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Snoek FJ, Anarte-Ortiz MT, Anderbro T, Cyranka K, Hendrieckx C, Hermanns N, Indelicato L, McGuire BE, Mocan A, Nefs G, Polonsky WH, Stewart R, Vallis M. Roles and competencies of the clinical psychologist in adult diabetes care-A consensus report. Diabet Med 2024; 41:e15312. [PMID: 38385984 DOI: 10.1111/dme.15312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 02/23/2024]
Abstract
AIMS Psychological care is recognised as an integral part of quality diabetes care. We set out to describe the roles and competencies of the clinical psychologist as a member of the multidisciplinary adult diabetes care team, focused on secondary care. METHODS The authors are clinically experienced psychologists involved in adult diabetes care, from Australia, Europe and North America, and active members of the international psychosocial aspects of diabetes study group. Consensus was reached as a group on the roles and competencies of the clinical psychologist working in adult diabetes secondary care, building both on expert opinion and a selective review and discussion of the literature on psychological care in diabetes, clinical guidelines and competency frameworks. RESULTS The clinical psychologist fulfils multiple roles: (1) as a clinician (psychological assessment and therapy), (2) as advisor to the healthcare team (training, consulting), (3) as a communicator and promotor of person-centred care initiatives and (4) as a researcher. Four competencies that are key to successfully fulfilling the above-mentioned roles in a diabetes setting are as follows: (a) specialised knowledge, (b) teamwork and advice, (c) assessment, (d) psychotherapy (referred to as STAP framework). CONCLUSIONS The roles and competencies of clinical psychologists working in diabetes extend beyond the requirements of most university and post-graduate curricula. There is a need for a comprehensive, accredited specialist post-graduate training for clinical psychologists working in diabetes care, building on the proposed STAP framework. This calls for a collaborative effort involving diabetes organisations, clinical psychology societies and diabetes psychology interest groups.
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Affiliation(s)
- Frank J Snoek
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Maria Teresa Anarte-Ortiz
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Málaga, Spain
- Departamento de Personalidad, Evaluacion y Tratamiento Psicologico, Instituto de Investigación Biomedica de Málaga (IBIMA), Málaga, Spain
| | - Therese Anderbro
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Katarzyna Cyranka
- Department of Psychiatry, Jagiellonian University Medical College, Krakow, Poland
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Christel Hendrieckx
- The Australian Centre for Behavioural Research in Diabetes, Carlton, Victoria, Australia
- School of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Norbert Hermanns
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
- Department of Clinical Psychology, Psychotherapy of the University of Bamberg, Bamberg, Germany
| | - Liliana Indelicato
- Divission od Endocrinology, Diabetes and Metabolic Diseases, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Brian E McGuire
- School of Psychology, University of Galway and Centre for Diabetes, Endocrinology & Metabolism, Galway University Hospital, Galway, Ireland
| | - Andreia Mocan
- Center for Diabetes, Nutrition and Metabolic Diseases, Emergency Clinical County Hospital, Cluj-Napoca, Romania
| | - Giesje Nefs
- Department of Medical Psychology, Radboud UMC, Nijmegen, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Diabeter, National Treatment and Research Center for Children, Adolescents and Adults with Type 1 Diabetes, Rotterdam, The Netherlands
| | - William H Polonsky
- Behavioral Diabetes Institute, San Diego, California, USA
- Department of Medicine, University of California, San Diego, California, USA
| | - Rose Stewart
- Betsi Cadwaladr University Health Board, Hospitals and Health Care, North Wales, UK
| | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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de Wit M, van Raalte DH, van den Berg K, Racca C, Muijs LT, Lutgers HL, Siegelaar SE, Serné E, Snoek FJ. Glucose variability and mood in people with type 1 diabetes using ecological momentary assessment. J Psychosom Res 2023; 173:111477. [PMID: 37643560 DOI: 10.1016/j.jpsychores.2023.111477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Mood fluctuations related to blood glucose excursions are a commonly reported source of diabetes-distress, but research is scarce. We aimed to assess the relationship between real-time glucose variability and mood in adults with type 1 diabetes (T1D) using ecological momentary assessments. METHODS In this prospective observational study, participants wore a masked continuous glucose monitor and received prompts on their smartphone 6 times a day to answer questions about their current mood (Profile Of Mood States (POMS)-SF (dimensions: Anxiety, Depressive symptoms, Anger, Fatigue, Vigor)) for 14 days. Mixed model analyses examined associations over time between daily Coefficient of Variation (CV) of blood glucose and mean and variability (CV) of POMS scores. Further, within-person differences in sleep and nocturnal hypoglycemia were explored. RESULTS 18 people with T1D (10 female, mean age 44.3 years) participated. A total of 264 out of 367 days (70.2%) could be included in the analyses. No overall significant associations were found between CV of blood glucose and mean and CV of POMS scores, however, nocturnal hypoglycemia moderated the associations between CV of blood glucose and POMS scales (mean Fatigue Estimate 1.998, p < .006, mean Vigor Estimate -3.308, p < .001; CV Anger Estimate 0.731p = 0.02, CV Vigor Estimate -0.525, p = .006). CONCLUSION We found no overall relationship between real-time glycemic variability and mood per day. Further research into within-person differences such as sleep and nocturnal hypoglycemia is warranted.
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Affiliation(s)
- Maartje de Wit
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Medical Psychology, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands.
| | - Daniël H van Raalte
- Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands; Amsterdam UMC, location Vrije Universiteit Amsterdam, Endocrinology and Metabolism, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, location Vrije Universiteit Amsterdam, Vasculair Medicine, de Boelelaan 1117, Amsterdam, the Netherlands; Diabetes Center Amsterdam UMC, location Vrije Universiteit Amsterdam, Vasculair Medicine, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Cardiovasculair Science, Amsterdam, the Netherlands
| | - Kirsten van den Berg
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Medical Psychology, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
| | - Catherina Racca
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Endocrinology and Metabolism, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Linda T Muijs
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Medical Psychology, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
| | - Helen L Lutgers
- Medical Center Leeuwarden, Department of Internal Medicine, Leeuwarden, the Netherlands
| | - Sarah E Siegelaar
- Amsterdam UMC, location University of Amsterdam, Department of Endocrinology and Metabolism, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands
| | - Erik Serné
- Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands; Amsterdam UMC, location Vrije Universiteit Amsterdam, Endocrinology and Metabolism, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, location Vrije Universiteit Amsterdam, Vasculair Medicine, de Boelelaan 1117, Amsterdam, the Netherlands; Diabetes Center Amsterdam UMC, location Vrije Universiteit Amsterdam, Vasculair Medicine, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Cardiovasculair Science, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Medical Psychology, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
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Jancev M, Snoek FJ, Frederix GWJ, Knottnerus H, Blauw H, Witkop M, Moons KGM, van Bon AC, DeVries JH, Serné EH, van Sloten TT, de Valk HW. Dual hormone fully closed loop in type 1 diabetes: a randomised trial in the Netherlands - study protocol. BMJ Open 2023; 13:e074984. [PMID: 37612114 PMCID: PMC10450048 DOI: 10.1136/bmjopen-2023-074984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Abstract
INTRODUCTION The management of type 1 diabetes (T1DM) has undergone significant advancements with the availability of novel technologies, notably continuous and flash glucose monitoring (CGM and FGM, respectively) and hybrid closed loop (HCL) therapy. The dual hormone fully closed loop (DHFCL) approach with insulin and glucagon infusion has shown promising effects in small studies on glycaemic regulation and quality of life in T1DM. METHODS AND ANALYSIS The Dual Hormone Fully Closed Loop for Type 1 Diabetes (DARE) study is a non-commercial 12-month open-label, two-arm randomised parallel-group trial. The primary aim of this study is to determine the long-term effects on glycaemic control, patient-reported outcome measurements and cost-effectiveness of the DHFCL compared with usual care, that is, HCL or treatment with multiple daily insulin injections+FGM/CGM. We will include 240 adult patients with T1DM in 14 hospitals in the Netherlands. Individuals will be randomised 1:1 to the DHFCL or continuation of their current care. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Medical Research Ethics Committee NedMec, Utrecht, the Netherlands. Findings will be disseminated through peer-reviewed publications and presentations at local, national and international conferences. TRIAL REGISTRATION NUMBER NCT05669547.
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Affiliation(s)
- Milena Jancev
- Vascular Medicine and Endocrinology, UMC Utrecht, Utrecht, The Netherlands
| | - Frank J Snoek
- Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Geert W J Frederix
- Epidemiology & Health Economics, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | | | | | - Karel G M Moons
- Epidemiology & Health Economics, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Arianne C van Bon
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - J Hans DeVries
- Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Erik H Serné
- Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Harold W de Valk
- Vascular Medicine and Endocrinology, UMC Utrecht, Utrecht, The Netherlands
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Embaye J, Bassi G, Dingemans AE, Doesborg L, Snoek FJ, de Wit M. Associations between disordered eating behaviour, diabetes distress and emotion regulation strategies in adults with type 1 diabetes: results from a Dutch-Italian cross-sectional study. Diabet Med 2023:e15122. [PMID: 37078998 DOI: 10.1111/dme.15122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/06/2023] [Accepted: 04/18/2023] [Indexed: 04/21/2023]
Abstract
AIMS Disordered eating behaviour (DEB) and diabetes distress are prevalent in adults with type 1 diabetes (T1D). Emotion regulation strategies, such as cognitive reappraisal and expressive suppression, are associated with DEB and managing stress in general. Here we examine the associations between DEB, diabetes distress, and emotion regulation strategies in the context of T1D. METHODS Adults with T1D in The Netherlands and Italy completed an online survey, covering DEB (DEPS-R), diabetes distress (PAID-5), and emotion regulation strategies (ERQ). Associations between DEB, diabetes distress, and emotion regulation strategies were examined using path analysis. RESULTS N = 291 participants completed the survey (78.9% women, 39±13 years, HbA1c: 55±16 mmol/mol (7.2% (3.6%)); TIR: 66%±25). N = 79 participants (27.1%) reported DEB (DEPS-R≥20) and n = 159 participants (54.6%) reported elevated diabetes distress (PAID-5≥8). The path analysis, with small-to-medium effect sizes, revealed that higher diabetes distress was associated with more DEB (β = .23, 95% CI [.13, .34]). Lower diabetes distress was associated with more use of cognitive reappraisal (β = -.24, 95% CI [-.36, -.12]). More DEB was associated with more use of expressive suppression (β = .14, 95% CI [.04, .24]). CONCLUSIONS This cross-sectional study suggests an association between DEB and diabetes distress, between cognitive reappraisal and less diabetes distress and between expressive suppression and more DEB. The results suggest that it may prove beneficial to prioritize strengthening emotion regulation strategies in interventions for people with T1D and DEB. Future research should help clarify causality with regard to emotion regulation and DEB in adults with T1D.
