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Yuksel E, Bulbul L, Yilmaz S, Hatipoglu S, Cakir EDP. Evaluation of Quality of Life and Psychosocial Problems in Children with Type 1 Diabetes Mellitus. SISLI ETFAL HASTANESI TIP BULTENI 2024; 58:146-154. [PMID: 39021699 PMCID: PMC11249999 DOI: 10.14744/semb.2024.21456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/11/2024] [Indexed: 07/20/2024]
Abstract
Objectives To evaluate the frequency of psychosocial problems and the factors affecting the quality of life in children and adolescents aged between 8 and 18 years with type 1 diabetes mellitus (T1DM). Methods In the study, children and adolescents aged between 8 and 18 years who had been followed for at least 6 months for T1DM were evaluated (T1DM group), and compared with healthy children and adolescents who applied to the general pediatric outpatient clinic and did not have any chronic disease (control group). Data on disease follow-up of children and adolescents with T1DM were obtained from medical records. Sociodemographic characteristics of both groups were recorded in the study form. In addition, the Children's Depression Inventory (CDI), Screen for Child Anxiety Related Disorders (SCARED) and Children Quality of Life Questionnaire (KINDL: KINDerLebensqualitätsfragebogen) were applied to both groups. The scale scores of the T1DM group and the control group were compared. Factors affecting the scale scores of the T1DM group were evaluated. Results A total of 181 children or adolescents, 81 of whom were in the T1DM group and 100 in the control group, were evaluated for this study. The mean age was 13.1±2.4 years in the T1DM group and 12.4±2.1 years in the control group. The mean CDI, SCARED, and KINDL scores, respectively; it was 15.3±7.2, 23.6±11.9, and 53.5±13.7 in the T1DM group and 7.9±6.8, 14.7±13, 60±11.6 in the control group. There was a statistically significant difference between the two groups in terms of mean CDI, SCARED, and KINDL scores (all p values <0.001). As compliance with the diabetic diet decreased at home, there was a significant increase in the mean CDI score (p=0.005) and a significant decrease in the KINDL score (p=0.002). It was observed that KINDL score decreased significantly as compliance with the diabetic diet decreased outside the home (p=0.001). Conclusion Quality of life is lower, and levels of depression and anxiety are higher in children with T1DM compared to healthy children. Psychosocial support should be provided from the moment of diagnosis in order to improve the psychosocial problems and quality of life of children with T1DM.
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Affiliation(s)
- Elida Yuksel
- Department of Pediatrics, Acibadem Atakent Hospital, Istanbul, Türkiye
| | - Lida Bulbul
- Department of Pediatric Allergy and Immunology, University of Health Science Türkiye, Bagcilar Training and Research Hospital, Istanbul, Türkiye
| | - Semra Yilmaz
- Department of Pediatric Psychiatry, Memorial Bahcelievler Hospital, Istanbul, Türkiye
| | - Sami Hatipoglu
- Department of Pediatrics, University of Health Science Türkiye, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
| | - Esra Deniz Papatya Cakir
- Department of Pediatric Endocrinology, University of Health Science Türkiye, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
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Hussein S, Jespersen LN, Ingersgaard MV, Skovby P, Grabowski D. Trying to be like everybody else: A qualitative study revealing the importance of social contexts and illness representations among adolescents with type 1 diabetes and their parents. Chronic Illn 2024; 20:37-48. [PMID: 36760087 DOI: 10.1177/17423953231155287] [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] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Type 1 diabetes is one of the most common chronic conditions in young children and adolescents. During the period of adolescence, young people with diabetes often struggle with self-management and have compromised health-related quality of life. This often leads to familial conflicts affecting all family members negatively. The aim of this study is to provide qualitative insight into the everyday life of families with adolescents with type 1 diabetes. METHODS The data consisted of participatory family workshops conducted using interactive dialogue tools. The total number of participants was 33 (adolescents n = 13, parents n = 20). The adolescents were between 15 and 17 years. The data were analyzed using systematic text condensation. RESULTS The results showed two main themes. The first theme, Diabetes-friendly and unfriendly social contexts, highlighted how the (dis)comfortability of disclosing diabetes was a significant factor in achieving optimal metabolic control. For parents, it affected their perception of social support. The second theme, incongruent illness representations among family members, dealt with the extended family conflict during the period of adolescence. DISCUSSION Insights from our study could help healthcare professionals apply a family-centered approach minimizing family conflict and supporting metabolic control when consulting families with adolescents with type 1 diabetes.
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Affiliation(s)
- Sana Hussein
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Louise Norman Jespersen
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Marianne Vie Ingersgaard
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Pernille Skovby
- Herning Hospital, Region of Central Jutland, Herning, Denmark
| | - Dan Grabowski
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
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3
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Ashraf MN, Cheng AYY, Robinson DJ. Emotional, Psychological, and Social Well-being Experience of Long-Term Living with Type 1 Diabetes Mellitus: A Patient-Psychiatrist-Endocrinologist Perspective. Diabetes Ther 2024; 15:317-323. [PMID: 38233629 PMCID: PMC10838889 DOI: 10.1007/s13300-023-01527-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024] Open
Abstract
Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease that impacts blood glucose levels and can also lead to an increased prevalence of psychiatric conditions. Living with T1DM has been associated with a significant impact on a person's social, mental, and psychological quality of life (QoL). Stressors related to T1DM include the demands of managing the condition, acceptance of the diagnosis, and recognition of the sizeable personal responsibility involved in managing the condition. Participating in treatment designed to improve QoL can still take a psychological toll on individuals with T1DM and can lead to a wide range of psychological distress, including anxiety, fear, depression, stress, anger, frustration, and denial (among many others). Ongoing research seeks to investigate the range of psychiatric conditions that are common among people with T1DM. Bringing patient perspectives into research to design and implement workable solutions is the future of a novel holistic approach to managing T1DM-related mental health impact. Connecting with other people living with T1DM, clinicians, counselors/therapists, mental health professionals, and social workers might alleviate some of the challenges of managing the emotional issues and psychological distress associated with T1DM. Here, we provide the perspective of someone with over 33 years of living with T1DM, its impact on his mental health, QoL, the steps undertaken, and the path to successful management. This perspective is complemented by opinions from two expert clinicians-an endocrinologist and a psychiatrist. Sharing the real-life subjective burden experienced by the person living with diabetes could be one step towards increasing awareness of the toll of mental health disorders on people living with T1DM. This patient experience, complemented by expert endocrinologist and psychiatrist opinions, could pave the way for an effective two-way dialogue to manage the condition effectively.
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Affiliation(s)
| | - Alice Y Y Cheng
- Trillium Health Partners and Unity Health Toronto, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - David J Robinson
- Canadian Mental Health Association, London, Canada
- Case Western Reserve University, Cleveland, OH, USA
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Ait-Taleb Lahsen H, Ragala MEA, El Abed H, Zarrouq B, Halim K. Effects of therapeutic patient education program on glycemic control and quality of life among children and adolescents with type 1 diabetes mellitus in Fez city, Morocco. Perspect Clin Res 2024; 15:24-30. [PMID: 38282632 PMCID: PMC10810050 DOI: 10.4103/picr.picr_80_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/14/2023] [Accepted: 06/30/2023] [Indexed: 01/30/2024] Open
Abstract
Context Type 1 diabetes mellitus (T1DM) is a chronic disease, mainly observed in children or youth, with a significantly increased incidence in young children. Structured therapeutic patient education (TPE) is a must to help them manage their disease effectively and lead a healthy lifestyle. Aims This study aimed to assess the effects of a structured TPE program on glycemic markers and quality of life (QOL) of T1DM children and adolescents in Fez city, Morocco. Settings and Design It is a quasi-experimental study. Materials and Methods One hundred T1DM children and adolescents, aged 8-18, participated in a TPE intervention at the pediatric department in a hospital center in Fez, Morocco. Glycemic markers were measured and QOL was assessed by a validated questionnaire. Statistical Analysis Used Parametric and nonparametric tests were used and statistical significance determined by P < 0.05. Results At 3 months' follow-up, both global and dimensional QOL mean scores improved significantly (P ≤ 0.0001), whereas glycosylated hemoglobin (HbA1c) decreased (10.28% vs. 10.62%), tough with no statistical significance (P = 0.160). Furthermore, a significant improvement was observed in the maximum preprandial (2, 11 g/L [1.51-2.58] vs. 2, 37 g/L [1.81-3.21], P = 0.001) and postprandial blood glucose levels (2, 50 g/L [1.90-3.27] vs. 2, 95 g/L [2.07-3.99], P = 0.001) after 3 months; with no significant change in their minimum. Conclusion Although this TPE intervention was more effective in improving patients' QOL than their HbA1c, it is worth striving to implement regular TPE programs for T1DM pediatric patients and adjust them to achieve a better patients' glycemic markers levels.
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Affiliation(s)
- Hanaâ Ait-Taleb Lahsen
- Department of Biology, LSNAMOPEQ, Faculty of Sciences Dhar El Mahraz Fsdm, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- High Institute of Nursing and Technical Health Professions, Fez ISPITS, Fez, Morocco
| | - Mohammed El Amine Ragala
- Department of Biology, LSNAMOPEQ, Faculty of Sciences Dhar El Mahraz Fsdm, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Department of Biology, High School Teachers-Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Hanane El Abed
- Department of Biology, LSNAMOPEQ, Faculty of Sciences Dhar El Mahraz Fsdm, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- High Institute of Nursing and Technical Health Professions, Fez ISPITS, Fez, Morocco
| | - Btissame Zarrouq
- Department of Biology, High School Teachers-Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Laboratory of Epidemiology and Research in Health Sciences, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Karima Halim
- Department of Biology, LSNAMOPEQ, Faculty of Sciences Dhar El Mahraz Fsdm, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Department of Biology, High School Teachers-Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco
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Yang S, Yang JF, Gong X, Weiss MA, Strano MS. Rational Design and Efficacy of Glucose-Responsive Insulin Therapeutics and Insulin Delivery Systems by Computation Using Connected Human and Rodent Models. Adv Healthc Mater 2023; 12:e2300587. [PMID: 37319398 PMCID: PMC10592437 DOI: 10.1002/adhm.202300587] [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: 02/22/2023] [Revised: 06/02/2023] [Indexed: 06/17/2023]
Abstract
Glucose-responsive insulins (GRIs) use plasma glucose levels in a diabetic patient to activate a specifically designed insulin analogue to a more potent state in real time. Alternatively, some GRI concepts use glucose-mediated release or injection of insulin into the bloodstream. GRIs hold promise to exhibit much improved pharmacological control of the plasma glucose concentration, particularly for the problem of therapeutically induced hypoglycemia. Several innovative GRI schemes are introduced into the literature, but there remains a dearth of quantitative analysis to aid the development and optimization of these constructs into effective therapeutics. This work evaluates several classes of GRIs that are proposed using a pharmacokinetic model as previously described, PAMERAH, simulating the glucoregulatory system of humans and rodents. GRI concepts are grouped into three mechanistic classes: 1) intrinsic GRIs, 2) glucose-responsive particles, and 3) glucose-responsive devices. Each class is analyzed for optimal designs that maintain glucose levels within the euglycemic range. These derived GRI parameter spaces are then compared between rodents and humans, providing the differences in clinical translation success for each candidate. This work demonstrates a computational framework to evaluate the potential clinical translatability of existing glucose-responsive systems, providing a useful approach for future GRI development.
