiology, Medicine Faculty, Ilam University of Medical Science, Ilam, Iran
| | - Alireza Abdi
- Critical Care and Emergency Department, Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Milad Borji
- Critical Care and Emergency Department, Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Asma Tarjoman
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
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11
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Dybdal D, Tolstrup JS, Sildorf SM, Boisen KA, Svensson J, Skovgaard AM, Teilmann GK. Increasing risk of psychiatric morbidity after childhood onset type 1 diabetes: a population-based cohort study. Diabetologia 2018; 61:831-838. [PMID: 29242985 DOI: 10.1007/s00125-017-4517-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/06/2017] [Indexed: 01/09/2023]
Abstract
AIMS/HYPOTHESIS The aim of this study was to investigate psychiatric morbidity following childhood onset of type 1 diabetes. METHODS In a matched, population-based cohort study based on Danish national registers, we identified children and adolescents who had been diagnosed as an in- or outpatient with type 1 diabetes before the age of 18, and afterwards diagnosed with a psychiatric disorder (n = 5084). Control individuals were matched according to sex and date of birth (n = 35,588). The Cox proportional hazards model was used to assess associations between type 1 diabetes and the incidence of psychiatric disorders as well as the effects of age at onset and duration of type 1 diabetes on the risk of subsequently developing psychiatric morbidities. RESULTS An increased risk of being diagnosed with mood disorders and anxiety, dissociative, eating, stress-related and somatoform disorders was observed in both sexes in the years following type 1 diabetes onset, with the highest risk observed five years or more after onset (HR 1.55 [95% CI 1.38, 1.74]). The risk of psychoactive substance-misuse disorders increased significantly only in boys, and the risk of personality disorders increased only in girls. CONCLUSIONS/INTERPRETATION In the years following type 1 diabetes onset, an increased risk of eating disorders, anxiety and mood disorders, substance misuse, and personality disorders was found. These findings highlight a clinical need to monitor the mental health of children and adolescents in the years following type 1 diabetes onset to identify and treat psychiatric problems associated with type 1 diabetes.
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Affiliation(s)
- Daniel Dybdal
- Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Dyrehavevej 29, DK 3400, Hillerød, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Stine M Sildorf
- Department of Paediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark
| | - Kirsten A Boisen
- Centre of Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Jannet Svensson
- Department of Paediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Grete K Teilmann
- Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Dyrehavevej 29, DK 3400, Hillerød, Denmark.
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12
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Almeida MC, Claudino DA, Grigolon RB, Fleitlich-Bilyk B, Claudino AM. Psychiatric disorders in adolescents with type 1 diabetes: a case-control study. ACTA ACUST UNITED AC 2018; 40:284-289. [PMID: 29412336 PMCID: PMC6899402 DOI: 10.1590/1516-4446-2017-2259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/03/2017] [Indexed: 01/09/2023]
Abstract
Objectives: To study the prevalence of psychiatric disorders in adolescents with and without type 1 diabetes, the factors associated with its presence, and to test the reliability of a screening tool for use in clinical settings. Methods: Eighty-one adolescents were enrolled in this case-control study, including 36 diabetic participants and 45 controls. Clinical and sociodemographic data were collected and psychiatric symptoms and diagnoses were obtained from adolescents and their parents using a screening tool (Strengths & Difficulties Questionnaire) and a semi-structured interview (Development and Well-Being Assessment). Results: Psychiatric disorders were identified in 22.2% of the sample (30.56% among diabetic adolescents vs. 15.56% of controls: OR = 2.39, 95%CI 0.82-6.99; p = 0.11). Overweight (body mass index percentile ≥ 85) was the only factor associated with psychiatric disorder (OR = 3.07; 95%CI 1.03-9.14; p = 0.04). Compared to the semi-structured interview, the screening instrument showed 80% sensitivity, 96% specificity, 88.9% positive predictive value and 92.3% negative predictive value for the presence of psychiatric diagnoses in adolescents. Conclusion: Psychiatric morbidity was high in this sample of adolescents, especially among those with diabetes. Routine use of the Strengths and Difficulties Questionnaire can help with early detection of psychiatric disorders in this at-risk group.