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Affiliation(s)
- Jiska Embaye
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, 1081, HV, Amsterdam, Netherlands
| | - Giulia Bassi
- University of Padova, Department Of Developmental And Socialization Psychology, Padova, Italy
| | | | - Loes Doesborg
- Rivierduinen Eating Disorders Ursula, 2333 ZZ, Leiden, Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, 1081, HV, Amsterdam, Netherlands
| | - Maartje de Wit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, 1081, HV, Amsterdam, Netherlands
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Serné EH, van den Berg IK, Racca C, van Raalte DH, Kramer MHH, de Wit M, Snoek FJ. Improved Effectiveness of Immediate Continuous Glucose Monitoring in Hypoglycemia-Prone People with Type 1 Diabetes Compared with Hypoglycemia-Focused Psychoeducation Following a Previous Structured Education: A Randomized Controlled Trial. Diabetes Technol Ther 2023; 25:50-61. [PMID: 36326825 DOI: 10.1089/dia.2022.0232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective: Stepped-care has been suggested in the management of patients with problematic hypoglycemia and impaired awareness of hypoglycemia (IAH), initially with psychoeducational programs based on blood glucose awareness training, progressing to diabetes technology in those with persisting need. We examined the clinical effectiveness of stepped-care starting with HypoAware and adding continuous glucose monitoring (CGM) as needed, versus immediate CGM in type 1 diabetes patients with problematic hypoglycemia despite previous structured education in insulin adjustment. Research Design and Methods: A randomized controlled trial (N = 52, mean age 53, 56% females). The stepped-care group attended HypoAware. If a severe hypoglycemic event (SHE) had occurred or IAH was still present after 6 months, CGM was initiated. The control group started immediate CGM. Primary endpoint was the number of participants with self-reported SHE. Secondary outcomes, evaluated at 6 and 12 months, were glycated hemoglobin (HbA1c), the number of participants with IAH time below range (TBR; <54 mg/dL), and patient-reported outcomes (PROs). Results: At 6 months, the number of patients reporting SHE had decreased significantly more in the CGM group: -39% (P < 0.05). HbA1c decreased more in the CGM group (-0.47 percentage-points, P < 0.05). IAH was restored in 31% of patients in both groups. TBR (<54 mg/dL) was lower in the CGM group (-2.4 percentage-points, P < 0.05). In the stepped-care group, 93% started CGM/intermittently scanned CGM. At 12 months, the number of patients reporting SHE was still higher in the stepped-care group. No differences were found in PROs. Conclusions: Immediate start of CGM is more effective than a hypoglycemia-focused reeducation program in reducing SHE risk and attaining glycemic targets in individuals with problematic hypoglycemia and IAH despite previous education in insulin dose adjustment. Trial registration: Netherlands Trial Register, NL64474.029.18.
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Affiliation(s)
- Erik H Serné
- Department of Internal Medicine, Diabetes Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingrid Kirsten van den Berg
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Caterina Racca
- Department of Internal Medicine, Diabetes Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniël H van Raalte
- Department of Internal Medicine, Diabetes Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mark H H Kramer
- Department of Internal Medicine, Diabetes Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maartje de Wit
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Snoek FJ. Mental health in diabetes care. Time to step up. Front Clin Diabetes Healthc 2022; 3:1039192. [PMID: 36992782 PMCID: PMC10012141 DOI: 10.3389/fcdhc.2022.1039192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022]
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Harreiter J, Mendoza LC, Simmons D, Desoye G, Devlieger R, Galjaard S, Damm P, Mathiesen ER, Jensen DM, Andersen LLT, Dunne F, Lapolla A, Dalfra MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Hill D, Jelsma JGM, Snoek FJ, Worda C, Bancher-Todesca D, van Poppel MNM, Corcoy R, Kautzky-Willer A. Vitamin D3 Supplementation in Overweight/Obese Pregnant Women: No Effects on the Maternal or Fetal Lipid Profile and Body Fat Distribution-A Secondary Analysis of the Multicentric, Randomized, Controlled Vitamin D and Lifestyle for Gestational Diabetes Prevention Trial (DALI). Nutrients 2022; 14:nu14183781. [PMID: 36145157 PMCID: PMC9503968 DOI: 10.3390/nu14183781] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022] Open
Abstract
Vitamin D deficiency is a common finding in overweight/obese pregnant women and is associated with increased risk for adverse pregnancy outcome. Both maternal vitamin D deficiency and maternal obesity contribute to metabolic derangements in pregnancy. We aimed to assess the effects of vitamin D3 supplementation in pregnancy versus placebo on maternal and fetal lipids. Main inclusion criteria were: women <20 weeks’ gestation, BMI ≥ 29 kg/m2. Eligible women (n = 154) were randomized to receive vitamin D3 (1600 IU/day) or placebo. Assessments were performed <20, 24−28 and 35−37 weeks and at birth. Linear regression models were used to assess effects of vitamin D on maternal and cord blood lipids. In the vitamin D group significantly higher total 25-OHD and 25-OHD3 levels were found in maternal and cord blood compared with placebo. Adjusted regression models did not reveal any differences in triglycerides, LDL-C, HDL-C, free fatty acids, ketone bodies or leptin between groups. Neonatal sum of skinfolds was comparable between the two groups, but correlated positively with cord blood 25-OH-D3 (r = 0.34, p = 0.012). Vitamin D supplementation in pregnancy increases maternal and cord blood vitamin D significantly resulting in high rates of vitamin D sufficiency. Maternal and cord blood lipid parameters were unaffected by Vitamin D3 supplementation.
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Affiliation(s)
- Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40400-43120
| | - Lilian C. Mendoza
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08025 Barcelona, Spain
| | - David Simmons
- Macarthur Clinical School, Western Sydney University, Sydney 2560, Australia
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria
| | - Roland Devlieger
- Department of Development and Regeneration, KU Leuven, University Leuven, 3000 Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Obstetrics, Gynecology and Fertility, GZA Sint-Augustinus, 2610 Wilrijk, Belgium
| | - Sander Galjaard
- Department of Development and Regeneration, KU Leuven, University Leuven, 3000 Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Elisabeth R. Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Dorte M. Jensen
- Steno Diabetes Center Odense, Odense University Hospital, 5000 Odense, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, Faculty of Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Lise Lotte T. Andersen
- Department of Gynaecology and Obstetrics, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, Faculty of Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Fidelma Dunne
- Clinical Research Facility (CRF) and National University of Ireland, H91 TK33 Galway, Ireland
| | - Annunziata Lapolla
- Department of Medicine, Universita Degli Studi di Padova, 35128 Padova, Italy
| | - Maria G. Dalfra
- Department of Medicine, Universita Degli Studi di Padova, 35128 Padova, Italy
| | | | - Ewa Wender-Ozegowska
- Department of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, 60-525 Poznan, Poland
| | - Agnieszka Zawiejska
- Department of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, 60-525 Poznan, Poland
| | - David Hill
- Lawson Health Research Institute, London, ON N6A 4V2, Canada
| | - Judith G. M. Jelsma
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
| | - Frank J. Snoek
- Amsterdam UMC, Department of Medical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Christof Worda
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Dagmar Bancher-Todesca
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Mireille N. M. van Poppel
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Rosa Corcoy
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08025 Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria
- Gender Institute, La Pura, 3571 Gars am Kamp, Austria
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Brouwer A, van de Ven PM, Kok A, Snoek FJ, Beekman ATF, Bremmer MA. Symptoms of depression and insomnia in older age: A within-individual analysis over 20 years. J Am Geriatr Soc 2022; 70:2051-2059. [PMID: 35383906 PMCID: PMC9541249 DOI: 10.1111/jgs.17765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022]
Abstract
Background Depression and insomnia often co‐occur, and precede one another. Possibly, insomnia gives rise to depression, and vice versa. We tested whether insomnia symptoms of an older individual are associated with later depressive symptoms in that older individual, and vice versa. Methods We performed a longitudinal analysis of data from a prospective cohort study in a large sample of community‐dwelling older people (N = 3081), with measurements every three years, over a time period of 20 years. The within‐individual longitudinal reciprocal relationship between symptoms of depression (Center for Epidemiological Studies Depression Scale), and symptoms of insomnia (three‐item questionnaire, including difficulty initiating sleep, nightly awakenings, and early morning awakening) was modeled by means of a bivariate linear growth model. We tested whether symptoms of insomnia were associated with symptoms of depression three years later, and vice versa. Results Severity of symptoms of depression and insomnia and their within‐individual average change over time were moderately correlated (correlation of intercepts: rho 0.41, 95% CI: 0.36 to 0.46 p < 0.001; correlation of slopes: rho 0.39, 95% CI: 0.25 to 0.52, p < 0.001). Symptoms of depression were not found to be associated with an additional risk of higher symptoms of insomnia three years later, and vice versa (p = 0.329 and p = 0.919, respectively). Similar results were found when analyses were corrected for covariates. Conclusions In older individuals, depression and insomnia are associated and tend to increase concurrently over time, but constitute no additional risk for one another over repeated three‐year intervals. These findings contradict previous research that suggests that depression and insomnia are risk factors for one another over time. The current study stands out due to the longitudinal within‐individual statistical approach, but is limited by the three‐year interval between measures.
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Affiliation(s)
- Annelies Brouwer
- Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands.,Department of Research and Innovation, GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Peter M van de Ven
- Amsterdam UMC, Vrije Universiteit, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Almar Kok
- Amsterdam UMC, Vrije Universiteit, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, the Netherlands.,Department of Sociology, VU University, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Vrije Universiteit and University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands.,Department of Research and Innovation, GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Marijke A Bremmer
- Amsterdam UMC, Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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9
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Acosta-Manzano P, Leopold-Posch B, Simmons D, Devlieger R, Galjaard S, Corcoy R, Adelantado JM, Dunne F, Harreiter J, Kautzky-Willer A, Damm P, Mathiesen ER, Jensen DM, Andersen LL, Tanvig M, Lapolla A, Dalfra MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Hill DJ, Snoek FJ, Jelsma J, Desoye G, van Poppel M. The unexplored role of sedentary time and physical activity in glucose and lipid metabolism-related placental mRNAs in pregnant women who are obese: the DALI lifestyle randomised controlled trial. BJOG 2022; 129:708-721. [PMID: 34559946 DOI: 10.1111/1471-0528.16945] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE We aimed to explore: (i) the association of sedentary time (ST) and physical activity (PA) during pregnancy with the placental expression of genes related to glucose and lipid metabolism in pregnant women who are obese; (ii) maternal metabolic factors mediating changes in these placental transcripts; and (iii) cord blood markers related to the mRNAs mediating neonatal adiposity. DESIGN Multicentre randomised controlled trial. SETTING Hospitals in nine European countries. POPULATION A cohort of 112 pregnant women with placental tissue. METHODS Both ST and moderate-to-vigorous PA (MVPA) levels were measured objectively using accelerometry at three time periods during pregnancy. MAIN OUTCOME MEASURES Placental mRNAs (FATP2, FATP3, FABP4, GLUT1 and PPAR-γ) were measured with NanoString technology. Maternal and fetal metabolic markers and neonatal adiposity were assessed. RESULTS Longer periods of ST, especially in early to middle pregnancy, was associated with lower placental FATP2 and FATP3 expression (P < 0.05), whereas MVPA at baseline was inversely associated with GLUT1 mRNA (P = 0.02). Although placental FATP2 and FATP3 expression were regulated by the insulin-glucose axis (P < 0.05), no maternal metabolic marker mediated the association of ST/MVPA with placental mRNAs (P > 0.05). Additionally, placental FATP2 expression was inversely associated with cord blood triglycerides and free fatty acids (FFAs; P < 0.01). No cord blood marker mediated neonatal adiposity except for cord blood leptin, which mediated the effects of PPAR-γ on neonatal sum of skinfolds (P < 0.05). CONCLUSIONS In early to middle pregnancy, ST is associated with the expression of placental genes linked to lipid transport. PA is hardly related to transporter mRNAs. Strategies aimed at reducing sedentary behaviour during pregnancy could modulate placental gene expression, which may help to prevent unfavourable fetal and maternal pregnancy outcomes. TWEETABLE ABSTRACT Reducing sedentary behaviour in pregnancy might modulate placental expression of genes related to lipid metabolism in women who are obese.