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Affiliation(s)
- Sungyun Yang
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Jing Fan Yang
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Xun Gong
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Michael A Weiss
- Department of Biochemistry and Molecular Biology, Indiana University of Medicine, Indianapolis, IN, 46202, USA
| | - Michael S Strano
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
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Lafontaine S, Mok E, Frei J, Henderson M, Rahme E, Dasgupta K, Nakhla M. Associations of Diabetes-related and Health-related Quality of Life With Glycemic Levels in Adolescents With Type 1 Diabetes Preparing to Transition to Adult Care. Can J Diabetes 2023; 47:525-531. [PMID: 37182591 DOI: 10.1016/j.jcjd.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVES As adolescents with type 1 diabetes (T1D) progress to adulthood, they assume responsibility for diabetes self-management while dealing with competing life demands, decreasing parental support, and the transfer to adult care. Lower perceived quality of life (QOL) may hamper diabetes management, which is associated with suboptimal glycemic levels. Our objective was to determine associations of diabetes- and health-related QOL with glycemic management (glycated hemoglobin [A1C]) in adolescents with T1D before their transfer to adult care. METHODS We conducted a cross-sectional analysis of baseline data from the Group Education Trial to Improve Transition (GET-IT- T1D) in adolescents with T1D (16 to 17 years of age). Participants completed validated questionnaires measuring diabetes-related QOL (PedsQL 3.2 Diabetes Module) and health-related QOL (PedsQL 4.0 Generic Core Scales). Associations of QOL Total and subscale scores with A1C were assessed using linear regression models adjusted for sex, diabetes duration, socioeconomic status, insulin pump use, and mental health comorbidity. RESULTS One hundred fifty-three adolescents with T1D were included (mean age, 16.5 [standard deviation, 0.3] years). Diabetes-related QOL Total scores (adjusted β=-0.04; 95% confidence interval [CI], -0.05 to -0.02) as well as subscale scores for Diabetes Symptoms (adjusted β=-0.02; 95% CI, -0.04 to -0.00) and Diabetes Management (adjusted β=-0.04; 95% CI, -0.05 to -0.02) were inversely associated with A1C. Health-related QOL Total scores were not associated with A1C, but Psychosocial Health subscale scores were (adjusted β=-0.01; 95% CI, -0.03 to -0.00). CONCLUSION Our results suggest that strategies focussing on diabetes-related QOL and psychosocial health may help prepare adolescents for the increasing responsibility of diabetes self-care.
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Affiliation(s)
- Simon Lafontaine
- Division of Endocrinology, Department of Pediatrics, McGill University Health Centre, Montréal, Québec, Canada
| | - Elise Mok
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Jennifer Frei
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Mélanie Henderson
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche CHU Sainte-Justine, Montréal, Québec, Canada; School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Elham Rahme
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Kaberi Dasgupta
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Meranda Nakhla
- Division of Endocrinology, Department of Pediatrics, McGill University Health Centre, Montréal, Québec, Canada; Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
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7
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Chen HWJ, Marzo RR, Sapa NH, Ahmad A, Anuar H, Baobaid MF, Jamaludin NA, Hamzah H, Sarrafan S, Ads HO, Kumar KA, Hadi J, Sazali H, Abdalqader MA. Trends in Health Communication: Social Media Needs and Quality of Life among Older Adults in Malaysia. Healthcare (Basel) 2023; 11:healthcare11101455. [PMID: 37239741 DOI: 10.3390/healthcare11101455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/27/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND While social media continues to dominate, social media platforms have become powerful health communication tools for older users. However, fulfilling their social media needs can be both detrimental and beneficial to their quality of life (QoL). This study assessed social media needs as they relate to QoL among older adults in Malaysia. METHODS We conducted a cross-sectional study and adopted convenience sampling to recruit participants. The participants were required to self-report their sociodemographic profile, social media use and needs, and QoL. Social media use and needs were assessed using the Social Networking Sites Uses and Needs (SNSUN) scale, and QoL was assessed using the WHOQOL-BREF questionnaire. Multiple linear regression was performed to identify the predictors of QoL. RESULTS The findings revealed that the fulfilment of social integrative needs was the strongest predictor of higher QoL in all domains. However, those using social media for their affective needs demonstrated lower psychological health quality. CONCLUSIONS Fulfilling social integrative needs is the key to improving the QoL among older adults. The continuous development of age-friendly applications is essential to keep up with constantly changing social media trends and bridge the gap of social media inequalities. More importantly, it would enable older adults to utilize social media to its fullest potential and enjoy a higher QoL through accessible health communication tools.
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Affiliation(s)
- Hana W Jun Chen
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Roy Rillera Marzo
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Petaling Jaya 47500, Selangor, Malaysia
| | - Nur Hafizah Sapa
- School of Graduate Studies, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Absar Ahmad
- College of Veterinary Science and Animal Husbandry, Birsa Agricultural University, Ranchi 834006, Jharkhand, India
| | - Haryati Anuar
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Mohammed Faez Baobaid
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Nurul Akmal Jamaludin
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Hazian Hamzah
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Siamak Sarrafan
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Hassan Omar Ads
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Kavitha Ashok Kumar
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Jalal Hadi
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
| | - Hafsah Sazali
- International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
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Rankin D, Kimbell B, Hovorka R, Lawton J. Adolescents' and their parents' experiences of using a closed-loop system to manage type 1 diabetes in everyday life: qualitative study. Chronic Illn 2022; 18:742-756. [PMID: 33472409 PMCID: PMC9643806 DOI: 10.1177/1742395320985924] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Type 1 diabetes can have life-shattering consequences for adolescents and parents. A closed-loop system is a cutting-edge technology which automatically regulates glucose to reduce the burden of diabetes management. We explored adolescents' and parents' experiences of using this technology to understand how it affects their biographies and everyday lives. METHODS In-depth interviews with 18 adolescents newly diagnosed with type 1 diabetes and 21 parents after ≥12 months experience using closed-loop technology. Data were analysed thematically. RESULTS Participants reported very few disruptions to their lives when using a closed-loop. Reports of family conflict were minimal as the closed-loop enabled dietary flexibility and glucose levels to be checked effortlessly. Adolescents described doing 'normal' activities without worrying about high/low glucose, and parents reported allowing them to do so unsupervised because the closed-loop would regulate their glucose and keep them safe. Some adolescents expressed concerns about the visibility of components and, to avoid stigma, described curtailing activities such as swimming. Participants described how the closed-loop enabled adolescents to be in control of, or create distance from, diabetes. DISCUSSION The closed-loop has life-enhancing consequences for both adolescents and parents and helps to reduce the biographical disruption of type 1 diabetes in this age group.
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Affiliation(s)
- D Rankin
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - B Kimbell
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - R Hovorka
- Wellcome Trust - Medical Research Institute of Metabolic Science, University of Cambridge, Cambridge, UK.,Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - J Lawton
- Usher Institute, University of Edinburgh, Edinburgh, UK
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El Samahy MH, Salah NY, Abdeen MS, Falastin BRK. Psychosocial aspects of continuous subcutaneous insulin infusion in children with type 1 diabetes in Egypt; a limited resources country perspective. Diabetol Metab Syndr 2022; 14:82. [PMID: 35690827 PMCID: PMC9188159 DOI: 10.1186/s13098-022-00853-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Novel innovations continue to emerge in type-1 diabetes (T1D) management aiming to improve glycemic control. Assessing the psychosocial outcomes of different treatment modalities is specifically crucial among children with T1D and differs from one population to another. OBJECTIVES To compare the health related quality of life (HRQoL) and confidence in diabetes self-management (CIDS) among children with T1D on continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) and to correlate them with the efficacy of glycemic control, Mini-International Neuropsychiatric Interview for Children and Adolescents(MINI-KID) depression module and socioeconomic-standard scale. METHODS This real life study (ClinicalTrials.gov number NCT04756011) included 60 children with T1D (30 on CSII and 30 on MDI), aged 6-18 years. Disease duration, insulin therapy, average self-monitoring of blood glucose (SMBG) and HbA1C were assessed. CIDS, socioeconomic-standard, MINI-KID depression and HRQoL scales were applied. RESULTS Children with T1D on CSII have significantly higher HRQoL and CIDS than those on MDI (P < 0.001). A significant negative correlation is found between HRQoL and insulin daily dose(P = 0.022), HbA1C(P < 0.001), average SMBG(P < 0.001) and MINI-KID depression scale(P < 0.001). A significant positive correlation is found between HRQoL and CIDS(P < 0.001) and health care, home sanitation, family possessions and occupation socioeconomic scores(P = 0.033, P = 0.001, P < 0.001 and P = 0.006, respectively). Multivariate regression analysis revealed that HRQoL is most associated with MINI-KID depression scale (P = 0.004) and annual total cost(P < 0.001). CONCLUSION Children with T1D on CSII have significantly better HRQoL, CIDS and HbA1C with less depression than those on MDI.
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Affiliation(s)
| | - Nouran Yousef Salah
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Mai Seifeldin Abdeen
- Department of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Parent-Child Conflict Moderates the Relationship Between Executive Functioning and Child Disruptive Behaviors in Youth with T1D. J Clin Psychol Med Settings 2022; 29:357-364. [PMID: 34985630 PMCID: PMC9893479 DOI: 10.1007/s10880-021-09838-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 02/04/2023]
Abstract
Executive function (EF) skills, parent-child conflict, and high blood glucose (BG) may impact child externalizing behaviors. We examined these child and parent factors in families of 5-9 year olds with recent-onset type 1 diabetes (T1D). Parents (N = 125) reported child EF, child externalizing behaviors, and conflict regarding T1D-specific tasks. We used self-monitoring BG uploads to calculate the percentage of time children had high BG (> 180 mg/dl). We entered data into a moderated path analysis using MPlus8. The path analysis revealed a positive direct effect for parent-reported child EF and child externalizing behavior (p < .01). Further, T1D-specific conflict moderated the positive association between parent-reported child EF and child externalizing behaviors (p < .05). Early screening of child EF, externalizing behavior, and family conflict may be particularly important in the recent-onset period of T1D. The introduction of T1D-related conflict after diagnosis may impact child externalizing behavior and limited child EF skills that pre-date diagnosis.
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11
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Nikitina IL, Kelmanson IA. Health-related quality of life in 4-to-6-year-old children with type 1 diabetes mellitus estimated by children and their mothers. Eur J Pediatr 2022; 181:549-560. [PMID: 34424400 PMCID: PMC8380516 DOI: 10.1007/s00431-021-04239-0] [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: 05/14/2021] [Revised: 07/29/2021] [Accepted: 08/10/2021] [Indexed: 02/07/2023]
Abstract
Administration of pediatric Health Related Quality of Life (HRQoL) inventories frequently assesses both the child and parent perspectives in young children with type 1 diabetes mellitus (T1DM), but parent-proxy and child self-reports may differ, and little is known on these discrepancies. The aim is to evaluate HRQoL estimated by young children with T1DM and by their mothers, potential discrepancies in the children-maternal estimates and the factors influencing these discrepancies. Thirty-five 4-to-6-year-old children (19 boys) with T1DM admitted to the Pediatric Endocrinology Department were approached with the self-report KINDL questionnaire for children aged 4-6 years (Kiddy-KINDL for children). Their mothers were approached with the parental version (Kiddy-KINDL for parents). Both versions enable measuring child HRQoL in physical, emotional wellbeing, self-esteem, family, friends, everyday functioning, and the disease dimensions, as well as KINDL total on a 0-100 scale. Statistically significant differences were found between children's and maternal estimates on the KINDL total and "Disease" scales, in that the maternal proxy-reports produced lower values. A statistically significant difference between self- and proxy-reports was found for the KINDL "Emotional wellbeing" scale values, and the maternal proxy-reports yielded higher estimates compared with children's self-reports. These associations remained significant after adjustment for major potential confounders. Maternal education, maternal marital status, insulin regimen, and achievement of glycemic control modified the effect of child-maternal discrepancies.Conclusion: Attempts should be made to improve parental understanding of child problems related to his/her disease with due account to individual family social and demographic characteristics. What is Known: • HRQoL in children with T1DM has been advocated as an important complementary outcome to clinical and laboratory markers. • Self-and parental proxy-reports on HRQoL may differ, but little is known on these discrepancies and on the factors influencing them in young children with T1DM. What is New: • Mothers tend to underestimate general and disease-related components of HRQoL but likely to overestimate psychological wellbeing of their ill young children with T1DM. • Maternal education, marital status, insulin regimen, and achievement of glycemic control modify estimations of HRQoL and child-maternal discrepancies.