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Affiliation(s)
- Mireille C Almeida
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Denise A Claudino
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ruth B Grigolon
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Bacy Fleitlich-Bilyk
- Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (IPQ-FMUSP), São Paulo, SP, Brazil
| | - Angélica M Claudino
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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13
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Fedor A, Schumacher JR, Banning J, McKinnis R, Wilson M. Perceptions of How the Transition From Home Life to College Life Affects Type 1 Diabetes Management. Diabetes Spectr 2017; 30:315-319. [PMID: 29151722 PMCID: PMC5687106 DOI: 10.2337/ds17-0019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Alyssa Fedor
- Park Nicolett Methodist Hospital, St. Louis Park, MN
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14
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Mental health issues in children and adolescents with chronic illness. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTH CARE 2017. [DOI: 10.1108/ijhrh-05-2017-0020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose
The purpose of this paper is to consider mental health issues in children and adolescents with chronic illness or health conditions, including their treatment, and issues related to delivery of services.
Design/methodology/approach
A selective review of the literature was conducted to highlight significant mental health issues and their treatment in youth with various types of chronic illness.
Findings
A significant portion of youth experience mental health problems related to their chronic health conditions. While evidence-based treatments are available to address these problems, significant barriers exist that impede the delivery of psychological and behavioral interventions for many youth.
Research limitations/implications
More controlled studies are needed to demonstrate the effectiveness and cost offset of delivering psychological and behavioral interventions for the population of youth with various types of chronic health conditions, particularly in clinical and community settings.
Social implications
Policy reform can ensure that mental health issues are effectively addressed for children with chronic illness. Policy is needed that promotes integrated health care, whereby psychological and behavioral interventions are delivered in health care settings along with medical interventions to reduce barriers to care.
Originality/value
Significant numbers of children and adolescents have chronic health conditions and many experience mental health problems related to their conditions. While evidence-based treatments are available to address these problems, significant barriers impede the delivery of psychological and behavioral interventions for many youth. Health care policy promoting integrated health care to deliver psychological and behavioral interventions in health care settings along with medical interventions should reduce barriers to care and improve both physical and mental health outcomes for youth.
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15
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Song T, Ding YW, Sun Y, He YN, Qi DJ, Wu Y, Wu B, Lang L, Yu K, Zhao X, Zhu LL, Wang S, Yu XS. A population-based study on health-related quality of life among urban community residents in Shenyang, Northeast of China. BMC Public Health 2015; 15:921. [PMID: 26386951 PMCID: PMC4575423 DOI: 10.1186/s12889-015-2238-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 09/07/2015] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Due to the rising standard of living environment and advances in public health and medical care in China, it has been a tendency in recent years that health-related quality of life (HRQoL) has been increasingly acknowledged in community health management. However, large-scale population-based study on evaluating HQRoL in northeast of China was not conducted. This article aims to investigate the HRQoL in community residents in Northeast China and explore the associated factors. METHODS Stratified multiple-stage sampling method was used in the cross-sectional survey to investigate HRQoL of community residents in northeast of China. Univariate analysis and multiple linear regressions were used to analyze the factors associated to HRQoL of the community residents. RESULTS The results were confirmed that HRQoL in general population was well performed for the first time in northeast of China in a large scale population. Community residents had better mental health than physical health. The factors influencing HRQoL included gender, age, educational level, marital status, ethnic group, chronic disease status, having breakfast frequency weekly and sleep quality. However, drinking and smoking habits did not affect residents' HRQoL. CONCLUSIONS In this study, the result of the large-scale survey was satisfactory in northeast of China, providing HRQoL status of community residents. Policies on specific health management in community public health would emphasize on lifestyle behaviors especially eating habits in order to improving HRQoL.
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Affiliation(s)
- Tian Song
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Yan-wei Ding
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Yan Sun
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Yi-Ni He
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Dian-Jun Qi
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Ying Wu
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Bin Wu
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Lang Lang
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Kai Yu
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Xin Zhao
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Liang-liang Zhu
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Shuang Wang
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
| | - Xiao-Song Yu
- General Medical Practice of the First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, Liaoning Province, 110001, PR China.
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