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Affiliation(s)
- P Acosta-Manzano
- PA-HELP 'Physical Activity for Health Promotion, CTS-1018' Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
| | - B Leopold-Posch
- Department of Obstetrics and Gynaecology, Medical University Graz, Graz, Austria
| | - D Simmons
- Western Sydney University, Campbelltown, New South Wales, Australia
| | - R Devlieger
- Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - S Galjaard
- Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, KU Leuven, University Hospitals Leuven, Leuven, Belgium
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - R Corcoy
- CIBER Bioengineering, Biomaterials and Nanomedicine, Instituto de Salud Carlos III, Zaragoza, Spain
| | - J M Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - F Dunne
- Galway Diabetes Research Centre (GDRC) and National University of Ireland, Galway, Ireland
| | - J Harreiter
- Gender Medicine Unit, Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - A Kautzky-Willer
- Gender Medicine Unit, Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - P Damm
- Departments of Endocrinology and Obstetrics, Rigshospitalet and Department of Clinical Medicine, Centre for Pregnant Women with Diabetes, University of Copenhagen, Copenhagen, Denmark
| | - E R Mathiesen
- Departments of Endocrinology and Obstetrics, Rigshospitalet and Department of Clinical Medicine, Centre for Pregnant Women with Diabetes, University of Copenhagen, Copenhagen, Denmark
| | - D M Jensen
- Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - L L Andersen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - M Tanvig
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - A Lapolla
- Department of Medical and Surgical Sciences, Università degli Studi di Padova, Padua, Italy
| | - M G Dalfra
- Department of Medical and Surgical Sciences, Università degli Studi di Padova, Padua, Italy
| | - A Bertolotto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Wender-Ozegowska
- Department of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | - A Zawiejska
- Chair of Medical Education, Department of Medical Simulation, Poznan University of Medical Sciences, Poznan, Poland
| | - D J Hill
- Lawson Health Research Institute, London, Ontario, Canada
| | - F J Snoek
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, VU University, Amsterdam, the Netherlands
| | - Jgm Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - G Desoye
- Department of Obstetrics and Gynaecology, Medical University Graz, Graz, Austria
| | - Mnm van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
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10
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de Wit M, Pouwer F, Snoek FJ. How to identify clinically significant diabetes distress using the Problem Areas in Diabetes (PAID) scale in adults with diabetes treated in primary or secondary care? Evidence for new cut points based on latent class analyses. BMJ Open 2022; 12:e056304. [PMID: 35277408 PMCID: PMC8919470 DOI: 10.1136/bmjopen-2021-056304] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION The Problem Areas of Diabetes (PAID) questionnaire is a frequently used measure to assess diabetes-distress. The aim of this study was to identify clinically meaningful levels of diabetes-distress, using latent class analyses (LCA), and to determine which groups were at increased risk of elevated diabetes-distress in terms of sex, age, type of diabetes and glycaemic control. METHODS Data were derived from four studies (total N=2966, 49% female, age range 18-95 years, 43% type 1 diabetes, diabetes duration range 0-79 years). LCAs were performed to examine possible latent groups in the distribution of answers on the individual PAID items. Demographic and diabetes-related characteristics were added to the model to estimate their effects on latent class membership and receiver operating curves curves to determine cut-offs. RESULTS Three levels of diabetes distress were distinguished with defined cut-off scores and labelled as: low, moderate and high diabetes distress. Levels of distress did not associate with distinct clusters of items. Older people were more likely to be part of the low distress class; women and people with high HbA1c were more likely to be part of the high distress class. Sensitivity and specificity of the commonly used cut-off of 40 for high distress are 0.95 and 0.97, respectively. To distinguish the moderate distress group, cut-off scores of 17 and 39 are optimal with a sensitivity of 0.93 and a specificity of 0.94. CONCLUSION Three levels of diabetes-distress can be distinguished: low, moderate and high diabetes distress. Younger people, women and people with poor glycaemic control are at an increased risk for high levels of distress. A cut-off of 40 is satisfactory to detect people with high levels of diabetes-distress; a score of 0-16 indicates low diabetes distress and a score of 17-39 moderate diabetes distress.
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Affiliation(s)
- M de Wit
- Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frans Pouwer
- Department of Psychology, University College South Denmark, Odense, Denmark
- School of Psychology, Deakin University, Burwood, Victoria, Australia
- Steno Diabetes Center Odense, Odense, Denmark
| | - F J Snoek
- Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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11
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Snoek FJ, Spaepen E, Mojdami D, Mönnig E, Syring K, Yan Y, Mitchell BD. The multinational onversations and eactions round evere ypoglycemia (CRASH) study: Impact of health care provider communications and recommendations on people with diabetes. J Clin Transl Endocrinol 2022; 27:100295. [PMID: 35242584 PMCID: PMC8881663 DOI: 10.1016/j.jcte.2022.100295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 11/18/2022] Open
Abstract
The multinational CRASH study found that substantive recommendations from health care providers were predictive of actions taken by people with diabetes during and after a severe hypoglycemic event, which highlights the importance of equipping people with actionable strategies to prevent and treat severe hypoglycemia should a severe hypoglycemic event arise.
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Affiliation(s)
- Frank J. Snoek
- Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Netherlands
| | | | | | | | | | - Yu Yan
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Beth D. Mitchell
- Eli Lilly and Company, Indianapolis, IN, USA
- Corresponding author at: Eli Lilly and Company, 893 Delaware St, Indianapolis, IN 46225.
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12
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Snoek FJ, Spaepen E, Nambu BA, Child CJ, Bajpai S, Balantac Z, Bushnell DM, Pokrzywinski R, Mitchell BD. Conversations and Reactions Around Severe Hypoglycemia (CRASH) Study: Results From People With Diabetes and Caregivers in the United States. Clin Diabetes 2022; 40:477-488. [PMID: 36381307 PMCID: PMC9606560 DOI: 10.2337/cd21-0131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A survey was conducted in eight countries to examine conversations around, and experiences and treatments during, severe hypoglycemia among people with diabetes and caregivers of people with diabetes. This article reports a subgroup analysis from the United States involving 219 people with diabetes and 210 caregivers. Most respondents (79.7%) did not use professional health care services during their most recent severe hypoglycemic event, and 40.3% did not report the event to their health care providers at a subsequent follow-up visit. Hypoglycemic events left respondents feeling scared (70.9%), unprepared (42.7%), and helpless (46.9%). These clinically important psychosocial impacts on people with diabetes and caregivers underscore the need for conversations about hypoglycemia prevention and management.
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Affiliation(s)
- Frank J. Snoek
- Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, the Netherlands
| | | | | | | | | | | | | | | | - Beth D. Mitchell
- Eli Lilly and Company, Indianapolis, IN
- Corresponding author: Beth D. Mitchell,
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13
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Holt RIG, DeVries JH, Hess-Fischl A, Hirsch IB, Kirkman MS, Klupa T, Ludwig B, Nørgaard K, Pettus J, Renard E, Skyler JS, Snoek FJ, Weinstock RS, Peters AL. Correction to: The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2022; 65:255. [PMID: 34851428 PMCID: PMC8895052 DOI: 10.1007/s00125-021-05600-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
[Image: see text]
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Affiliation(s)
- Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - J Hans DeVries
- Amsterdam UMC, Internal Medicine, University of Amsterdam, Amsterdam, the Netherlands
- Profil Institute for Metabolic Research, Neuss, Germany
| | - Amy Hess-Fischl
- Kovler Diabetes Center, University of Chicago, Chicago, IL, USA
| | - Irl B Hirsch
- UW Medicine Diabetes Institute, Seattle, WA, USA
| | - M Sue Kirkman
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Tomasz Klupa
- Department of Metabolic Diseases, Center for Advanced Technologies in Diabetes, Jagiellonian University Medical College, Kraków, Poland
| | - Barbara Ludwig
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Kirsten Nørgaard
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | | | - Eric Renard
- Montpellier University Hospital, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, Inserm, Montpellier, France
| | - Jay S Skyler
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Frank J Snoek
- Amsterdam UMC, Medical Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | | | - Anne L Peters
- Keck School of Medicine of USC, Los Angeles, CA, USA
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14
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Brouwer A, van Raalte DH, Lamers F, Rutters F, Elders PJM, Van Someren EJW, Snoek FJ, Beekman ATF, Bremmer MA. Insulin resistance as a marker for the immune-metabolic subtype of depression. J Affect Disord 2021; 295:1371-1376. [PMID: 34565592 DOI: 10.1016/j.jad.2021.08.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/14/2021] [Accepted: 08/27/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Insulin resistance (IR), a marker of metabolic dysregulation and pro-inflammatory state, moderates the antidepressant treatment effect in patients with type 2 diabetes (T2D) and is therefore a potential marker for personalized treatment. Based on data from a light therapy trial (NTR4942), we aimed to evaluate whether 1) depression symptoms differ according to the level of IR, and 2) improvement of specific depression symptoms drive the positive effects of light therapy in those with higher IR. METHODS This secondary analysis in 59 individuals with depression and T2D explored differences in depressive symptom profile (30-item Inventory of Depressive Symptomatology (IDS)) at baseline and in response to light therapy (versus placebo), between lower and higher IR individuals, using Likelihood Ratio tests and Linear-by-linear association. IR was measured using the gold standard, a hyperinsulinemic-euglycaemic clamp. RESULTS At baseline, higher IR individuals reported more symptoms of irritability (p=0.024) anhedonia (no interest in people and activities: p=0.011; absence of pleasure and enjoyment: p=0.021), fatigue (fatigue: p=0.036; physical fatigue: p=0.035) and hypersomnia (p=0.029) relative to persons with lower IR, who reported more insomnia (nightly awakening: p=0.041; early morning awakening: p=0.012). Light therapy led to an improvement across IDS symptoms in higher IR individuals, while in lower IR individuals, light therapy improved early morning awakening (p=0.005) and interest in people and activities (p=0.015), but worsened mood (feeling sad: p=0.001; feeling irritable: p=0.002; interpersonal sensitivity: p=0.014). CONCLUSIONS Results add to the hypothesis of an immune-metabolic subtype of depression, and suggest that IR might be a promising focus for precision medicine.