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Affiliation(s)
- Irina L. Nikitina
- Department of Children’s Diseases, Institute for Medical Education of the V.A.Almazov National Medical Research Centre, Akkuratova Str., 2, 197341 St. Petersburg, Russia
| | - Igor A. Kelmanson
- Department of Children’s Diseases, Institute for Medical Education of the V.A.Almazov National Medical Research Centre, Akkuratova Str., 2, 197341 St. Petersburg, Russia
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12
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Ingersgaard MV, Hoeeg D, Willaing I, Grabowski D. An exploratory study of how young people experience and perceive living with type 1 diabetes during late adolescence and emerging adulthood. Chronic Illn 2021; 17:475-492. [PMID: 31739683 DOI: 10.1177/1742395319886487] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Suboptimal glycemic control and psychosocial challenges are significant concerns for adolescents and emerging adults (collectively young people) with type 1 diabetes. Knowledge about young peoples' attitudes towards living with type 1 diabetes is inadequate, but the issue is important in the development of strategies to improve glycemic control and psychosocial well-being. This study explored young peoples' perceptions of living with type 1 diabetes. METHODS An exploratory, qualitative design was employed. Data were collected through five participatory workshops with 19 young people (age 15-25). Data were thematically analyzed. RESULTS The overall depiction of living with type 1 diabetes was paradoxical; it affected everything and nothing. Living with type 1 diabetes was a balancing act between accommodating a "normal" way of living and self-management tasks of the treatment regimen. Participants' perceptions reflected shifting accounts that could be divided into five themes: (1) special rules during youth, (2) striving for autonomy, (3) an uncertain future, (4) social support, and (5) stigma and disclosure. DISCUSSION It is important to probe for the multiple and interrelated social contexts that underlie young peoples' motives for adhering to and deviating from treatment regimens. Future studies should focus on relational aspects, including stigma mechanisms, the role of friends, and facilitation of balanced parental involvement.
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Affiliation(s)
| | | | | | - Dan Grabowski
- Steno Diabetes Center Copenhagen, Health Promotion, Gentofte, Denmark
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13
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Neuman V, Plachy L, Pruhova S, Kolouskova S, Petruzelkova L, Obermannova B, Vyzralkova J, Konecna P, Vosahlo J, Romanova M, Pavlikova M, Sumnik Z. Low-Carbohydrate Diet among Children with Type 1 Diabetes: A Multi-Center Study. Nutrients 2021; 13:nu13113903. [PMID: 34836158 PMCID: PMC8622801 DOI: 10.3390/nu13113903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/11/2021] [Accepted: 10/27/2021] [Indexed: 01/31/2023] Open
Abstract
AIMS/HYPOTHESIS The proportion of children with type 1 diabetes (T1D) who have experience with low-carbohydrate diet (LCD) is unknown. Our goal was to map the frequency of LCD among children with T1D and to describe their clinical and laboratory data. METHODS Caregivers of 1040 children with T1D from three centers were addressed with a structured questionnaire regarding the children's carbohydrate intake and experience with LCD (daily energy intake from carbohydrates below 26% of age-recommended values). The subjects currently on LCD were compared to a group of non-LCD respondents matched to age, T1D duration, sex, type and center of treatment. RESULTS A total of 624/1040 (60%) of the subjects completed the survey. A total of 242/624 (39%) subjects reported experience with voluntary carbohydrate restriction with 36/624 (5.8%) subjects currently following the LCD. The LCD group had similar HbA1c (45 vs. 49.5, p = 0.11), lower average glycemia (7.0 vs. 7.9, p = 0.02), higher time in range (74 vs. 67%, p = 0.02), lower time in hyperglycemia >10 mmol/L (17 vs. 20%, p = 0.04), tendency to more time in hypoglycemia <3.9 mmol/L(8 vs. 5%, p = 0.05) and lower systolic blood pressure percentile (43 vs. 74, p = 0.03). The groups did not differ in their lipid profile nor in current body height, weight or BMI. The LCD was mostly initiated by the parents or the subjects themselves and only 39% of the families consulted their decision with the diabetologist. CONCLUSIONS/INTERPRETATION Low carbohydrate diet is not scarce in children with T1D and is associated with modestly better disease control. At the same time, caution should be applied as it showed a tendency toward more frequent hypoglycemia.
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Affiliation(s)
- Vit Neuman
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, CZ-15006 Prague, Czech Republic; (L.P.); (S.P.); (S.K.); (L.P.); (B.O.); (Z.S.)
- Correspondence: ; Tel.: +420-2-2443-2090; Fax: +420-2-2443-2020
| | - Lukas Plachy
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, CZ-15006 Prague, Czech Republic; (L.P.); (S.P.); (S.K.); (L.P.); (B.O.); (Z.S.)
| | - Stepanka Pruhova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, CZ-15006 Prague, Czech Republic; (L.P.); (S.P.); (S.K.); (L.P.); (B.O.); (Z.S.)
| | - Stanislava Kolouskova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, CZ-15006 Prague, Czech Republic; (L.P.); (S.P.); (S.K.); (L.P.); (B.O.); (Z.S.)
| | - Lenka Petruzelkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, CZ-15006 Prague, Czech Republic; (L.P.); (S.P.); (S.K.); (L.P.); (B.O.); (Z.S.)
| | - Barbora Obermannova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, CZ-15006 Prague, Czech Republic; (L.P.); (S.P.); (S.K.); (L.P.); (B.O.); (Z.S.)
| | - Jana Vyzralkova
- Department of Pediatrics, University Hospital Brno, CZ-62500 Brno, Czech Republic; (J.V.); (P.K.)
| | - Petra Konecna
- Department of Pediatrics, University Hospital Brno, CZ-62500 Brno, Czech Republic; (J.V.); (P.K.)
| | - Jan Vosahlo
- Department of Pediatrics, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, CZ-10034 Prague, Czech Republic; (J.V.); (M.R.)
| | - Martina Romanova
- Department of Pediatrics, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, CZ-10034 Prague, Czech Republic; (J.V.); (M.R.)
| | - Marketa Pavlikova
- Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, CZ-18675 Prague, Czech Republic;
| | - Zdenek Sumnik
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, CZ-15006 Prague, Czech Republic; (L.P.); (S.P.); (S.K.); (L.P.); (B.O.); (Z.S.)
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14
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Relationship between Diabetes Family Conflicts or Problem Recognition in Illness Self-Management and Quality of Life of Adolescents with T1DM and Their Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010710. [PMID: 34682456 PMCID: PMC8535413 DOI: 10.3390/ijerph182010710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate the relationship between diabetes family conflicts or problem recognition in illness self-management (PRISM) and the parental perceived quality of life (QoL) of adolescents with type 1 diabetes mellitus (T1DM) and their parents. This was a cross-sectional study, and the participants comprised 111 parents of type 1 diabetes adolescents; data were collected via an online survey and analyzed by descriptive statistics, correlation, and multiple linear regression analysis using the IBM SPSS 25.0 program. The explanatory power of the QoL model in parents of adolescents with T1DM, constructed using three variables—diabetes family conflict (B = −0.56), regimen pain and bother (B = −11.25), and peer interactions (B = −7.48), which are PRISM barriers—was 35.7% (F = 5.70, p < 0.001). Diabetes family conflicts (B = −0.86) and peer interactions (B = −9.04) explained 57.3% of the variance in the parental perceived QoL of adolescents with T1DM (F = 12.33, p < 0.001). In order to improve the QoL in parents and adolescents with type 1 diabetes, interventions to effectively manage diabetes family conflicts and improve peer interactions are necessary.
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15
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Tremolada M, Cusinato M, Bonichini S, Fabris A, Gabrielli C, Moretti C. Health-Related Quality of Life, Family Conflicts and Fear of Injecting: Perception Differences between Preadolescents and Adolescents with Type 1 Diabetes and Their Mothers. Behav Sci (Basel) 2021; 11:bs11070098. [PMID: 34356715 PMCID: PMC8301019 DOI: 10.3390/bs11070098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 01/09/2023] Open
Abstract
Good management of diabetes requires at the same time self-regulation behaviour and a balanced involvement of family components. This cross-sectional study’s aims were: understanding fear of injections and perceptions of family conflicts in preadolescents and adolescents with type 1 diabetes mellitus and their mothers, comparing their perceptions, and identifying the risk factors impacting patients’ quality of life. Eligibility criteria were: treatment for diabetes mellitus type I, currently aged 10–18 years, attending the hospital for annual hospital follow-ups. Exclusion criteria were: intellectual disabilities, inability to complete questionnaires alone and neuropsychiatric illness with active pharmacotherapy. The study design was cross-sectional. Participants were one hundred and two patients (Mean age = 14.6, SD = 2.4; age range = 10–19 years; Females = 52 and Males = 50) and their mothers (Mean age = 46.9, SD = 6.2, age range = 27–63 years), who filled in self and proxy-report questionnaires (N total= 204). The results showed that 20% of patients and 14.7% of their mothers reported clinical scores for fear of self-injection and blood testing. The mothers reported lower fear of injecting and higher family conflicts compared with the patients. Age, fear of injecting and family conflicts were significantly associated with patients’ quality of life perceptions. Clinical considerations and recommendations are given based on the empirical results.
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Affiliation(s)
- Marta Tremolada
- Department of Development and Social Psychology, University of Padua, 35131 Padova, Italy;
- Correspondence: ; Tel.: +39-3474-868-835
| | - Maria Cusinato
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Azienda Ospedale Università di Padova, 35127 Padova, Italy; (M.C.); (A.F.); (C.G.); (C.M.)
| | - Sabrina Bonichini
- Department of Development and Social Psychology, University of Padua, 35131 Padova, Italy;
| | - Arianna Fabris
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Azienda Ospedale Università di Padova, 35127 Padova, Italy; (M.C.); (A.F.); (C.G.); (C.M.)
| | - Claudia Gabrielli
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Azienda Ospedale Università di Padova, 35127 Padova, Italy; (M.C.); (A.F.); (C.G.); (C.M.)
| | - Carlo Moretti
- Pediatric Diabetes Unit, Department of Women’s and Children’s Health, Azienda Ospedale Università di Padova, 35127 Padova, Italy; (M.C.); (A.F.); (C.G.); (C.M.)
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16
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Disordered Eating Behaviors Among Italian Adolescents with Type 1 Diabetes: Exploring Relationships with Parents' Eating Disorder Symptoms, Externalizing and Internalizing Behaviors, and Body Image Problems. J Clin Psychol Med Settings 2021; 27:727-745. [PMID: 31587133 DOI: 10.1007/s10880-019-09665-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The purpose of this study is to examine associations of disordered eating behaviors (DEBs) with body image problems, parents' eating disorder symptoms, and emotional and behavioral problems among adolescents with type 1 diabetes (T1D). 200 adolescents (M age = 15.24 ± 1.45 years) with T1D completed a self-report measure of DEBs and body ideal internalization, and their parents completed self-report measures of parents' eating problems and child's psychological symptoms. Seventy-three (36.5%) adolescents were DEPS-r-positive (scores ≥ 20), with higher rates among girls (χ2 = 9.034, p = .003). Adolescents with T1D and DEBs reported lower SES, worse metabolic control, higher zBMI (p < .001), more eating disorder symptoms, more body image problems, and more emotional and behavioral problems than adolescents with T1D but no DEBs (all p < .05). Parents of adolescents with DEBs showed higher levels of bulimia (p = .028) than parents of adolescents without DEBs. In both genders, pressure to conform to societal norms about body image (p < .01) and externalization symptoms (p < .05) emerged as significant predictors of DEBs. Findings suggest that adolescents with T1D and DEBs showed an alarming psychological condition, with higher level of body image and more emotional and behavioral problems.
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17
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Semenkovich KA, Berlin KS, Ankney RL, Keenan ME, L Cook J, Klages KL, Banks GG, Rybak TM, Alemzadeh R, Eddington AR. Development and initial validation of the diabetes family conflict scale (revised)-short form in a racially and income diverse sample. Pediatr Diabetes 2021; 22:529-539. [PMID: 33476074 DOI: 10.1111/pedi.13182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/03/2020] [Accepted: 01/18/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The purpose of the study was to develop a short form of the revised diabetes family conflict scale (DFCS) in a racially and income diverse sample while retaining strong psychometric properties. METHODS One seventy nine youth with type 1 diabetes (ages 12-18 years) and caregivers completed the DFCS-Revised as well as assessments of adherence, psychosocial functioning, and diabetes-related stress. Hemoglobin A1c was also obtained. The sample was split at random into a development sample and validation sample. RESULTS Confirmatory factor analyses in the validation sample supported the use of a six-item short form (DFCS-SF) either as a total score (6-items) or a direct (3-item) and indirect (3-item) score. Variations of the DFCS-SF (three items of the 6-item short form) also had acceptable model fit. The short-form questionnaires had acceptable internal consistency and convergent validity (6-item: Cronbach's a = 0.865, full scale DFCS r = 0.954; 3-item: Cronbach's a = 0.757, full scale DFCS r = 0.912). The DFCS-SF showed measurement invariance across both youth and caregiver respondents. Greater report of the DFCS-SF by both youth and caregivers was significantly associated with higher HbA1c, more diabetes-related stress, and more psychosocial concerns. CONCLUSIONS The DFCS-SF developed in the present study shows psychometric integrity in a diverse population of youth and can be utilized by providers to rapidly assess and potentially implement interventions to reduce diabetes family conflict, a psychosocial concern which is associated with elevated HbA1c, non-optimal adherence, diabetes-related stress, and psychological distress.
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Affiliation(s)
| | - Kristoffer S Berlin
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA.,Department of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Rachel L Ankney
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Mary E Keenan
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Jessica L Cook
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kimberly L Klages
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA.,Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Gabrielle G Banks
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA.,Department of Pediatrics, University of Mississippi Medical Center, Mississippi, USA
| | - Tiffany M Rybak
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA.,Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Ramin Alemzadeh
- Department of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Angelica R Eddington
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA.,Department of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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18
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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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Fox DA, Bone JN, Keidar S, Amed S. Family conflict in type 1 diabetes: Who is at risk? Pediatr Diabetes 2020; 21:1575-1582. [PMID: 32902884 DOI: 10.1111/pedi.13116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/30/2020] [Accepted: 09/02/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVE Diabetes-related conflict between caregiver and child has been associated with lower quality of life, reduced treatment adherence, and higher hemoglobin A1C. The objective of this project was to identify patient and family characteristics associated with higher levels of diabetes-specific family conflict. METHODS This was a cross-sectional study. Caregivers of children aged 4- to 18-years-old with type 1 diabetes were recruited from diabetes clinics across British Columbia. Data were collected through chart reviews and patient surveys, including the Diabetes Family Conflict Scale and the Adherence in Diabetes Questionnaire. All caregivers and children ≥8-years-old were invited to complete the survey. Potential predictors were explored using univariate and multivariable linear regression models. RESULTS In the unadjusted analysis, higher caregiver report of conflict (n = 196) was associated with: low family income, non-Caucasian ethnicity, missed school, older age at diagnosis, and insulin regimen (2-3 injections/day rather than multiple daily injections or pump). When all variables were adjusted for simultaneously, income, insulin regimen, one or more stay at home parent and recent hospitalization were significant. For the child report (n = 111), higher maternal education was associated with lower conflict in the unadjusted analysis and non-Caucasian ethnicity was associated with higher conflict in the adjusted analysis. CONCLUSIONS This exploratory study identified possible novel associations between patient and family characteristics and diabetes-related family conflict.
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Affiliation(s)
- Danya A Fox
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey N Bone
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shelly Keidar
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shazhan Amed
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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20
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Thompson D, Callender C, Gonynor C, Cullen KW, Redondo MJ, Butler A, Anderson BJ. Using Relational Agents to Promote Family Communication Around Type 1 Diabetes Self-Management in the Diabetes Family Teamwork Online Intervention: Longitudinal Pilot Study. J Med Internet Res 2019; 21:e15318. [PMID: 31538940 PMCID: PMC6754689 DOI: 10.2196/15318] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/30/2019] [Accepted: 08/13/2019] [Indexed: 01/19/2023] Open
Abstract
Background Family conflict can reduce adolescent adherence to type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be efficacious in reducing conflict and low adherence to diabetes-related tasks. Its reach and potential impact, however, were limited by the need to deliver the intervention sessions in person. Relational agents (ie, computerized versions of humans) have been shown to appeal to diverse audiences and may be an acceptable replacement for a human in technology-based behavior change interventions. Objective The purpose of this paper is to present the results of a pilot study assessing feasibility and acceptability of Diabetes Family Teamwork Online, an adapted version of the Family Teamwork intervention, delivered over the internet and guided by a relational agent. Methods Parent-adolescent dyads were recruited through a diabetes care clinic at a large tertiary care hospital in the southwestern United States. A one-group design, with assessments at baseline, immediate postintervention, and 3 months later, was used to assess feasibility. A priori feasibility criteria included an assessment of recruitment, completion, attrition, program satisfaction, therapeutic alliance, attitudes toward the relational agent, and data collection. The institutional review board at Baylor College of Medicine approved the protocol (H-37245). Results Twenty-seven adolescents aged 10 to 15 years with type 1 diabetes and their parents were enrolled. Criteria used to assess feasibility were (1) recruitment goals were met (n=20), (2) families completed ≥75% of the modules, (3) attrition rate was ≤10%, (4) program satisfaction was high (≥80% of families), (5) therapeutic alliance was high (average score of ≥60/84), (6) families expressed positive attitudes toward the relational agent (average item score of ≥5 on ≥4 items), (7) ≥80% of data were collected at post 1 and post 2, and (8) few technical issues (≤10%) occurred during intervention delivery. All feasibility criteria were met. Qualitative data confirmed that adolescents and parents had positive reactions to both the content and approach. Conclusions The Diabetes Family Teamwork Online intervention proved to be a feasible and acceptable method for enhancing communication around diabetes management tasks in families with an adolescent who has type 1 diabetes. International Registered Report Identifier (IRRID) RR2-10.2196/resprot.5817
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Affiliation(s)
- Debbe Thompson
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Chishinga Callender
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Caroline Gonynor
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Karen W Cullen
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Maria J Redondo
- Diabetes and Endocrinology Section, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Ashley Butler
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Barbara J Anderson
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
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21
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Snyder LL, Stafford JM, Dabelea D, Divers J, Imperatore G, Law J, Lawrence JM, Pihoker C, Mayer-Davis EJ. Socio-economic, demographic, and clinical correlates of poor glycaemic control within insulin regimens among children with Type 1 diabetes: the SEARCH for Diabetes in Youth Study. Diabet Med 2019; 36:1028-1036. [PMID: 31050009 PMCID: PMC6635011 DOI: 10.1111/dme.13983] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 12/31/2022]
Abstract
AIM To examine the distribution and association of sociodemographic, adherence, and barriers-to-care factors in relation to glycaemic control within insulin regimens in US children with Type 1 diabetes in the SEARCH for Diabetes in Youth Study. METHODS Self- or parent-reported data from 1095 children with Type 1 diabetes aged 10-17 years were collected on insulin regimen, sociodemographics, diabetes self-management, diabetes-related family conflict and barriers to care. Multivariable logistic regression analysis identified poor glycaemic control correlates within each insulin regimen. RESULTS Participants included 694 children on insulin pump therapy, 188 receiving basal-bolus injections, and 213 on a mixed insulin regimen. Of these, 28.5%, 45.2% and 51.2%, respectively, had poor glycaemic control [HbA1c ≥ 80 mmol/mol (9.5%)]. Family conflict between parent and child regarding diabetes management was the only factor significantly associated with poor glycaemic control in all insulin regimens (insulin pump, P≤ 0.0001; basal-bolus injections, P=0.0002; mixed insulin regimen, P=0.0103). For children on insulin pump, poor control was significantly associated with non-white race (P=0.0008), living in multiple households (P=0.0331), having Medicaid insurance (P=0.0090), and decreased insulin adherence (P<0.0001). For children on a mixed insulin regimen, living in multiple households (P=0.0256) and not spending enough time with healthcare provider (P=0.0058) correlated with poor control. CONCLUSIONS A high percentage of US children with Type 1 diabetes had poor glycaemic control, especially those not using an insulin pump. Early identification of children with risk factors associated with poor glycaemic control within insulin regimens and addressing diabetes-related family conflict may allow interventions to improve diabetes management.
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Affiliation(s)
- L L Snyder
- Division of Endocrinology, Diabetes & Metabolism, Nemours Children's Health System, Jacksonville, FL, USA
| | - J M Stafford
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - D Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J Divers
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - G Imperatore
- Division of Diabetes Translation, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
| | - J Law
- School of Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J M Lawrence
- Department of Research and Evaluation, Division of Epidemiologic Research, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - C Pihoker
- Division of Endocrinology and Diabetes, Seattle's Children's Hospital, Seattle, WA, USA
| | - E J Mayer-Davis
- Gillings School of Global Public Health, Departments of Nutrition and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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22
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Gallagher KAS, DeSalvo D, Gregory J, Hilliard ME. Medical and Psychological Considerations for Carbohydrate-Restricted Diets in Youth With Type 1 Diabetes. Curr Diab Rep 2019; 19:27. [PMID: 31030356 DOI: 10.1007/s11892-019-1153-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW Given the challenges achieving recommended glycemic targets in youth with type 1 diabetes (T1D), providers may consider recommending carbohydrate-restricted diets (CRDs) to optimize glycemic control. The goal of the present review is to describe relevant literature on the potential medical and psychosocial benefits and risks of CRDs in youth with T1D. RECENT FINDINGS Limited data exist on the effects of CRDs in pediatric populations. Findings from studies with youth and adults are mixed; some indicate that CRDs may be associated with desirable medical outcomes, such as improved glycemic control and reduced HbA1c, which may contribute to positive psychological outcomes such as reduced diabetes distress and depressive symptoms. Others suggest that CRDs may also be associated with detrimental outcomes, including mineral deficiencies and suboptimal growth, and dietary restriction has been linked to greater diabetes distress, disordered eating, and diabetes management. More research is needed to evaluate benefits and risks of CRDs in youth. Providers should exercise caution when discussing CRDs with youth and families, particularly when considering CRDs for youth at elevated risk for eating disordered behavior.
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Affiliation(s)
- Katherine A S Gallagher
- Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin Street, Suite 1630, Houston, TX, 77030, USA
| | - Daniel DeSalvo
- Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin Street, Suite 1020, Houston, TX, 77030, USA
| | - Justin Gregory
- Vanderbilt University School of Medicine, 1500 21st Ave, Suite 1514, Nashville, TN, 37212, USA
| | - Marisa E Hilliard
- Baylor College of Medicine and Texas Children's Hospital, 1102 Bates Ave, Suite 940, Houston, TX, 77030, USA.