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Affiliation(s)
- Annelies Brouwer
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands.
| | - Daniël H van Raalte
- Amsterdam UMC, Dept. of Internal Medicine, Diabetes Center, Vrije Universiteit, Amsterdam, the Netherlands
| | - Femke Lamers
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, Dept. of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Petra J M Elders
- Amsterdam UMC, Dept. of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Eus J W Van Someren
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands; Dept. of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands; Amsterdam UMC, Dept. of Integrative Neurophysiology, Centre for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, Vrije Universiteit, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Dept. of Medical Psychology, Amsterdam Public Health research institute, Vrije Universiteit and University of Amsterdam, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands
| | - Marijke A Bremmer
- Amsterdam UMC and GGZ inGeest, Dept. of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, De Boelelaan 1117, 1081 HV, Postbus, 7075, 1007 MB, Amsterdam, the Netherlands
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15
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Holt RIG, DeVries JH, Hess-Fischl A, Hirsch IB, Kirkman MS, Klupa T, Ludwig B, Nørgaard K, Pettus J, Renard E, Skyler JS, Snoek FJ, Weinstock RS, Peters AL. The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2021; 64:2609-2652. [PMID: 34590174 PMCID: PMC8481000 DOI: 10.1007/s00125-021-05568-3] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) convened a writing group to develop a consensus statement on the management of type 1 diabetes in adults. The writing group has considered the rapid development of new treatments and technologies and addressed the following topics: diagnosis, aims of management, schedule of care, diabetes self-management education and support, glucose monitoring, insulin therapy, hypoglycaemia, behavioural considerations, psychosocial care, diabetic ketoacidosis, pancreas and islet transplantation, adjunctive therapies, special populations, inpatient management and future perspectives. Although we discuss the schedule for follow-up examinations and testing, we have not included the evaluation and treatment of the chronic microvascular and macrovascular complications of diabetes as these are well-reviewed and discussed elsewhere. The writing group was aware of both national and international guidance on type 1 diabetes and did not seek to replicate this but rather aimed to highlight the major areas that healthcare professionals should consider when managing adults with type 1 diabetes. Though evidence-based where possible, the recommendations in the report represent the consensus opinion of the authors. Graphical abstract.
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Affiliation(s)
- Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - J Hans DeVries
- Amsterdam UMC, Internal Medicine, University of Amsterdam, Amsterdam, the Netherlands
- Profil Institute for Metabolic Research, Neuss, Germany
| | - Amy Hess-Fischl
- Kovler Diabetes Center, University of Chicago, Chicago, IL, USA
| | - Irl B Hirsch
- UW Medicine Diabetes Institute, Seattle, WA, USA
| | - M Sue Kirkman
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Tomasz Klupa
- Department of Metabolic Diseases, Center for Advanced Technologies in Diabetes, Jagiellonian University Medical College, Kraków, Poland
| | - Barbara Ludwig
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Kirsten Nørgaard
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | | | - Eric Renard
- Montpellier University Hospital, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, Inserm, Montpellier, France
| | - Jay S Skyler
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Frank J Snoek
- Amsterdam UMC, Medical Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | | | - Anne L Peters
- Keck School of Medicine of USC, Los Angeles, CA, USA
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16
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Holt RIG, DeVries JH, Hess-Fischl A, Hirsch IB, Kirkman MS, Klupa T, Ludwig B, Nørgaard K, Pettus J, Renard E, Skyler JS, Snoek FJ, Weinstock RS, Peters AL. The Management of Type 1 Diabetes in Adults. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2021; 44:2589-2625. [PMID: 34593612 DOI: 10.2337/dci21-0043] [Citation(s) in RCA: 180] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) convened a writing group to develop a consensus statement on the management of type 1 diabetes in adults. The writing group has considered the rapid development of new treatments and technologies and addressed the following topics: diagnosis, aims of management, schedule of care, diabetes self-management education and support, glucose monitoring, insulin therapy, hypoglycemia, behavioral considerations, psychosocial care, diabetic ketoacidosis, pancreas and islet transplantation, adjunctive therapies, special populations, inpatient management, and future perspectives. Although we discuss the schedule for follow-up examinations and testing, we have not included the evaluation and treatment of the chronic microvascular and macrovascular complications of diabetes as these are well-reviewed and discussed elsewhere. The writing group was aware of both national and international guidance on type 1 diabetes and did not seek to replicate this but rather aimed to highlight the major areas that health care professionals should consider when managing adults with type 1 diabetes. Though evidence-based where possible, the recommendations in the report represent the consensus opinion of the authors.
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Affiliation(s)
- Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, U.K. .,Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, U.K
| | - J Hans DeVries
- Amsterdam UMC, Internal Medicine, University of Amsterdam, Amsterdam, the Netherlands.,Profil Institute for Metabolic Research, Neuss, Germany
| | | | | | - M Sue Kirkman
- University of North Carolina School of Medicine, Chapel Hill, NC
| | - Tomasz Klupa
- Department of Metabolic Diseases, Center for Advanced Technologies in Diabetes, Jagiellonian University Medical College, Kraków, Poland
| | - Barbara Ludwig
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Kirsten Nørgaard
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | | | - Eric Renard
- Montpellier University Hospital, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, Inserm, Montpellier, France
| | - Jay S Skyler
- University of Miami Miller School of Medicine, Miami, FL
| | - Frank J Snoek
- Amsterdam UMC, Medical Psychology, Vrije Universiteit, Amsterdam, the Netherlands
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17
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Taboada Gjorup AL, Snoek FJ, van Duinkerken E. Diabetes Self-Care in Older Adults With Type 1 Diabetes Mellitus: How Does Cognition Influence Self-Management. Front Clin Diabetes Healthc 2021; 2:727029. [PMID: 36994333 PMCID: PMC10012116 DOI: 10.3389/fcdhc.2021.727029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022]
Abstract
With increasing knowledge and improvements in options for glycemic control, the life-expectancy of patients with type 1 diabetes mellitus (T1DM) has increased considerably over the past decades. Whereas this is undeniably positive for patients, aging is related to natural decline in cognitive functions. As patients with T1DM across the life-span are susceptible to cognitive deterioration, an interaction with aging may be expected and the risk of development of dementia might be increased. As achieving glycemic control depends on a set of diabetes self-management behaviors, it is imperative to understand how cognitive functions are involved in the upkeep of these behaviors and how cognitive impairment may affect them. In this narrative review, we set out to understand the relationship between cognition and T1DM self-care by first reviewing the glycemic targets in older adults, what treatment options are available, and what cognitive functions they draw upon. We will then review the cognitive literature in older adults that is available and then link both together. Lastly, we finish with clinical recommendations and suggestions for future research.
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Affiliation(s)
- Ana Lúcia Taboada Gjorup
- Post-Graduate Program in Neurology, Department of Neurology, University Hospital Gaffrée and Guinle, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Internal Medicine, University Hospital Gaffrée and Guinle, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Frank J. Snoek
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Eelco van Duinkerken
- Post-Graduate Program in Neurology, Department of Neurology, University Hospital Gaffrée and Guinle, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center for Epilepsy, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil
- *Correspondence: Eelco van Duinkerken,
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Immanuel J, Simmons D, Desoye G, Corcoy R, Adelantado JM, Devlieger R, Lapolla A, Dalfra MG, Bertolotto A, Harreiter J, Wender-Ozegowska E, Zawiejska A, Dunne FP, Damm P, Mathiesen ER, Jensen DM, Andersen LLT, Hill DJ, Jelsma JGM, Snoek FJ, Scharnagl H, Galjaard S, Kautzky-Willer A, VAN Poppel MNM. Corrigendum to "Performance of early pregnancy HbA 1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women" [Diab. Res. Clin. Pract. 168 (2020) 108378]. Diabetes Res Clin Pract 2021; 179:109023. [PMID: 34479741 DOI: 10.1016/j.diabres.2021.109023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Jincy Immanuel
- Macarthur Clinical School, Western Sydney University, Sydney, Australia
| | - David Simmons
- Macarthur Clinical School, Western Sydney University, Sydney, Australia; Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England.
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria
| | - Rosa Corcoy
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Recerca de ĺHospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan M Adelantado
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Belgium; Gynaecology and Obstetrics, University Hospitals Leuven, Belgium
| | | | | | | | - Jürgen Harreiter
- Department of Medicine III, Division of Endocrinology, Gender Medicine Unit Medical University of Vienna, Vienna, Austria
| | | | | | | | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Dorte M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Lise Lotte T Andersen
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - David J Hill
- Recherche en Santé Lawson SA, St. Gallen, Switzerland; Lawson Health Research Institute, London, Ontario, Canada
| | - Judith G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Psychology, Amsterdam, the Netherlands
| | - Hubert Scharnagl
- Medical University of Graz, Clinical Inst Medical and Chemical Laboratory Diagnostics, Graz, Austria
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Belgium; Gynaecology and Obstetrics, University Hospitals Leuven, Belgium; Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Alexandra Kautzky-Willer
- Department of Medicine III, Division of Endocrinology, Gender Medicine Unit Medical University of Vienna, Vienna, Austria; Gender Institute Gars am Kamp, Vienna, Austria
| | - Mireille N M VAN Poppel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Institute of Sport Science, University of Graz, Graz, Austria
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van Duinkerken E, IJzerman RG, Barkhof F, Moll AC, Diamant M, Snoek FJ, Klein M. Cognitive Functioning and Hippocampal Connectivity in Patients With Longstanding Type 1 Diabetes and Apolipoprotein E ε4. Diabetes Care 2021; 44:dc210483. [PMID: 34380705 DOI: 10.2337/dc21-0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/16/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE While the apolipoprotein E ε4 allele (ApoE-ε4) is related to cognitive and brain decline in the general population, its effect on the brain in type 1 diabetes mellitus (T1DM) remains unclear. Therefore, the aim was to determine the interaction between ApoE-ε4 and T1DM on cognitive performance and hippocampal structure and connectivity as the brain area most vulnerable to ApoE-ε4 effects in adult patients with T1DM. RESEARCH DESIGN AND METHODS Blood sampling was performed in 104 patients with T1DM and 49 control subjects for ApoE genotyping, neuropsychology, and neuroimaging to determine hippocampal volume and resting-state connectivity. The interaction between T1DM status and ApoE-ε4 presence was investigated and adjusted for age and mean systolic blood pressure. RESULTS ApoE genotyping could not be performed for three patients with T1DM. Significant interaction effects, indicating a differential effect of ApoE-ε4 between both groups, were found for overall cognitive functioning and for the subdomains of information processing speed and attention. Additionally, interaction effects were present for right hippocampal connectivity with the right posterior cingulate and supramarginal gyri. Subsequent group analysis showed that patients with T1DM with ApoE-ε4 performed worse on these cognitive domains with increased connectivity, relative to their counterparts without ApoE-ε4. In contrast, no cognitive effects, but decreased connectivity, were observed in control subjects with ApoE-ε4. In patients with T1DM, higher right hippocampus connectivity with the posterior cingulate gyrus was related to poorer overall cognitive functioning. CONCLUSIONS The results may suggest that ApoE-ε4 presence leaves our patients with T1DM more susceptible to cognitive decrements at a younger age, possibly through vascular pathways, warranting further longitudinal studies.
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Affiliation(s)
- Eelco van Duinkerken
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Instituto Estadual do Cérebro Paulo Niemeyer, Center for Epilepsy, Rio de Janeiro, RJ, Brazil
- Department of Neurology, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Richard G IJzerman
- Amsterdam Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Institute of Neurology and Healthcare Engineering, University College London, London, U.K
| | - Annette C Moll
- Department of Ophthalmology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Michaela Diamant
- Amsterdam Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Martin Klein
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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20
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Muijs LT, de Wit M, Knoop H, Snoek FJ. Feasibility and user experience of the unguided web-based self-help app 'MyDiaMate' aimed to prevent and reduce psychological distress and fatigue in adults with diabetes. Internet Interv 2021; 25:100414. [PMID: 34401373 PMCID: PMC8350600 DOI: 10.1016/j.invent.2021.100414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/19/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Psychological distress and fatigue are common in persons with diabetes, adversely affecting quality of life and complicating diabetes self-management. Offering diabetes-specific self-guided cognitive behavioral therapy (CBT) may be helpful for persons with diabetes and mild symptoms of psychological distress and fatigue. We are the first to test the feasibility and user experiences of a web-based self-help app called 'MyDiaMate' in adults with type 1 and type 2 diabetes. METHODS AND MATERIALS MyDiaMate was developed in close collaboration with persons with diabetes and professionals, building on elements from existing (guided) diabetes-specific CBT interventions. The study was advertised, offering free access to the app for adults with diabetes for a period of three months. Feasibility and user experiences were tested in a non-randomized study with pre- and post- measurements and interviews in a small sample.. In addition usage of the app was studied using log-data.. RESULTS In total N = 55 adults with diabetes signed up for the study. Mean age was M = 42.7 (SD = 15.6), mostly women (n = 39, 70.9%), higher educated (n = 36, 65.5%), and diagnosed with type 1 diabetes (n = 37, 67.3%). About half reported current or a history of psychological complaints. All the participants completed baseline assessments, and n = 32 participants (58%) completed the follow-up questionnaire. Main reasons for participating in the study were: to preserve or improve mental fitness (40.6%), curiosity (25.0%) and wanting to contribute to research (34.4%). No major technical issues were encountered in accessing or using the app. The app was opened at least once by n = 51 participants, median use of the modules was 28 min (1-80) within a period of 1 to 92 days (median = 10). Almost all participants (n = 50, 98.0%) opened the basic module 'Diabetes in balance', of whom 32 (62.7%) completed this module. 'My mood' and 'My energy' were opened by n = 40 (78.4%) and n = 32 (62.7%) participants, respectively, and completed by n = 21 (52.5%) and n = 9 (28.1%) of the participants. Of all participants, 40.6% would recommend the app to others living with diabetes. CONCLUSIONS This study confirmed the feasibility of MyDiaMate as a diabetes-specific self-guided app for adults wishing to preserve or improve their psychological health. While user experiences were overall positive, further tailoring the content to individual needs and preferences could enhance uptake, usage and appreciation. Future research should explore its effectiveness in a randomized controlled trial.
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Affiliation(s)
- Linda T. Muijs
- Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
| | - Maartje de Wit
- Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
- Corresponding author.
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Frank J. Snoek
- Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, the Netherlands
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21
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Snoek FJ, Fisher L, Polonsky WH, Stuckey H, Hessler D, Tang T, Hermanns N, Mundet X, Silva M, Sturt J, Okazaki K, Hadjiyianni I, Desai U, Perez-Nieves M. Overcoming psychological insulin resistance: A practical guide for healthcare professionals. Prim Care Diabetes 2021; 15:619-621. [PMID: 33785288 DOI: 10.1016/j.pcd.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 11/29/2022]
Abstract
Despite the demonstrated benefits of using insulin, nearly a third of the patients with type 2 diabetes (T2D) are initially reluctant to initiate insulin therapy when it is first recommended by their healthcare provider (HCP). Several studies have documented the reasons for this phenomenon known as psychological insulin resistance (PIR) and also identified actionable strategies for HCPs to assist people with T2D to overcome their PIR. However, most strategies are based on the experiences of HCPs, rather than of patients. Based on findings from a study exploring real-world patient experience around HCP actions for mitigating PIR, we suggest that HCPs use collaborative strategies throughout the course of T2D treatment to 1) explore reasons for PIR, 2) help patients overcome PIR, and 3) follow-up regarding experience with insulin.
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Affiliation(s)
- Frank J Snoek
- Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Lawrence Fisher
- University of California, San Francisco, San Francisco, CA, USA
| | - William H Polonsky
- Behavioral Diabetes Institute, San Diego, CA, USA; University of California, San Diego, La Jolla, CA, USA
| | | | | | - Tricia Tang
- University of British Columbia, Vancouver, Canada
| | | | - Xavier Mundet
- Universitat Autonoma de Barcelona, Bellaterra, Spain
| | - Maria Silva
- Instituto Multidisciplinar de Medicina, Sao Paulo, Brazil
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Alkaabi JM, Al-Maskari F, Afandi B, Yousef S, Shah SM, Heideman WH, Papadimitropoulos EA, Zoubeidi T, Souid AK, Paulo MS, Snoek FJ. Effects of Diabetes Prevention Education Program for Overweight and Obese Subjects with a Family History of Type 2 Diabetes Mellitus: A Pilot Study from the United Arab Emirates. Oman Med J 2021; 36:e268. [PMID: 34164158 PMCID: PMC8214807 DOI: 10.5001/omj.2021.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/29/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives The association of obesity and family history of type 2 diabetes mellitus (T2DM) provides an opportunity for risk stratification and prevention, as these two conditions are the most well-known risk factors for T2DM. We aimed to test the feasibility and effects of a diabetes mellitus prevention education program designed for overweight and obese Emirati people with at least one parent with T2DM. Methods We conducted a pilot study using a pre-post design without a control arm at the Diabetes Center at Tawam Hospital in Al Ain, UAE. Overweight and obese subjects with at least one parent with T2DM were invited to participate. Three study assessments were conducted at baseline, three months, and six months including a questionnaire, anthropometry, and laboratory assessments. Interventions included three individualized or family-engaged counseling sessions based on the DiAlert protocol. The study outcomes included awareness of risks and prevention opportunities to T2DM, behavior changes in nutrition and exercise, decreased waist-circumference, and clinical/metabolic/inflammatory markers. Pre-post changes were analyzed using repeated-measures analysis of variance. Results One hundred twenty-two overweight or obese individuals were approached. Forty-four individuals met the eligibility criteria, and 32 individuals (35.0±9.0 years; 75.0% female) completed the study. At six months, there were significant improvements in the glycated hemoglobin levels (p = 0.007), high-density lipoprotein (p < 0.049), serum creatinine (p < 0.025), estimated glomerular filtration rate (p = 0.009), and adiponectin levels (p < 0.024). Sixteen of 32 participants had ≥ 2 cm reduction in waist circumference. They demonstrated notable physical and laboratory improvements in moderate-vigorous activity, average activity counts per day, tumor necrosis factor-alpha, and interleukin-6 total cholesterol, triglyceride, and low-density lipoprotein. Conclusions Offering family-oriented diabetes education to people at risk for T2DM is well received and has favorable effects on relevant risk factors. Better testing with large-scale randomized controlled studies is needed, and implementing similar educational programs for the Emirati population seems warranted.
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Affiliation(s)
- Juma M Alkaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | | | - Said Yousef
- Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Syed M Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Wieke H Heideman
- Department of Medical Psychology, The EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | | | - Taoufik Zoubeidi
- Department of Analytics in the Digital Era, College of Business and Economics, United Arab Emirates University, Al Ain, UAE
| | - Abdul-Kader Souid
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Frank J Snoek
- Department of Medical Psychology, The EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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23
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Goethals ER, Lemiere J, Snoek FJ, Casteels K, Luyckx K, de Wit M. Executive function mediates the link between externalizing behavior and HbA1c in children and adolescents with type 1 diabetes: A cross-national investigation. Pediatr Diabetes 2021; 22:503-510. [PMID: 33314616 DOI: 10.1111/pedi.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/14/2020] [Accepted: 11/11/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Externalizing behavior (i.e., conduct problems, hyperactivity) and executive function (EF) problems in children and adolescents with type 1 diabetes (T1D) have been associated with worse diabetes-related and psychosocial outcomes but have not been examined in relationship to each other. We aimed to examine whether externalizing behavior is associated with HbA1c and whether this relationship is mediated by EF problems, specifically metacognition (i.e., ability to initiate, plan, organize and monitor behavior) and behavioral regulation (i.e., impulse control, regulation of emotion and behavior). RESEARCH DESIGN AND METHODS Cohorts of Belgian and Dutch parents of children and adolescents (6-18 years) with T1D filled out questionnaires on externalizing behavior (Strengths and Difficulties Questionnaire; SDQ) and EF (Behavior Rating Inventory of Executive Function; BRIEF) composite scales. Treating physicians collected HbA1c values. Mediation analyses were performed separately for the BRIEF composite Metacognition and Behavior Regulation scales, correcting for age, sex and diabetes duration. RESULTS The 335 parents of children and adolescents with T1D (mean age 12.3 ± 2.8 SD; mean HbA1c 7.6% ± 1.1 SD [60 mmol/mol ± 12.0 SD]; mean diabetes duration 5.3 ± 3.6 SD; 49.6% female) participated. Analyses showed that the association between externalizing behavior and HbA1c is mediated by metacognition (ab path Point estimate = 0.05 BCa CI 95% 0.02-0.08), and not behavioral regulation. CONCLUSIONS Results uncovered the influence externalizing behavior may have on EF problems in the metacognition domain, which in turn seem to influence HbA1c. Clinicians should be mindful of these EF problems when working with children and adolescents displaying externalizing behavior, and not only target behavioral but also cognitive processes.
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Affiliation(s)
- Eveline R Goethals
- School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Harvard Medical School, Joslin Diabetes Center, Boston, Massachusetts, USA
| | - Jurgen Lemiere
- Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Frank J Snoek
- Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Koen Luyckx
- School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Unit for Professional Training and Service in the Behavioural Sciences, University of the Free State, Bloemfontein, South Africa
| | - Maartje de Wit
- Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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24
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Farooqi AT, Snoek FJ, Khunti K. Management of chronic cardiometabolic conditions and mental health during COVID-19. Prim Care Diabetes 2021; 15:21-23. [PMID: 32917554 PMCID: PMC7831728 DOI: 10.1016/j.pcd.2020.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/12/2020] [Accepted: 08/27/2020] [Indexed: 11/18/2022]
Affiliation(s)
| | - F J Snoek
- Amsterdam UMC University Medical Centers, Netherlands
| | - K Khunti
- Diabetes Research Centre, University of Leicester, United Kingdom
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25
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Immanuel J, Simmons D, Harreiter J, Desoye G, Corcoy R, Adelantado JM, Devlieger R, Lapolla A, Dalfra MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Dunne FP, Damm P, Mathiesen ER, Jensen DM, Andersen LLT, Hill DJ, Jelsma JGM, Kautzky-Willer A, Galjaard S, Snoek FJ, van Poppel MNM. Metabolic phenotypes of early gestational diabetes mellitus and their association with adverse pregnancy outcomes. Diabet Med 2021; 38:e14413. [PMID: 32991758 DOI: 10.1111/dme.14413] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/10/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022]
Abstract
AIMS To describe the metabolic phenotypes of early gestational diabetes mellitus and their association with adverse pregnancy outcomes. METHODS We performed a post hoc analysis using data from the Vitamin D And Lifestyle Intervention for gestational diabetes prevention (DALI) trial conducted across nine European countries (2012-2014). In women with a BMI ≥29 kg/m2 , insulin resistance and secretion were estimated from the oral glucose tolerance test values performed before 20 weeks, using homeostatic model assessment of insulin resistance and Stumvoll first-phase indices, respectively. Women with early gestational diabetes, defined by the International Association of Diabetes and Pregnancy Study Groups criteria, were classified into three groups: GDM-R (above-median insulin resistance alone), GDM-S (below-median insulin secretion alone), and GDM-B (combination of both) and the few remaining women were excluded. RESULTS Compared with women in the normal glucose tolerance group (n = 651), women in the GDM-R group (n = 143) had higher fasting and post-load glucose values and insulin levels, with a greater risk of having large-for-gestational age babies [adjusted odds ratio 3.30 (95% CI 1.50-7.50)] and caesarean section [adjusted odds ratio 2.30 (95% CI 1.20-4.40)]. Women in the GDM-S (n = 37) and GDM-B (n = 56) groups had comparable pregnancy outcomes with those in the normal glucose tolerance group. CONCLUSIONS In overweight and obese women with early gestational diabetes, higher degree of insulin resistance alone was more likely to be associated with adverse pregnancy outcomes than lower insulin secretion alone or a combination of both.