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23
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Yang J, Guo J, Tang Y, Huang L, Wiley J, Zhou Z, Whittemore R. The mediating effect of coping styles and self‐efficacy between perceived stress and satisfaction with QOL in Chinese adolescents with type 1 diabetes. J Adv Nurs 2019; 75:1439-1449. [DOI: 10.1111/jan.13933] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 10/19/2018] [Accepted: 11/27/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Jundi Yang
- Xiangya School of Nursing Central South University Changsha Hunan Province China
| | - Jia Guo
- Xiangya School of Nursing Central South University Changsha Hunan Province China
| | - Yujia Tang
- Xiangya School of Nursing Central South University Changsha Hunan Province China
| | - Lingling Huang
- School of Nursing Shen Zhen University Shen Zhen Guangdong Province China
| | - James Wiley
- School of Nursing University of California, San Francisco San Francisco California
| | - Zhiguang Zhou
- Diabetes Center Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University Changsha China
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24
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Gasparrini E, Rosati F, Gaetti MT. Long-term follow-up of newborns at neurological risk. Ital J Pediatr 2019; 45:38. [PMID: 30885247 PMCID: PMC6423827 DOI: 10.1186/s13052-019-0629-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/04/2019] [Indexed: 11/18/2022] Open
Abstract
Background In order to give a new contribution to the knowledge of the psycho-physical, behavioral and socio-relational development of the individuals who were born at neurological risk, we have carried out a research work through a retrospective and observational analysis in such people, followed in their neuro-evolutionary development from the Department of Pediatrics and Neonatology of the Hospital of Jesi. The purpose of this work is to value the quality of life of the individuals born at neurological risk at a distance of time from the birth. In the literature only recently there are studies on the quality of life of some categories of people, but survey does not seem to be performed in individuals previously born at neurological risk. Methods A statistical descriptive and inferential survey has been carried out on 812 individuals who were born at neurological risk, 442 preterm newborns and 370 term newborns, followed from 1977 until to 2007. They were classed in order to their age at the time of our observation. We have submitted the entire sample to a Questionnaire to investigate some areas of their life, ranging from their clinical and psycho-social history to their personal coming of life. Then the same persons, subdivided according to the various age groups, were subjected to other Questionnaires on the quality of life, internationally used. Results Neurological outcomes were found in 14.7% of the preterm newborns and in 6% of the term newborns, with a significant correlation between neurological outcomes and gestational age, low birth-weight, hypoxic-ischemic encephalopathy and low APGAR-index. Neuro-disabilities were found prevalently belong to the small for gestational age preterm newborns. A low quality of life emerged in those who had neurological outcomes. Conclusions Our study on the individuals who were born at neurological risk, analyzed at a distance, shows that a good health is associated with a good quality of life, while a low quality of life occurs to those who had neurological outcome, especially in the physical, cognitive, emotional and socio-relational aspects. As far as the few neurological outcomes which we have found in this survey, we think that they are due, other than to the natural factors, also to the high quality of the obstetric and neonatal care, to the early habilitation physiotherapy and to the important collaboration with the family.
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Affiliation(s)
- Enrico Gasparrini
- Department of Pediatrics and Neonatology - Hospital of Macerata, Macerata, Italy.
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25
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Saoji N, Palta M, Young HN, Moreno MA, Rajamanickam V, Cox ED. The relationship of Type 1 diabetes self-management barriers to child and parent quality of life: a US cross-sectional study. Diabet Med 2018; 35:1523-1530. [PMID: 29901829 PMCID: PMC6197886 DOI: 10.1111/dme.13760] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2018] [Indexed: 11/28/2022]
Abstract
AIM Families of children and adolescents with Type 1 diabetes experience self-management challenges that negatively impact diabetes control. This study assesses whether self-management challenges are also associated with quality of life (QOL) for children and adolescents with Type 1 diabetes and their parents. METHODS Children aged 8-12 years (n = 135), adolescents aged 13-16 years (n = 132) and their parents completed QOL assessments (diabetes-specific QOL from the PedsQL Diabetes Module or the Family Impact Module, both scaled 0-100) and a validated survey of up to six self-management barriers [PRISM; scaled 1 (low) to 5 (high)]. Regression coefficients were calculated to assess the association of self-management barriers with child and adolescent diabetes-specific QOL or parent QOL, including interaction effects to assess the stability of the associations. RESULTS Mean duration of diabetes was 4.7 years for children and 6.1 years for adolescents. The majority of children and adolescents did not meet target values for glycaemic control. All barriers but one (Healthcare Team Interactions) were associated with lower diabetes-specific QOL for children and adolescents, as well as lower QOL for parents (all P < 0.05). Barrier scores that were 1 unit higher were associated with diabetes-specific QOL that was 3.7-5.1 points lower for children and 5.8-8.8 points lower for adolescents, as well as QOL that was 6.0-12.6 points lower for parents. Diabetes-specific QOL was most strongly associated with 'Denial of Disease and Its Consequences' for children and with 'Regimen Pain and Bother' for adolescents. Parent QOL was most strongly associated with 'Understanding and Organizing Care'. Associations were stable across numerous demographic and disease factors. CONCLUSIONS Single-unit differences in self-management barrier scores are associated with clinically meaningful differences in QOL for children and parents. Interventions specifically tailored to address individual self-management barriers may improve both diabetes control and QOL.
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Affiliation(s)
- N Saoji
- Department of Population Health Sciences, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
| | - M Palta
- Department of Population Health Sciences, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
| | - H N Young
- Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA, USA
| | - M A Moreno
- Department of Pediatrics, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
| | - V Rajamanickam
- Department of Biostatistics and Medical Informatics, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
| | - E D Cox
- Department of Population Health Sciences, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
- Department of Pediatrics, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA
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26
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Munkácsi B, Papp G, Felszeghy E, Nagy BE, Kovács KE. The associations between mental health, health-related quality of life and insulin pump therapy among children and adolescents with type 1 diabetes. J Pediatr Endocrinol Metab 2018; 31:1065-1072. [PMID: 30291785 DOI: 10.1515/jpem-2018-0130] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 08/13/2018] [Indexed: 11/15/2022]
Abstract
Background Diabetes has previously been linked to mental health problems in children and adolescents, but more recent studies have yielded mixed findings. The aim of the current study was to compare symptoms of mental health problems in children and adolescents with and without type 1 diabetes (T1DM). Methods Life quality, subjective well-being, self-rated health, depression and somatic symptoms in children and adolescents with diabetes (n=130) were measured and compared to the results of a socio-demographically joined control group (n=177) which consists of healthy children and adolescents. Results A significant difference could be observed between the groups in well-being and depressive symptoms as according to the results, the research sample namely the children with T1DM could be described with significantly higher subjective well-being and mood, but with less physical symptoms and lower level of depression as those in the control group. Conclusions These findings suggest that T1DM is not associated with an increased risk of psychosocial problems, and confirm that even a severe disease of a child can lead to personal growth.
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Affiliation(s)
- Brigitta Munkácsi
- University of Debrecen, Faculty of Public Health, Doctoral School of Health Sciences, Debrecen, Hungary
| | - Gábor Papp
- University of Debrecen, Faculty of Arts, Institute of Psychology, Debrecen, Hungary
| | - Enikő Felszeghy
- University of Debrecen, Faculty of Medicine, Departement of Pediatrics, Debrecen, Hungary
| | - Beáta Erika Nagy
- University of Debrecen, Faculty of Medicine, Departement of Pediatrics, Debrecen, Hungary
| | - Karolina Eszter Kovács
- University of Debrecen, Faculty of Arts, Doctoral School of Human Sciences, Debrecen, Hungary
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27
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Delamater AM, de Wit M, McDarby V, Malik JA, Hilliard ME, Northam E, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Psychological care of children and adolescents with type 1 diabetes. Pediatr Diabetes 2018; 19 Suppl 27:237-249. [PMID: 30058247 DOI: 10.1111/pedi.12736] [Citation(s) in RCA: 161] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 01/09/2023] Open
MESH Headings
- Adaptation, Psychological/physiology
- Adolescent
- Burnout, Psychological/psychology
- Burnout, Psychological/therapy
- Child
- Consensus
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 1/therapy
- Endocrinology/organization & administration
- Endocrinology/standards
- Humans
- International Cooperation
- Neurodevelopmental Disorders/therapy
- Pediatrics/organization & administration
- Pediatrics/standards
- Practice Patterns, Physicians'/standards
- Psychotherapy/methods
- Psychotherapy/standards
- Quality of Life/psychology
- Resilience, Psychological
- Societies, Medical/organization & administration
- Societies, Medical/standards
- Stress, Psychological/etiology
- Stress, Psychological/therapy
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Affiliation(s)
- Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Maartje de Wit
- Department of Medical Psychology, EMGO Institute for Health & Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Vincent McDarby
- National Children's Research Centre and Our Lady's Children's Hospital, Dublin, Ireland
| | - Jamil A Malik
- Center of Excellence, National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | | | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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28
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Burns K, Farrell K, Myszka R, Park K, Holmes-Walker DJ. Access to a youth-specific service for young adults with type 1 diabetes mellitus is associated with decreased hospital length of stay for diabetic ketoacidosis. Intern Med J 2018; 48:396-402. [PMID: 29034986 DOI: 10.1111/imj.13649] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/27/2017] [Accepted: 10/09/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Management of type 1 diabetes mellitus in youth with diabetes (YWD) is complex, and glycaemic control often deteriorates during this challenging period. We hypothesise that attendance at a youth-specific diabetes clinic reduces hospital admission rates and length of stay (LOS) for diabetic ketoacidosis (DKA). AIMS To assess the impact of a youth-specific diabetes service for YWD on DKA admissions in two adjacent local health districts. METHODS A retrospective cohort analysis of admissions for DKA in YWD aged 15-25 years, presenting to four hospitals in Western Sydney in 2011 was performed. Number of admissions, LOS and DKA severity were assessed. Cost was analysed as a function of LOS. Groups were divided by attendance at a youth-specific diabetes service and no record of attendance. RESULTS There were 55 DKA admissions from 39 patients (median age 20.0 years); the majority of admissions (82%) was YWD not supported by a youth-specific diabetes service. Median LOS was significantly longer in the unsupported group (3.0 vs 1.5 days, P = 0.028). Median pH at presentation in the unsupported group was significantly lower, 7.11 versus 7.23 (P = 0.05). The admission rate was four times greater for those not supported by youth-specific diabetes services, 5.5% compared with 1.6% (P = 0.001). The estimated cost saved by youth-specific services was over $250,000 pa. CONCLUSIONS Lack of access to supported care for YWD during transition from paediatric to adult care has an adverse impact on subsequent DKA admission rates and LOS.