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Affiliation(s)
- J Immanuel
- Macarthur Clinical School, Western Sydney University, Sydney, NSW, Australia
| | - D Simmons
- Macarthur Clinical School, Western Sydney University, Sydney, NSW, Australia
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, UK
| | - J Harreiter
- Department of Medicine III, Division of Endocrinology, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - G Desoye
- Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria
| | - R Corcoy
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut de Recerca de l´Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
| | - J M Adelantado
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
- Gynaecology and Obstetrics, University Hospitals Leuven, Belgium
| | - A Lapolla
- Universita Degli Studi di Padova, Padua, Italy
| | - M G Dalfra
- Universita Degli Studi di Padova, Padua, Italy
| | - A Bertolotto
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - E Wender-Ozegowska
- Department of Reproduction, Poznan University of Medical Sciences, Poland
| | - A Zawiejska
- Department of Reproduction, Poznan University of Medical Sciences, Poland
| | - F P Dunne
- National University of Ireland, Galway, Ireland
| | - P Damm
- Centre for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - E R Mathiesen
- Centre for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - D M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - L L T Andersen
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - D J Hill
- Recherche en Santé Lawson SA, St. Gallen, Switzerland
- Lawson Health Research Institute, London, Ontario, Canada
| | - J G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam
| | - A Kautzky-Willer
- Department of Medicine III, Division of Endocrinology, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
- Gender Institute Gars am Kamp, Vienna, Austria
| | - S Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
- Gynaecology and Obstetrics, University Hospitals Leuven, Belgium
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - F J Snoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Psychology, Amsterdam, The Netherlands
| | - M N M van Poppel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam
- Institute of Sport Science, University of Graz, Graz, Austria
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26
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Lima RA, Desoye G, Simmons D, Devlieger R, Galjaard S, Corcoy R, Adelantado JM, Dunne F, Harreiter J, Kautzky‐Willer A, Damm P, Mathiesen ER, Jensen DM, Andersen LT, Tanvig M, Lapolla A, Dalfra MG, Bertolotto A, Manta U, Wender‐Ozegowska E, Zawiejska A, Hill DJ, Snoek FJ, Jelsma JGM, van Poppel M. The importance of maternal insulin resistance throughout pregnancy on neonatal adiposity. Paediatr Perinat Epidemiol 2021; 35:83-91. [PMID: 32352590 PMCID: PMC7891448 DOI: 10.1111/ppe.12682] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Although previous studies evaluated the association of maternal health parameters with neonatal adiposity, little is known regarding the complexity of the relationships among different maternal health parameters throughout pregnancy and its impact on neonatal adiposity. OBJECTIVES To evaluate the direct and indirect associations between maternal insulin resistance during pregnancy, in women with obesity, and neonatal adiposity. In addition, associations between maternal fasting glucose, triglycerides (TG), non-esterified fatty acids (NEFA), and neonatal adiposity were also assessed. METHODS This is a longitudinal, secondary analysis of the DALI study, an international project conducted in nine European countries with pregnant women with obesity. Maternal insulin resistance (HOMA-IR), fasting glucose, TG, and NEFA were measured three times during pregnancy (<20, 24-28, and 35-37 weeks of gestation). Offspring neonatal adiposity was estimated by the sum of four skinfolds. Structural equation modelling was conducted to evaluate the direct and indirect relationships among the variables of interest. RESULTS Data on 657 mother-infant pairs (50.7% boys) were analysed. Neonatal boys exhibited lower mean sum of skinfolds compared to girls (20.3 mm, 95% CI 19.7, 21.0 vs 21.5 mm, 95% CI 20.8, 22.2). In boys, maternal HOMA-IR at <20 weeks was directly associated with neonatal adiposity (β = 0.35 mm, 95% CI 0.01, 0.70). In girls, maternal HOMA-IR at 24-28 weeks was only indirectly associated with neonatal adiposity, which implies that this association was mediated via maternal HOMA-IR, glucose, triglycerides, and NEFA during pregnancy (β = 0.26 mm, 95% CI 0.08, 0.44). CONCLUSIONS The timing of the role of maternal insulin resistance on neonatal adiposity depends on fetal sex. Although the association was time-dependent, maternal insulin resistance was associated with neonatal adiposity in both sexes.
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Affiliation(s)
| | - Gernot Desoye
- Department of Obstetrics and GynecologyMedizinische Universitaet GrazGrazAustria
| | - David Simmons
- Western Sydney UniversityCampbelltownNew South WalesAustralia,The Institute of Metabolic ScienceAddenbrooke’s HospitalCambridgeUK
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and ObstetricsUniversity Hospitals LeuvenLeuvenBelgium
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and ObstetricsUniversity Hospitals LeuvenLeuvenBelgium,Division of Obstetrics and Prenatal MedicineDepartment of Obstetrics and GynaecologyErasmus MCUniversity Medical Centre RotterdamRotterdamThe Netherlands
| | - Rosa Corcoy
- Institut de Recerca de l´Hospital de la Santa Creu i Sant PauBarcelonaSpain,CIBER Bioengineering, Biomaterials and NanotechnologyInstituto de Salud Carlos IIIZaragozaSpain
| | - Juan M. Adelantado
- Institut de Recerca de l´Hospital de la Santa Creu i Sant PauBarcelonaSpain,CIBER Bioengineering, Biomaterials and NanotechnologyInstituto de Salud Carlos IIIZaragozaSpain
| | - Fidelma Dunne
- Galway Diabetes Research Centre and College of Medicine Nursing and Health SciencesNational University of IrelandGalwayIreland
| | - Jürgen Harreiter
- Gender Medicine Unit, Endocrinology and MetabolismDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Alexandra Kautzky‐Willer
- Gender Medicine Unit, Endocrinology and MetabolismDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Peter Damm
- Departments of Endocrinology and ObstetricsFaculty of Health and Medical SciencesCenter for Pregnant Women with DiabetesRigshospitaletInstitute of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Elisabeth R. Mathiesen
- Departments of Endocrinology and ObstetricsFaculty of Health and Medical SciencesCenter for Pregnant Women with DiabetesRigshospitaletInstitute of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Dorte M. Jensen
- Department of Gynecology and ObstetricsOdense University HospitalUniversity of Southern DenmarkOdenseDenmark,Department of Clinical ResearchFaculty of Health SciencesSteno Diabetes Center OdenseOdense University HospitalUniversity of Southern DenmarkOdenseDenmark
| | - Lise‐Lotte T. Andersen
- Department of Gynecology and ObstetricsOdense University HospitalUniversity of Southern DenmarkOdenseDenmark,Department of Clinical ResearchFaculty of Health SciencesUniversity of Southern DenmarkOdenseDenmark
| | - Mette Tanvig
- Department of Gynecology and ObstetricsOdense University HospitalUniversity of Southern DenmarkOdenseDenmark,Department of Clinical ResearchFaculty of Health SciencesUniversity of Southern DenmarkOdenseDenmark
| | | | | | | | - Urszula Manta
- Department of ReproductionPoznan University of Medical SciencesPoznanPoland
| | | | | | | | - Frank J. Snoek
- Department of Medical PsychologyAmsterdam Public Health research instituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Judith G. M. Jelsma
- Department of Public and Occupational HealthAmsterdam Public Health Research InstituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
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Muijs LT, Racca C, de Wit M, Brouwer A, Wieringa TH, de Vries R, Serné EH, van Raalte DH, Rutters F, Snoek FJ. Glucose variability and mood in adults with diabetes: A systematic review. Endocrinol Diabetes Metab 2021; 4:e00152. [PMID: 33532604 PMCID: PMC7831227 DOI: 10.1002/edm2.152] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/01/2020] [Accepted: 05/02/2020] [Indexed: 12/20/2022] Open
Abstract
Aims To systematically review the literature regarding the association between glucose variability (GV) and mood in adults with diabetes, appraise the used methods and make suggestions for future research. Methods A systematic review of literature published up to May 2019 was performed. Abstracts and full texts were screened independently in duplicate. Experimental and observational studies reporting the association between GV and mood in adults with type 1 diabetes or type 2 diabetes were evaluated. A descriptive analysis of the extracted data was conducted, along with a quality assessment. Results Out of the 2.316 studies screened, eight studies met our criteria. Studies used a variety of measures and metrics to determine GV and mood. Four studies used continuous glucose monitoring (CGM). An association between GV and mood was found in four studies when correlating either postprandial glucose rate of increase with current mood or multiday GV with mood measured retrospectively. The other four studies did not find any association. Conclusions There is no clear empirical support for a link between GV and mood in adults with type 1 and type 2 diabetes. More rigorous research is warranted using CGM and ecological momentary assessment of mood to assess if and under what conditions an association between GV and mood exists.
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Affiliation(s)
- Linda T. Muijs
- Medical PsychologyAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Caterina Racca
- Internal MedicineDiabetes CenterAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Maartje de Wit
- Medical PsychologyAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Annelies Brouwer
- Internal MedicineDiabetes CenterAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Thomas H. Wieringa
- Medical PsychologyAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ralph de Vries
- Medical LibraryAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Erik H. Serné
- Internal MedicineDiabetes CenterAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Daniël H. van Raalte
- Internal MedicineDiabetes CenterAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Femke Rutters
- Epidemiology and BiostatisticsAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Frank J. Snoek
- Medical PsychologyAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
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Danne T, Joish VN, Afonso M, Banks P, Sawhney S, Lapuerta P, Davies MJ, Buse JB, Lin D, Reaney M, Guillonneau S, Snoek FJ, Bailey TS, Polonsky WH. Improvement in Patient-Reported Outcomes in Adults with Type 1 Diabetes Treated with Sotagliflozin plus Insulin Versus Insulin Alone. Diabetes Technol Ther 2021; 23:70-77. [PMID: 32721228 DOI: 10.1089/dia.2020.0068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Diabetes-related distress is common among persons affected by diabetes and is associated with suboptimal glycemic control and complications, thus constituting a relevant patient-report outcome (PRO). Improving glycemic control may reduce diabetes distress and improve treatment satisfaction. This post hoc analysis evaluated PRO data for a pooled cohort of adults with type 1 diabetes (T1D) receiving sotagliflozin as adjunct to optimized insulin in the inTandem1 and inTandem2 studies. Methods: Clinically meaningful changes in the Diabetes Treatment Satisfaction Questionnaire status version (DTSQs) and the two-item Diabetes Distress Scale (DDS2) total and individual scores were examined in the pooled data from the first 24 weeks of the studies. Results: In the cohort of patients with a baseline DTSQs total score ≤32 (∼76% of entire cohort), nearly twice as many patients treated with sotagliflozin 200 (45.9%) or 400 mg (42.3%) experienced a >3-point improvement from baseline versus those treated with placebo (24%). Treatment with sotagliflozin led to statistically significant (P < 0.05) improvements across all DTSQs items. Approximately 42% of all patients were considered to have a high risk of diabetes distress (total DDS2 score ≥6) at baseline following insulin optimization. More patients shifted from high to low risk with sotagliflozin compared with placebo (∼40% vs. 23%; P ≤ 0.0002). The baseline-adjusted difference in DDS2 from placebo was significantly (P < 0.001) reduced by -0.5 and -0.6 for sotagliflozin 200 and 400 mg, respectively. Conclusions: Patients with T1D treated with sotagliflozin in addition to optimized insulin therapy reported meaningful improvements in treatment satisfaction and diabetes distress. NCT02384941 and NCT02421510.