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Affiliation(s)
- Kharis Burns
- Diabetes Transition Support Program, Department Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Kaye Farrell
- Diabetes Transition Support Program, Department Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Rickie Myszka
- Diabetes Transition Support Program, Department Diabetes and Endocrinology, Nepean Hospital, Sydney, New South Wales, Australia
| | - Kris Park
- Diabetes Transition Support Program, Department Diabetes and Endocrinology, Nepean Hospital, Sydney, New South Wales, Australia
| | - D Jane Holmes-Walker
- Diabetes Transition Support Program, Department Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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29
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Rybak TM, Ali JS, Berlin KS, Klages KL, Banks GG, Kamody RC, Ferry RJ, Alemzadeh R, Diaz-Thomas AM. Patterns of Family Functioning and Diabetes-Specific Conflict in Relation to Glycemic Control and Health-Related Quality of Life Among Youth With Type 1 Diabetes. J Pediatr Psychol 2018; 42:40-51. [PMID: 28173113 DOI: 10.1093/jpepsy/jsw071] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 07/25/2016] [Accepted: 07/27/2016] [Indexed: 01/12/2023] Open
Abstract
Objectives General and diabetes-specific family functioning may be associated with youth’s adaptation to type 1 diabetes (T1D); however, empirically derived patterns of family functioning and diabetes-specific conflict among youth have not been explored in relation to T1D adaptation. Methods Youth (N = 161, aged 12–18) with T1D and caregivers completed measures of family functioning and diabetes-specific conflict that served as indicators in latent profile analyses. Differences in glycemic control (measured by hemoglobin A1cs [HbA1c] and health-related quality of life [HRQoL]) were compared across profiles. Results Four profiles that varied by levels of family functioning, diabetes-specific conflict, and congruence between youth and caregiver perspectives emerged and related to T1D adaptation differently. Greater agreement between caregiver and youth and lower diabetes-specific conflict was associated with lower HbA1c and greater HRQoL. Conclusions Person-centered approaches are useful to quantify how many individuals fit into a particular pattern and determine how specific family dynamics may function together differently in relation to T1D adaptation for various subgroups of the population.
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Affiliation(s)
- Tiffany M Rybak
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Jeanelle S Ali
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Kristoffer S Berlin
- Department of Psychology, The University of Memphis, Memphis, TN, USA.,Department of Pediatrics, University of Tennessee Health Science Center-Memphis, Memphis, TN, USA
| | - Kimberly L Klages
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Gabrielle G Banks
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Rebecca C Kamody
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Robert J Ferry
- Department of Pediatrics, University of Tennessee Health Science Center-Memphis, Memphis, TN, USA
| | - Ramin Alemzadeh
- Department of Pediatrics, University of Tennessee Health Science Center-Memphis, Memphis, TN, USA
| | - Alicia M Diaz-Thomas
- Department of Pediatrics, University of Tennessee Health Science Center-Memphis, Memphis, TN, USA
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30
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Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an update on the recent body of evidence emerging for type 2 diabetes as identified through the SEARCH for Diabetes in Youth study. RECENT FINDINGS This body of evidence illustrates that type 2 diabetes continues to increase in incidence, although this increase may be partially attributable to increased surveillance. Disease management is influenced by the transition from adolescent to adult care and psychosocial factors may also contribute. This evidence also describes a high prevalence of disease-associated complications and comorbidities. Risk factors for cardiovascular disease are also highly prevalent. The SEARCH for Diabetes in Youth study continues to inform our understanding of the descriptive epidemiology and natural history of type 2 diabetes in youth. As the cohort matures, new opportunities emerge for building on our understanding of how youth-onset type 2 diabetes impacts future health.
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Affiliation(s)
- Elizabeth T Jensen
- Department of Epidemiology and Prevention, Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, 27599, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, 13001 E 17th Place - B119, Aurora, CO, 80045, USA.
- Department of Pediatrics, University of Colorado School of Medicine, 13123 E. 16th Ave - B065, Aurora, CO, 80045, USA.
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31
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Fazeli Farsani S, Abdullah-Koolmees H, Souverein PC, de Boer A, Mantel-Teeuwisse AK. Psychiatric medication use before and after the onset of type 1 diabetes in children and adolescents: A population-based cohort study. Pediatr Diabetes 2018; 19:121-128. [PMID: 28436135 DOI: 10.1111/pedi.12529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 03/23/2017] [Accepted: 03/24/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Several studies showed a bidirectional association between type 2 diabetes and psychiatric disorders in adults. Because there is limited information on the association between type 1 diabetes (T1D) and psychiatric disorders (including psychiatric medication use) in children and adolescents, we assessed frequency of use of these medications before and after the onset of T1D. METHODS A population-based cohort study was conducted in the Dutch PHARMO Record Linkage System (1999-2009). Children and adolescents (<19 years) with at least 2 insulin dispensings from community pharmacies (T1D cohort, N = 925) were matched by age and sex (reference cohort without insulin use, N = 3591). The 5-year prevalence of psychiatric medication use (psycholeptics [ATC N05] and psychoanaleptics [ATC N06]) before and after onset of T1D were estimated, compared, and stratified by age, sex, and medication subgroup. RESULTS The mean age of study participants was 10.1 years and 51% were boys. The 5-year prevalence of psychiatric medication use before the index date was significantly higher in the T1D cohort than in the reference cohort (7.2% vs 4.7%, respectively; P = .002) with the same pattern after developing T1D (10.4% vs 7.9%, respectively; P = .015). In both cohorts, adolescents (15-19 years) and boys had higher prevalences of use. This increased prevalence of psychiatric medication use both before and after the index date in T1D cohort was mainly driven by an increased use of psycholeptics (predominantly anxiolytics). CONCLUSIONS Children with T1D were more likely to use psychiatric medication in the years before and after the onset of T1D which was mainly driven by psycholeptic use.
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Affiliation(s)
- Soulmaz Fazeli Farsani
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - Heshu Abdullah-Koolmees
- Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Patrick C Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - Anthonius de Boer
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - Aukje K Mantel-Teeuwisse
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
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32
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Telo GH, Cureau FV, Lopes CS, Schaan BD. Common mental disorders in adolescents with and without type 1 diabetes: Reported occurrence from a countrywide survey. Diabetes Res Clin Pract 2018; 135:192-198. [PMID: 29155124 DOI: 10.1016/j.diabres.2017.10.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/16/2017] [Accepted: 10/26/2017] [Indexed: 01/04/2023]
Abstract
AIMS The aim of this study was to evaluate the frequency of common mental disorders symptoms in adolescents with type 1 diabetes in comparison to a population-based sample of adolescents in Brazil. METHODS We compared characteristics of 116 youth with type 1 diabetes and 73,508 youth without type 1 diabetes from the same population-based sample of adolescents aged 12-17years, taken from the Brazilian Study of Cardiovascular Risk in Adolescents (ERICA). We evaluated the 12-item General Health Questionnaire (GHQ) score, which is a self-administered screening survey for detecting mental health symptoms. Scores ≥3 were used to determine common mental disorder. RESULTS Adolescents with and without type 1 diabetes were comparable with respect to age and race/ethnicity distributions. Youth with type 1 diabetes did not report higher scores on the weighted GHQ analyses in comparison to youth without type 1 diabetes (3.16, SE 0.76 vs. 2.10, SE 0.03, respectively; P = .167). No differences were found regarding the odds of having a GHQ score ≥3 (OR 1.48, 95% CI 0.72-3.08). However, analyses of mental health symptoms separately consistently showed that youth with type 1 diabetes more frequently endorsed mental health barriers in comparison to youth without type 1 diabetes. CONCLUSIONS Mental health symptoms seem to be more frequent than diagnosis of common mental disorders in adolescents with type 1 diabetes, which may also interfere in glycemic control. Our findings highlight the need for appropriate mental health assessment in diabetes care in order to prevent glycemic control deterioration.
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Affiliation(s)
- Gabriela H Telo
- Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Felipe V Cureau
- Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Cláudia S Lopes
- Public Health School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Beatriz D Schaan
- Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
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Sand P, Blom MD, Forsander G, Lundin CS. Family dynamics when a child becomes chronically ill: Impact of type 1 diabetes onset in children and adolescents. NORDIC PSYCHOLOGY 2017. [DOI: 10.1080/19012276.2017.1362990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Peter Sand
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Stora Nygatan 171/2, Göteborg 411 08, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Gun Forsander
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Stora Nygatan 171/2, Göteborg 411 08, Sweden
| | - Carina Sparud Lundin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Anderson BJ, Laffel LM, Domenger C, Danne T, Phillip M, Mazza C, Hanas R, Waldron S, Beck RW, Calvi-Gries F, Mathieu C. Factors Associated With Diabetes-Specific Health-Related Quality of Life in Youth With Type 1 Diabetes: The Global TEENs Study. Diabetes Care 2017; 40:1002-1009. [PMID: 28546221 PMCID: PMC5864137 DOI: 10.2337/dc16-1990] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 04/21/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Our objective was to characterize diabetes-specific health-related quality of life (D-HRQOL) in a global sample of youth and young adults with type 1 diabetes (T1D) and to identify the main factors associated with quality of life. RESEARCH DESIGN AND METHODS The TEENs study was an international, cross-sectional study of youth, 8-25 years of age, with T1D. Participants (N = 5,887) were seen in clinical sites in 20 countries across 5 continents enrolled for 3 predetermined age groups: 8-12, 13-18, and 19-25 years of age. To assess D-HRQOL, participants completed the PedsQL Diabetes Module 3.0 and were interviewed about family-related factors. Specifics about treatment regimen and self-management behaviors were collected from medical records. RESULTS Across all age groups, females reported significantly lower D-HRQOL than did males. The 19-25-year age group reported the lowest D-HRQOL. Multivariate linear regression analyses revealed that D-HRQOL was significantly related to HbA1c; the lower the HbA1c, the better the D-HRQOL. Three diabetes-management behaviors were significantly related to better D-HRQOL: advanced methods used to measure food intake; more frequent daily blood glucose monitoring; and more days per week that youth had ≥30 min of physical activity. CONCLUSIONS In all three age groups, the lower the HbA1c, the better the D-HRQOL, underscoring the strong association between better D-HRQOL and optimal glycemic control in a global sample of youth and young adults. Three diabetes-management behaviors were also related to optimal glycemic control, which represent potentially modifiable factors for clinical interventions to improve D-HRQOL as well as glycemic control.
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Affiliation(s)
| | | | | | - Thomas Danne
- Auf der Bult Kinder- und Jugendkrankenhaus, Hannover, Germany
| | - Moshe Phillip
- Institute for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Carmen Mazza
- Hospital de Pediatria J.P. Garrahan, Buenos Aires, Argentina
| | - Ragnar Hanas
- Sahlgrenska Academy, Gothenburg, Sweden.,NU Hospital Group, Uddevalla, Sweden
| | - Sheridan Waldron
- National Children & Young People's Diabetes Network, London, U.K
| | - Roy W Beck
- Jaeb Center for Health Research, Tampa, FL
| | | | - Chantal Mathieu
- Clinical and Experimental Endocrinology, UZ Gasthuisberg, University of Leuven, Leuven, Belgium
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Terrasson J, Terrade F, Somat A, Nivot-Adamiak S, Guitteny MA, de Kerdanet M. Association between quality of life of adolescents with type 1 diabetes and parents’ illness perception as evaluated by adolescents. PSYCHOL HEALTH MED 2017; 23:347-359. [DOI: 10.1080/13548506.2017.1348608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Johanna Terrasson
- Department of Psychology, Centre de Recherche en Psychologie, Cognition et Communication (CRPCC, EA 1285), Rennes, France
| | - Florence Terrade
- Department of Psychology, Centre de Recherche en Psychologie, Cognition et Communication (CRPCC, EA 1285), Rennes, France
| | - Alain Somat
- Department of Psychology, Centre de Recherche en Psychologie, Cognition et Communication (CRPCC, EA 1285), Rennes, France
| | | | | | - Marc de Kerdanet
- Pediatric Endocrinology Unit, University Hospital, Rennes, France
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DeBoer MD, Valdez R, Chernavvsky DR, Grover M, Burt Solorzano C, Herbert K, Patek S. The Impact of Frequency and Tone of Parent-Youth Communication on Type 1 Diabetes Management. Diabetes Ther 2017; 8:625-636. [PMID: 28405895 PMCID: PMC5446384 DOI: 10.1007/s13300-017-0259-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The purpose of this study is to assess the impact of frequency and tone of parent-youth communication on glycemic control as measured by the Family Communication Inventory (FCI). Adolescence provides a unique set of diabetes management challenges, including suboptimal glycemic control. Continued parental involvement in diabetes management is associated with improved HbA1c outcomes; however, diabetes-related conflict within the family can have adverse effects. Although it is clear that communication plays an important role in diabetes outcomes, the specific impact of frequency and tone of such communication is largely understudied. METHODS A total of 110 youths with type 1 diabetes and their parents completed questionnaires assessing diabetes-related adherence, family conflict, and family communication (i.e., frequency and tone) during a routine clinic visit. Routine testing of HbA1c was performed. RESULTS Youth- and parent-reported frequency of communication were unrelated to HbA1c. Instead, greater discrepancies between parents and children on reported frequency of communication (most commonly parents reporting frequent and youth reporting less frequent communication) corresponded with poorer glycemic control and increased family conflict. More positive tone of communication as rated by youth was associated with lower HbA1c. CONCLUSIONS Diabetes-related communication is more complex than conveyed simply by how often children and their parents communicate. Tone of communication and discrepancies in a family's perception of the frequency of communication were better than frequency as predictors of glycemic control. The FCI appears to capture the frequency and tone of diabetes-related communication, though larger-scale studies are warranted to inform future use of this scale.