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Affiliation(s)
- Thomas Danne
- Department for General Pediatrics, Diabetes, Endocrinology, and Clinical Research, Children's Hospital Auf der Bult, Hannover Medical School, Hannover, Germany
| | - Vijay N Joish
- Lexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA
| | | | - Phillip Banks
- Lexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA
| | | | - Pablo Lapuerta
- Lexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA
| | | | - John B Buse
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Dee Lin
- Sanofi US, Inc., Bridgewater, New Jersey, USA
| | | | | | - Frank J Snoek
- Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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29
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Immanuel J, Simmons D, Desoye G, Corcoy R, Adelantado JM, Devlieger R, Lapolla A, Dalfra MG, Bertolotto A, Harreiter J, Wender-Ozegowska E, Zawiejska A, Dunne FP, Damm P, Mathiesen ER, Jensen DM, Andersen LLT, Hill DJ, Jelsma JGM, Snoek FJ, Scharnagl H, Galjaard S, Kautzky-Willer A, VAN Poppel MNM. Performance of early pregnancy HbA 1c for predicting gestational diabetes mellitus and adverse pregnancy outcomes in obese European women. Diabetes Res Clin Pract 2020; 168:108378. [PMID: 32828833 DOI: 10.1016/j.diabres.2020.108378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/25/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Abstract
AIMS To investigate the performance of early pregnancy HbA1c for predicting gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in obese women. METHODS Post hoc analysis using data from the Vitamin D And Lifestyle Intervention for GDM prevention trials conducted across 9 European countries (2012-2014). Pregnant women (BMI ≥ 29 kg/m2) underwent a baseline HbA1c and oral glucose tolerance tests at < 20 weeks, 24-28 weeks, and 35-37 weeks. Women with GDM were referred for treatment. RESULTS Among the 869 women tested, the prevalence of GDM was 25.9% before 20 weeks, with a further 8.6% at 24-28 weeks. The areas under the curves for HbA1c at the two time points were 0.55 (0.50-0.59) and 0.54 (0.47-0.61), respectively. An early HbA1c ≥ 5.7% (39 mmol/mol) (N = 111) showed low sensitivity (18.2%) with 89.1% specificity for GDM before 20 weeks, at 24-28 weeks (sensitivity of 8.0% and specificity of 88.6% after excluding early GDM), and throughout gestation (sensitivity of 15.9% and specificity of 89.4%). The ≥ 5.7% (39 mmol/mol) threshold was significantly associated with concurrent GDM before 20 weeks (adjusted OR (aOR) 2.77(1.39-5.51)) and throughout gestation (aOR 1.72 (1.02-2.89)), but not adverse pregnancy outcomes. CONCLUSIONS Early pregnancy HbA1c is of limited use for predicting either GDM or adverse outcomes in overweight/obese European women.
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Affiliation(s)
- Jincy Immanuel
- Macarthur Clinical School, Western Sydney University, Sydney, Australia
| | - David Simmons
- Macarthur Clinical School, Western Sydney University, Sydney, Australia; Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England, UK.
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria
| | - Rosa Corcoy
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Recerca de ĺHospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan M Adelantado
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Belgium; Gynaecology and Obstetrics, University Hospitals Leuven, Belgium
| | | | | | | | - Jürgen Harreiter
- Department of Medicine III, Division of Endocrinology, Gender Medicine Unit Medical University of Vienna, Vienna, Austria
| | | | | | | | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Dorte M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Lise Lotte T Andersen
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - David J Hill
- Recherche en Santé Lawson SA, St. Gallen, Switzerland; Lawson Health Research Institute, London, Ontario, Canada
| | - Judith G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Psychology, Amsterdam, The Netherlands
| | - Hubert Scharnagl
- Medical University of Graz, Clinical Inst Medical and Chemical Laboratory Diagnostics, Graz, Austria
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Belgium; Gynaecology and Obstetrics, University Hospitals Leuven, Belgium; Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Alexandra Kautzky-Willer
- Department of Medicine III, Division of Endocrinology, Gender Medicine Unit Medical University of Vienna, Vienna, Austria; Gender Institute Gars am Kamp, Vienna, Austria
| | - Mireille N M VAN Poppel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Institute of Sport Science, University of Graz, Graz, Austria
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30
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Balogh EG, Perez-Nieves M, Cao D, Hadjiyianni II, Ashraf N, Desai U, Snoek FJ, Sturt JA. Key Strategies for Overcoming Psychological Insulin Resistance in Adults with Type 2 Diabetes: The UK Subgroup in the EMOTION Study. Diabetes Ther 2020; 11:1735-1744. [PMID: 32562245 PMCID: PMC7376995 DOI: 10.1007/s13300-020-00856-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION Many patients with type 2 diabetes mellitus (T2DM) delay initiation of insulin therapy despite healthcare professional (HCP) advice. This phenomenon has been referred to as 'psychological insulin resistance' (PIR), and various contributing factors have been identified. Studies discussing approaches to overcoming PIR are lacking. Our aim was to identify the key strategies used by HCPs that most helped adults with T2DM and PIR in the UK to initiate insulin. METHODS As part of a global study, UK adults with T2DM and PIR were recruited (N = 125) to take a survey that included 38 HCP statements and actions about insulin initiation. Data assessed were perceived occurrence and helpfulness of these strategies in facilitating insulin initiation. RESULTS The most helpful strategies involved demonstrating the injection process (e.g. HCP talked patient through the process of taking insulin [83.6%]) and adopting a collaborative approach (HCP encouraged patient to contact the clinic immediately in case of any problems/questions [80.5%]). Additionally, HCPs highlighting the benefits of insulin (HCP explained that insulin was a natural substance needed by patient's body [81.2%]) and allaying patients' concerns (HCP explained that patient might not have to take insulin forever [78.0%]) helped patients initiate insulin. The least helpful action was HCPs repeatedly persuading patients to initiate insulin (40.9%). CONCLUSIONS The study recommends key strategies that HCPs can adopt to help adults with T2DM overcome PIR in the UK.
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Affiliation(s)
| | | | | | | | | | | | - Frank J Snoek
- Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, Netherlands
| | - Jackie A Sturt
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
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31
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Speight J, Hendrieckx C, Pouwer F, Skinner TC, Snoek FJ. Back to the future: 25 years of 'Guidelines for encouraging psychological well-being' among people affected by diabetes. Diabet Med 2020; 37:1225-1229. [PMID: 31661183 DOI: 10.1111/dme.14165] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2019] [Indexed: 01/01/2023]
Affiliation(s)
- J Speight
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - C Hendrieckx
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - F Pouwer
- School of Psychology, Deakin University, Geelong, Australia
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- STENO Diabetes Centre, Odense, Denmark
| | - T C Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- STENO Diabetes Centre, Copenhagen, Denmark
| | - F J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, The Netherlands
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32
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Dieberger AM, Desoye G, Stolz E, Hill DJ, Corcoy R, Simmons D, Harreiter J, Kautzky-Willer A, Dunne F, Devlieger R, Wender-Ozegowska E, Zawiejska A, Lapolla A, Dalfra MG, Bertolotto A, Galjaard S, Adelantado JM, Jensen DM, Andersen LL, Tanvig M, Damm P, Mathiesen ER, Snoek FJ, Jelsma JGM, van Poppel MNM. Less sedentary time is associated with a more favourable glucose-insulin axis in obese pregnant women-a secondary analysis of the DALI study. Int J Obes (Lond) 2020; 45:296-307. [PMID: 32661292 PMCID: PMC7840500 DOI: 10.1038/s41366-020-0639-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/03/2020] [Indexed: 12/29/2022]
Abstract
Background/objectives Obese pregnant women are at high risk of developing gestational diabetes mellitus (GDM), which might be reduced by sufficient physical activity (PA) and reduced sedentary time (ST). We assessed whether PA and ST are longitudinally associated with the glucose-insulin axis in obese pregnant women. Subjects/methods In this secondary analysis of the DALI (vitamin D And Lifestyle Intervention for gestational diabetes mellitus prevention) study, pregnant women, <20 weeks gestation, with a pre-pregnancy body mass index (BMI) ≥ 29 kg/m2, without GDM on entry were included. Time spent in moderate-to-vigorous PA (MVPA) and ST were measured objectively with accelerometers at <20 weeks, 24–28 weeks and 35–37 weeks of gestation. Fasting glucose (mmol/l) and insulin (mU/l), insulin resistance (HOMA-IR) and first-phase and second-phase insulin release (Stumvoll first and second phase) were assessed at the same time. Linear mixed regression models were used to calculate between-participant differences and within-participant changes over time. Analyses were adjusted for gestational age, randomisation, pre-pregnancy BMI, education and age. MVPA, Insulin, HOMA-IR and Stumvoll first and second phase were log-transformed for analyses due to skewness. Results 232 women were included in the analysis. Concerning differences between participants, more ST was associated with higher fasting glucose (Estimate: 0.008; 95% CI: 0.002, 0.014), fasting insulin (0.011; 0.002, 0.019), HOMA-IR (0.012; 0.004, 0.021) and Stumvoll first and second phase (0.008; 0.001, 0.014 and 0.007; 0.001, 0.014). Participants with more MVPA had lower Stumvoll first and second phase (−0.137; −0.210, −0.064 and −0.133; −0.202, −0.063). Concerning changes over time, an increase in ST during gestation was associated with elevated Stumvoll first and second phase (0.006; 0.000, 0.011). Conclusions As the glucose-insulin axis is more strongly associated with ST than MVPA in our obese population, pregnant women could be advised to reduce ST in addition to increasing MVPA. Moreover, our findings suggest that behaviour change interventions aiming at GDM risk reduction should start in early or pre-pregnancy.
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Affiliation(s)
- Anna M Dieberger
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria.