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Affiliation(s)
- Mark D DeBoer
- Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA.
| | - Rupa Valdez
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Daniel R Chernavvsky
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Monica Grover
- Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA
| | | | - Kirabo Herbert
- Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA
| | - Stephen Patek
- Department of Systems and Information Engineering, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
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Abstract
Type 1 diabetes mellitus (T1DM), also known as autoimmune diabetes, is a chronic disease characterized by insulin deficiency due to pancreatic β-cell loss and leads to hyperglycaemia. Although the age of symptomatic onset is usually during childhood or adolescence, symptoms can sometimes develop much later. Although the aetiology of T1DM is not completely understood, the pathogenesis of the disease is thought to involve T cell-mediated destruction of β-cells. Islet-targeting autoantibodies that target insulin, 65 kDa glutamic acid decarboxylase, insulinoma-associated protein 2 and zinc transporter 8 - all of which are proteins associated with secretory granules in β-cells - are biomarkers of T1DM-associated autoimmunity that are found months to years before symptom onset, and can be used to identify and study individuals who are at risk of developing T1DM. The type of autoantibody that appears first depends on the environmental trigger and on genetic factors. The pathogenesis of T1DM can be divided into three stages depending on the absence or presence of hyperglycaemia and hyperglycaemia-associated symptoms (such as polyuria and thirst). A cure is not available, and patients depend on lifelong insulin injections; novel approaches to insulin treatment, such as insulin pumps, continuous glucose monitoring and hybrid closed-loop systems, are in development. Although intensive glycaemic control has reduced the incidence of microvascular and macrovascular complications, the majority of patients with T1DM are still developing these complications. Major research efforts are needed to achieve early diagnosis, prevent β-cell loss and develop better treatment options to improve the quality of life and prognosis of those affected.
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Ye CY, Jeppson TC, Kleinmaus EM, Kliems HM, Schopp JM, Cox ED. Outcomes That Matter to Teens With Type 1 Diabetes. DIABETES EDUCATOR 2017; 43:251-259. [PMID: 28520550 DOI: 10.1177/0145721717699891] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose The purpose of the study was to describe outcomes that matter to teens with type 1 diabetes. Understanding outcomes that matter to teens could support successful interventions to improve diabetes self-management. Methods Fifty publicly available posts published in the "teen" sections of 2 major diabetes online forums between 2011 and 2013 were analyzed using qualitative research methods. From each post, content and descriptive data (eg, duration of diabetes and age) were collected. Two members of the research team independently used open coding techniques to identify outcomes (defined as impacts or consequences of type 1 diabetes) and organized them into themes and subthemes. A codebook was jointly developed to facilitate the identification of meaningful outcomes from the posts. Results Teens' average age was 15.7 years, and the average time since diabetes diagnosis was 6.3 years. The 3 most commonly mentioned outcomes were (1) interactions with peers ("I want to talk to someone who understands"), (2) emotional well-being ("Diabetes makes me want to cry"), and (3) blood glucose management ("My blood sugar never goes down"). Other identified outcomes included (4) physical well-being, (5) education and motivation of others, (6) family interactions, (7) academic achievement, and (8) interactions with important others such as teachers. Conclusions While teens are concerned about control of their blood glucose, there are many other outcomes that matter to them. Health care providers and diabetes educators may want to consider these other outcomes when motivating teens with type 1 diabetes to improve blood glucose control.
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Affiliation(s)
- Clara Y Ye
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Thor C Jeppson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Ellen M Kleinmaus
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Harald M Kliems
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Jennifer M Schopp
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
| | - Elizabeth D Cox
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Ms Ye, Mr Jeppson, Ms Kleinmaus, Mr Kliems, Ms Schopp, Dr Cox)
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Özyazıcıoğlu N, Avdal EÜ, Sağlam H. A determination of the quality of life of children and adolescents with type 1 diabetes and their parents. Int J Nurs Sci 2017; 4:94-98. [PMID: 31406726 PMCID: PMC6626105 DOI: 10.1016/j.ijnss.2017.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/26/2017] [Indexed: 11/09/2022] Open
Abstract
Objective Type 1 diabetes is a chronic illness which can have a negative effect on the health care and development of children and can put their lives in danger. This descriptive study aimed to determine the quality of life and the factors affecting it of children and adolescents with type 1 diabetes using the Pediatric Quality of Life Inventory (PedsQL). Methods The study was conducted in the Child Endocrinology Unit of a University Hospital in Bursa, Turkey. Totally 64 children eight-12 years and 85 adolescents aged 13–18 with type 1 diabetes and their parents were recruited. HbA1c measurements were obtained from the records of the endocrinology clinicare, which were made once every three months, and the average of the last three measurements was taken in the study. The PedsQL was used to measure quality of life of the children and adolescents. The data was analyzed using SPSS version 20.0 and P < 0.05 was considered significant. The demographic data of the children and parents were analyzed using means and percentiles. Pearson's correlation analysis was used to assess the relationship between two averages. Results Of the sub-groups on the scale, affective and school function scores were somewhat low, and social function scores were high. The quality of life scores of the children and adolescents were found to correlate with those of their parents. A negative correlation was found between HbA1c levels and adolescent quality of life, a positive correlation was found between the child's age and the quality of life of the child and parents, and a negative correlation was found between the number of children in the family and the quality of life of the child and parents. Conclusions An evaluation of the quality of life after a diagnosis of diabetes can be used to assess the problems which may be faced by children and adolescents and to combat these problems.
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Affiliation(s)
- Nurcan Özyazıcıoğlu
- Department of Pediatric Nursing, Faculty of Health Sciences, Uludağ University, Bursa, Turkey
| | - Elif Ünsal Avdal
- Department of Internal Medicine Nursing, Faculty of Health Science, Katip Çelebi University, Izmir, Turkey
| | - Halil Sağlam
- Department of Pediatrics, Pediatric Endocrinology Division, Faculty of Medicine, Uludağ University, Bursa, Turkey
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Lontchi-Yimagou E, Mapa-Tassou C, Dehayem MY, Essi MJ, Saji J, Takogue R, Sobngwi E, Mbanya JC. The effect of free diabetes care on metabolic control and on health-related quality of life among youths with type 1 diabetes in Cameroon. BMJ Open Diabetes Res Care 2017; 5:e000397. [PMID: 28761659 PMCID: PMC5530241 DOI: 10.1136/bmjdrc-2017-000397] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/19/2017] [Accepted: 05/10/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To assess the effect of free diabetes care on metabolic control and on health-related quality of life (HRQoL) of youths living with type 1 diabetes in Cameroon. RESEARCH DESIGN AND METHODS We conducted a clinical audit of a multicenter prospective cohort, performed in three of the nine clinics of the 'Changing Diabetes in Children' (CDiC) project in Cameroon. We collected data on demography, glycemic control, diabetes acute complications, and patients' HRQoL at baseline and after 1 year of follow-up. RESULTS One hundred and four patients (51 female) were included. The mean age was 16±2 years (min-max: 9-18), the mean duration of diabetes was 5±3 years, and the mean HbA1C level was 11.4%±2.7%. A significant reduction in HbA1c (11.4%±2.7% vs 8.7±2.4%), episodes of severe hypoglycemia (27/104 vs 15/104), and episodes of ketoacidosis (31/104 vs 7/104) were observed after 1 year (p<0.05). We did not observe any significant difference in the total HRQoL score (p=0.66). However, we observed a significant decrease in diabetes-associated symptoms (p<0.05). Age, level of education, duration of diabetes, glycemic control, and the presence or absence of diabetes complications did not significantly affect the total HRQoL score. CONCLUSIONS One year after free diabetes care offered through the CDiC project, a significant improvement was observed in glycemic control and acute complications of diabetes, but not in the total score of HRQoL of youths living with type 1 diabetes enrolled in the project.
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Affiliation(s)
- Eric Lontchi-Yimagou
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, The University of Yaoundé I, Yaoundé, Cameroon
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Clarisse Mapa-Tassou
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Mesmin Y Dehayem
- Endocrine and Diabetology Service, National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Marie-José Essi
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Jude Saji
- Public Health Research Institute, University of Montreal, Montreal, Canada
| | - Remy Takogue
- Endocrine and Diabetology Service, National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Eugène Sobngwi
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, The University of Yaoundé I, Yaoundé, Cameroon
- Endocrine and Diabetology Service, National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Jean Claude Mbanya
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, The University of Yaoundé I, Yaoundé, Cameroon
- Endocrine and Diabetology Service, National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
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Cheung R, Young Cureton V, Canham DL. Quality of Life in Adolescents With Type 1 Diabetes Who Participate in Diabetes Camp. J Sch Nurs 2016; 22:53-8. [PMID: 16435931 DOI: 10.1177/10598405060220010901] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Quality of life in adolescents with Type 1 diabetes is a growing area of interest in pediatric research. The complex diabetes regimen imposes challenges for an adolescent. Adolescents diagnosed with diabetes are a group that appears to be at risk for having a poor health-related quality of life. Although research supports the positive relationship of social support and well-being in adolescents, there are few studies discussing quality of life in adolescents that are based on the factor of social support. This study compared the quality of life in adolescents with Type 1 diabetes who have attended at least one diabetes camp to the quality of life of those who have never attended diabetes camp. Results provided evidence of the value of social support.
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Affiliation(s)
- Ruth Cheung
- Fremont Unified School District, Fremont, CA, USA
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Thompson D, Cullen KW, Redondo MJ, Anderson B. Use of Relational Agents to Improve Family Communication in Type 1 Diabetes: Methods. JMIR Res Protoc 2016; 5:e151. [PMID: 27468762 PMCID: PMC4981691 DOI: 10.2196/resprot.5817] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/06/2016] [Indexed: 11/25/2022] Open
Abstract
Background Physiological and environmental risk factors interact to undermine blood glucose control during early adolescence. This has been documented to be associated with family conflict and poor adherence to diabetes management tasks. Family Teamwork is an efficacious program demonstrated to enhance family communication and reduce conflict during this vulnerable period. It was designed to be delivered to families in-person, which limited reach and potential impact. Objective The purpose of this paper is to present the protocol for adapting Family Teamwork for Web-based delivery. Methods Formative research with health care providers, parents, and adolescents will help modify Family Teamwork for Web-based delivery by a relational agent (ie, a computerized character with human-like features and actions). Sessions will be interactive, requiring both parent and adolescent participation, with the relational agent serving as a health coach. After programming, usability testing will be conducted to help ensure the program is easy to use. Video and instructional materials will be developed to facilitate use, and a small pilot study will be conducted to assess feasibility. Families will provide written informed consent prior to participation in any phase of the study. The Institutional Review Board at Baylor College of Medicine reviewed and approved the protocol (H-37245). Results Formative research is underway. No results are available at this time. Conclusions This research has the potential to make an important contribution to diabetes management by using technology to enhance the reach of an efficacious program.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.
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Zysberg L, Bar Yoseph T, Goldman M. Emotional intelligence and glycemic management among type I diabetes patients. J Health Psychol 2016; 22:158-163. [PMID: 26227497 DOI: 10.1177/1359105315596373] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Type 1 diabetes is a lifelong physical and emotional challenge. The concept of emotional intelligence may offer better understanding of personal resources facilitating management of such challenges. We therefore hypothesized that emotional intelligence will negatively associate with two measures of diabetic management: HA1c and blood sugar levels. A total of 78 young adults with type 1 diabetes mellitus reported their last HA1c test result and their blood sugar level, as well as demographics and took the audio-visual test of emotional intelligence. The results showed a negative association between emotional intelligence and HA1c and marginal results in the same direction with blood sugar levels even when controlling for demographics.
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Petersson C, Huus K, Enskär K, Hanberger L, Samulesson U, Åkesson K. Impact of Type 1 Diabetes on Health-Related Quality of Life Among 8–18-Year-Old Children. Compr Child Adolesc Nurs 2016. [DOI: 10.1080/24694193.2016.1196265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Lukács A, Sasvári P, Török A, Barkai L. Generic and disease-specific quality of life in adolescents with type 1 diabetes: comparison to age-matched healthy peers. J Pediatr Endocrinol Metab 2016; 29:769-75. [PMID: 27166715 DOI: 10.1515/jpem-2015-0397] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 03/29/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study aimed to evaluate the health-related quality of life (HRQoL) of adolescents with type 1 diabetes (T1DM) on the basis of the pediatric quality of life inventory™ (PedsQL™) generic and diabetes-specific modules, and to compare it to that of healthy peers. METHODS This retrospective case-control study involved 650 participants between ages of 13 and 19 years including 296 adolescents with T1DM from four diabetes centers and 354 healthy peers matched for age and gender from three different cities of the country. Participants completed the validated PedsQL™ for assessing the HRQoL. The analysis included an independent t-test to compare the means of the total and subscales of the PedsQL™ between boys and girls as well as between a healthy group and a group with T1DM. Gender differences in exercise, insulin therapy modalities were evaluated with the Pearson χ2-test. RESULTS Adolescents with T1DM have similar HRQoL in all domains when compared to their healthy counterparts. Females report worse HRQoL regardless of the presence of the disease. Insulin pump therapy facilitates better glycemic control and HRQoL. Regular exercise positively correlates with the generic HRQoL in both groups; however, it has no relationship with glycemic control. CONCLUSIONS Optimal metabolic control and improved HRQoL are the eventual goals of diabetes management. Despite the difficulties, adolescents with diabetes can manage their disease well and live normal lives, similar to their healthy peers. Although diabetes-related problems exist, it seems that regular exercise and staying physically active, as well as promoting insulin pump therapy where it is applicable are related to favorable HRQoL.
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Minges KE, Whittemore R, Chao AM, Jefferson V, Murphy KM, Grey M. Clinical, Psychosocial, and Demographic Factors Are Associated With Overweight and Obesity in Early Adolescent Girls With Type 1 Diabetes. DIABETES EDUCATOR 2016; 42:538-48. [PMID: 27302183 DOI: 10.1177/0145721716654006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE The purpose of the study was to examine the differences in clinical, psychosocial, and demographic factors by sex and weight status. METHODS Baseline data were analyzed from 318 adolescents (mean age = 12.3 ± 1.1 years, 55.0% female, 62.7% white) with type 1 diabetes (T1D) from a multisite clinical trial. Differences were examined between normal weight (body mass index ≥5th and <85th percentile) and overweight/obese (body mass index ≥85th percentile) boys and girls with T1D in clinical, psychosocial, and demographic factors. Descriptive and multiple logistic regression analyses were used. RESULTS Overweight/obesity was prevalent (39.0%) and common in girls (42.6%) and boys (33.1%). In bivariate analyses, overweight/obese girls had parents with lower educational attainment, longer diabetes duration, and significantly worse self-management and psychosocial health as compared with normal weight girls. There were no differences between overweight/obese and normal weight girls in A1C, therapy type, race/ethnicity, or household income. No significant differences were found between normal weight and overweight/obese boys. In multivariate analysis, parental educational attainment (master or higher vs high school diploma or less) and perceived stress were significantly associated with overweight/obesity in girls. Longer duration of T1D bordered statistical significance. CONCLUSIONS Overweight/obesity is prevalent among adolescents with T1D. Clinical, psychosocial, and demographic factors are associated with overweight/obesity in girls but not boys. Greater attention to weight status and aspects of health that are germane to adolescents with T1D is warranted.
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Affiliation(s)
- Karl E Minges
- School of Nursing, Yale University, Orange, Connecticut, USA (Dr Minges, Dr Whittemore, Ms Jefferson, Dr Grey)
| | - Robin Whittemore
- School of Nursing, Yale University, Orange, Connecticut, USA (Dr Minges, Dr Whittemore, Ms Jefferson, Dr Grey)
| | - Ariana M Chao
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA (Dr Chao),Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA (Dr Chao)
| | - Vanessa Jefferson
- School of Nursing, Yale University, Orange, Connecticut, USA (Dr Minges, Dr Whittemore, Ms Jefferson, Dr Grey)
| | - Kathryn M Murphy
- The Children's Hospital of Philadelphia, Pennsylvania, USA (Dr Murphy)
| | - Margaret Grey
- School of Nursing, Yale University, Orange, Connecticut, USA (Dr Minges, Dr Whittemore, Ms Jefferson, Dr Grey)
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Samardzic M, Tahirovic H, Popovic N, Popovic-Samardzic M. Health-related quality of life in children and adolescents with type 1 diabetes mellitus from Montenegro: relationship to metabolic control. J Pediatr Endocrinol Metab 2016; 29:663-8. [PMID: 27054599 DOI: 10.1515/jpem-2015-0420] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/22/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim of this study was to evaluate health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes (TIDM) in Montenegro compared with healthy controls and to estimate the effect of metabolic control on perceptions of HRQOL. METHODS This study involved children and adolescents with T1DM, age- and gender-matched healthy children and their parents. Children and adolescents with T1DM and their parents completed Peds QL 4.0 Generic Core Scales (GCS) and PedsQL 3.0 Diabetes Module. Healthy children and their parents completed self- and proxy-report of Peds QL 4.0 GCS. RESULTS Our study (self- and proxy-report) showed that children and adolescents with T1DM had lower HRQOL on domain "Psychosocial health" and "School functioning" compared with healthy population (p=0.008; p≤0.001). Lower glycosylated hemoglobin (HbAlc) values were associated with fewer worries, and better health perception by diabetic children and their parents. We did not find notable differences between boys and girls on health perception. Different age groups reported similar QOL. Parents reported that the illness has a greater impact on children's lives than the children reported themselves. CONCLUSIONS Compared with the healthy children, the HRQOL was lower among children and adolescents with T1DM. Lower HbA1c was associated with better quality of life.
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Caferoğlu Z, İnanç N, Hatipoğlu N, Kurtoğlu S. Health-Related Quality of Life and Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus. J Clin Res Pediatr Endocrinol 2016; 8:67-73. [PMID: 26758371 PMCID: PMC4805051 DOI: 10.4274/jcrpe.2051] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The burdens imposed on a child and his/her parents by a diagnosis of type 1 diabetes mellitus (T1DM) adversely affect their health-related quality of life (HRQoL). HRQoL is important for prognosis and is related to metabolic control. To evaluate the HRQoL of Turkish children and adolescents with T1DM and to assess the correlation of HRQoL subscales (including physical and psychosocial health) with metabolic control, and particularly with hypo- and hyperglycaemic episodes. METHODS This cross-sectional study included 70 participants with T1DM aged between 8 and 18 years (study group) and 72 healthy controls who were matched to the study group in terms of age, gender, and sociodemographic characteristics (control group), and their parents. HRQoL was determined by the Pediatric Quality of Life Inventory. As an indicator of metabolic control, the most recent hemoglobin A1c (HbA1c) levels were obtained and the number of hypo- and hyperglycaemic episodes over the past one month were checked. RESULTS The study group had similar HRQoL scores for children's self-reports and parents' proxy-reports to the control group apart from a decreasing psychosocial health score for parents' proxy-reports in the study group. Although HbA1c level was not related to HRQoL scores, lower number of hypo- and hyperglycaemic episodes were associated with an increase in psychosocial health scores and physical health scores as well as an increase in the total score for parents' proxy-reports. CONCLUSION Although there was no correlation between metabolic control and HRQoL in children's self-reports, the improving HRQoL levels in parents' proxy-reports were associated with good metabolic control.
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Affiliation(s)
- Zeynep Caferoğlu
- Erciyes University Faculty of Health Science, Department of Nutrition and Dietetics, Kayseri, Turkey, E-mail: ,
| | - Neriman İnanç
- Nuh Naci Yazgan University Faculty of Health Science, Department of Nutrition and Dietetics, Kayseri, Turkey
| | - Nihal Hatipoğlu
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Kayseri, Turkey
| | - Selim Kurtoğlu
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Kayseri, Turkey
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Nieuwesteeg AM, Hartman EE, Aanstoot HJ, van Bakel HJA, Emons WHM, van Mil E, Pouwer F. The relationship between parenting stress and parent-child interaction with health outcomes in the youngest patients with type 1 diabetes (0-7 years). Eur J Pediatr 2016; 175:329-38. [PMID: 26438336 PMCID: PMC4757610 DOI: 10.1007/s00431-015-2631-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 08/23/2015] [Accepted: 08/31/2015] [Indexed: 10/30/2022]
Abstract
UNLABELLED To test whether parenting stress and the quality of parent-child interaction were associated with glycemic control and quality of life (QoL) in young children (0-7 years) with type 1 diabetes (T1DM), we videotaped 77 families with a young child with T1DM during mealtime (including glucose monitoring and insulin administration). Parent-child interactions were scored with a specifically designed instrument. Questionnaires assessed general and disease-related parenting stress and (diabetes-specific (DS)) QoL. HbA(1c) (glycemic control) was extracted from the medical records. Both general and disease-related parenting stress were associated with a lower (DS)QoL (r ranged from -0.39 to -0.70, p < 0.05), but not with HbA(1c) levels. Furthermore, with regard to the parent-child interaction, emotional involvement of parents (r = 0.23, p < 0.05) and expressed discomfort of the child (r = 0.23, p < 0.05) were related to suboptimal HbA(1c) levels. There was no clear pattern in the correlations between parent-child interaction and (DS)QoL. CONCLUSION The results support the notion that diabetes does not only affect the child with T1DM: T1DM is a family disease, as parenting factors (like stress and parent-child interactions) are associated with important child outcomes. Therefore, it is important for health-care providers to not only focus on the child with T1DM, but also on the family system.
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Affiliation(s)
- Anke M Nieuwesteeg
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
| | - Esther E Hartman
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
| | | | - Hedwig J A van Bakel
- Department of TRANZO, Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands.
| | - Wilco H M Emons
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
- Department of Methodology and Statistics, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands.
| | - Edgar van Mil
- Kidz&Ko, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands.
| | - Frans Pouwer
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
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Butwicka A, Fendler W, Zalepa A, Szadkowska A, Zawodniak-Szalapska M, Gmitrowicz A, Mlynarski W. Psychiatric Disorders and Health-Related Quality of Life in Children With Type 1 Diabetes Mellitus. PSYCHOSOMATICS 2016; 57:185-93. [DOI: 10.1016/j.psym.2015.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 10/29/2015] [Accepted: 10/30/2015] [Indexed: 11/30/2022]
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