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - David J Hill
- Recherche en Santé Lawson SA, Bronschhofen, Switzerland.,Lawson Health Research Institute, London, ON, N6C 2R5, Canada
| | - Rosa Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.,CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
| | - David Simmons
- Macarthur Clinical School, Western Sydney University, Sydney, Australia
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Fidelma Dunne
- Galway Diabetes Research Centre and College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | | | - Agnieszka Zawiejska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | | | - Sander Galjaard
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Juan M Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Dorte Møller Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Lise-Lotte Andersen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Mette Tanvig
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth Reinhardt Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Lima RA, Desoye G, Simmons D, Devlieger R, Galjaard S, Corcoy R, Adelantado JM, Dunne F, Harreiter J, Kautzky‐Willer A, Damm P, Mathiesen ER, Jensen DM, Andersen L, Tanvig M, Lapolla A, Dalfra MG, Bertolotto A, Wender‐Ozegowska E, Zawiejska A, Hill DJ, Snoek FJ, Jelsma JGM, van Poppel MNM. Temporal relationships between maternal metabolic parameters with neonatal adiposity in women with obesity differ by neonatal sex: Secondary analysis of the DALI study. Pediatr Obes 2020; 15:e12628. [PMID: 32141687 PMCID: PMC7317347 DOI: 10.1111/ijpo.12628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/05/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To investigate the importance of time in pregnancy and neonatal sex on the association between maternal metabolic parameters and neonatal sum of skinfolds. METHODS This was a longitudinal, secondary analysis of the vitamin D and lifestyle intervention for gestational diabetes mellitus study, conducted in nine European countries during 2012 to 2015. Pregnant women with a pre-pregnancy body mass index (BMI) of ≥29 kg/m2 were invited to participate. We measured 14 maternal metabolic parameters at three times during pregnancy: <20 weeks, 24 to 28 weeks, and 35 to 37 weeks of gestation. The sum of four skinfolds assessed within 2 days after birth was the measure of neonatal adiposity. RESULTS In total, 458 mother-infant pairs (50.2% female infants) were included. Insulin resistance (fasting insulin and HOMA-index of insulin resistance) in early pregnancy was an important predictor for boys' sum of skinfolds, in addition to fasting glucose and maternal adiposity (leptin, BMI and neck circumference) throughout pregnancy. In girls, maternal lipids (triglycerides and fatty acids) in the first half of pregnancy were important predictors of sum of skinfolds, as well as fasting glucose in the second half of pregnancy. CONCLUSIONS Associations between maternal metabolic parameters and neonatal adiposity vary between different periods during pregnancy. This time-dependency is different between sexes, suggesting different growth strategies.
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Affiliation(s)
| | - Gernot Desoye
- Department of Obstetrics and GynecologyMedizinische Universitaet GrazGrazAustria
| | - David Simmons
- Western Sydney UniversityCampbelltownNew South WalesAustralia,The Institute of Metabolic ScienceAddenbrooke's HospitalCambridgeUK
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and ObstetricsUniversity Hospitals LeuvenLeuvenBelgium
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and ObstetricsUniversity Hospitals LeuvenLeuvenBelgium,Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MCUniversity Medical CentreRotterdamThe Netherlands
| | - Rosa Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant PauBarcelonaSpain
| | - Juan M. Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant PauBarcelonaSpain,CIBER Bioengineering, Biomaterials and NanotechnologyInstituto de Salud Carlos IIIZaragozaSpain
| | - Fidelma Dunne
- Galway Diabetes Research Centre and College of Medicine Nursing and Health SciencesNational University of IrelandGalwayIreland
| | - Jürgen Harreiter
- Gender Medicine Unit, Endocrinology and Metabolism, Department of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Alexandra Kautzky‐Willer
- Gender Medicine Unit, Endocrinology and Metabolism, Department of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Department of Endocrinology and Obstetrics, RigshospitaletInstitute of Clinical Medicine, Faculty of Health and Medical Sciences, University of CopenhagenCopenhagenDenmark
| | - Elisabeth R. Mathiesen
- Center for Pregnant Women with Diabetes, Department of Endocrinology and Obstetrics, RigshospitaletInstitute of Clinical Medicine, Faculty of Health and Medical Sciences, University of CopenhagenCopenhagenDenmark
| | - Dorte M. Jensen
- Steno Diabetes Center OdenseOdense University HospitalOdenseDenmark,Department of Gynecology and ObstetricsOdense University HospitalOdenseDenmark,Department of Clinical Research, Faculty of Health SciencesUniversity of Southern DenmarkOdenseDenmark
| | - Lise‐Lotte Andersen
- Department of Gynecology and ObstetricsOdense University HospitalOdenseDenmark,Department of Clinical Research, Faculty of Health SciencesUniversity of Southern DenmarkOdenseDenmark
| | - Mette Tanvig
- Department of Gynecology and ObstetricsOdense University HospitalOdenseDenmark,Department of Clinical Research, Faculty of Health SciencesUniversity of Southern DenmarkOdenseDenmark
| | | | | | | | | | | | | | - Frank J. Snoek
- Department of Medical PsychologyAmsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Judith G. M. Jelsma
- Department of Public and Occupational HealthAmsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research instituteAmsterdamThe Netherlands
| | - Mireille N. M. van Poppel
- Institute of Sport ScienceUniversity of GrazGrazAustria,Department of Public and Occupational HealthAmsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research instituteAmsterdamThe Netherlands
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Harreiter J, Desoye G, van Poppel MNM, Kautzky-Willer A, Dunne F, Corcoy R, Devlieger R, Simmons D, Adelantado JM, Damm P, Mathiesen ER, Jensen DM, Anderson LLT, Lapolla A, Dalfrà MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Hill DJ, Snoek FJ. Correction to: The Effects of Lifestyle and/or Vitamin D Supplementation Interventions on Pregnancy Outcomes: What Have we Learned from the DALI Studies? Curr Diab Rep 2020; 20:35. [PMID: 32566999 DOI: 10.1007/s11892-020-01322-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The original version of this review article unfortunately contained a mistake.
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Affiliation(s)
- Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | | | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | | | - Rosa Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England.
- School of Medicine, Macarthur Clinical School, Western Sydney University, Locked Bag 1797, Campbelltown, NSW, 2751, Australia.
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Ben Â, Finch AP, van Dongen JM, de Wit M, van Dijk SEM, Snoek FJ, Adriaanse MC, van Tulder MW, Bosmans JE. Comparing the EQ-5D-5L crosswalks and value sets for England, the Netherlands and Spain: Exploring their impact on cost-utility results. Health Econ 2020; 29:640-651. [PMID: 32059078 DOI: 10.1002/hec.4008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 12/14/2019] [Accepted: 01/21/2020] [Indexed: 06/10/2023]
Abstract
This study compares the five-level EuroQol five-dimension questionnaire (EQ-5D-5L) crosswalks and the 5L value sets for England, the Netherlands, and Spain and explores the implication of using one or the other for the results of cost-utility analyses. Data from two randomized controlled trials in depression and diabetes were used. Utility value distributions were compared, and mean differences in utility values between the EQ-5D-5L crosswalk and the 5L value set were described by country. Quality-adjusted life years (QALYs) were calculated using the area-under-the-curve method. Incremental cost-effectiveness ratios (ICERs) were calculated, and uncertainty around ICERs was estimated using bootstrapping and graphically shown in cost-effectiveness acceptability curves. For all countries investigated, utility value distributions differed between the EQ-5D-5L crosswalk and 5L value set. In both case studies, mean utility values were lower for the EQ-5D-5L crosswalk compared with the 5L value set in England and Spain, but higher in the Netherlands. However, these differences in utility values did not translate into relevant differences across utility estimation methods in incremental QALYs and the interventions' probability of cost-effectiveness. Thus, our results suggest that EQ-5D-5L crosswalks and 5L value sets can be used interchangeably in patients affected by mild or moderate conditions. Further research is needed to establish whether these findings are generalizable to economic evaluations among severely ill patients.
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Affiliation(s)
- Ângela Ben
- Health Technology Assessment Section, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aureliano Paolo Finch
- Health Technology Assessment Section, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Johanna M van Dongen
- Health Technology Assessment Section, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maartje de Wit
- Department of Medical Psychology, Amsterdam University Medical Centers - VUmc, Amsterdam, The Netherlands
| | - Susan E M van Dijk
- Health Technology Assessment Section, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centers - VUmc, Amsterdam, The Netherlands
| | - Marcel C Adriaanse
- Health Technology Assessment Section, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maurits W van Tulder
- Health Technology Assessment Section, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Health Technology Assessment Section, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Wieringa TH, de Wit M, Twisk JWR, Snoek FJ. Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics. BMJ Open Diabetes Res Care 2020; 8:8/1/e001146. [PMID: 32241781 PMCID: PMC7170392 DOI: 10.1136/bmjdrc-2019-001146] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The Diabetes Symptom Checklist-Revised (DSC-R) is a well-validated patient-reported outcome designed to assess symptom burden in persons with type 2 diabetes mellitus (T2DM) across eight domains. The DSC-R has so far primarily been used in research settings. With the aim to make the DSC-R applicable in clinical practice by improving its interpretability, we sought to identify patient characteristics associated with DSC-R (domain) scores as a first initiative toward reference values. RESEARCH DESIGN AND METHODS We used baseline data from two large observational studies to select patient characteristics significantly associated with DSC-R domain and total scores. Multivariable Tobit analyses with the backward procedure per (domain) score were performed. RESULTS Data from 1531 participants with T2DM were included. On a 0-100 scale, the median DSC-R total score was 15.88 (7.06-29.41), with domain scores ranging from 5.00 (0.00-22.50) (pain) to 35.00 (10.00-60.00) (fatigue). Low well-being status was most profoundly associated with higher scores across all domains. Persons with one or more complication, as well as one or more symptomatic hypoglycemic episode during the past 3 months, scored higher on (almost) all domains and the total scale. CONCLUSIONS Complications, symptomatic hypoglycemia, and low well-being are important characteristics to take into account when using the DSC-R in individual patients. Further validation of our findings is warranted in diverse patient populations.
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Affiliation(s)
- Thomas H Wieringa
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Maartje de Wit
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Hendrieckx C, Gonder-Frederick L, Heller SR, Snoek FJ, Speight J. How has psycho-behavioural research advanced our understanding of hypoglycaemia in type 1 diabetes? Diabet Med 2020; 37:409-417. [PMID: 31814151 DOI: 10.1111/dme.14205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 11/29/2022]
Abstract
Almost 100 years since the discovery of insulin, hypoglycaemia remains a barrier for people with type 1 diabetes to achieve and maintain blood glucose at levels which prevent long-term diabetes-related complications. Although hypoglycaemia is primarily attributable to the limitations of current treatment and defective hormonal counter-regulation in type 1 diabetes, the central role of psycho-behavioural factors in preventing, recognizing and treating hypoglycaemia has been acknowledged since the early 1980s. Over the past 25 years, as documented in the present review, there has been a substantial increase in psycho-behavioural research focused on understanding the experience and impact of hypoglycaemia. The significant contributions have been in understanding the impact of hypoglycaemia on a person's emotional well-being and aspects of life (e.g. sleep, driving, work/social life), identifying modifiable psychological and behavioural risk factors, as well as in developing psycho-behavioural interventions to prevent and better manage (severe) hypoglycaemia. The impact of hypoglycaemia on family members has also been confirmed. Structured diabetes education programmes and psycho-behavioural interventions with a focus on hypoglycaemia have both been shown to be effective in addressing problematic hypoglycaemia. However, the findings have also revealed the complexity of the problem and the need for a personalized approach, taking into account the individual's knowledge of, and emotional/behavioural reactions to hypoglycaemia. Evidence is emerging that people with persistent and recurrent severe hypoglycaemia, characterized by deeply entrenched cognitions and lack of concern around hypoglycaemia, can benefit from tailored cognitive behavioural therapy.
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Affiliation(s)
- C Hendrieckx
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Melbourne, Victoria, Australia
| | - L Gonder-Frederick
- Centre for Diabetes Technology, Department of Psychiatry and Neurobehavioural Sciences, University of Virginia, Charlottesville, VA, USA
| | - S R Heller
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - F J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, The Netherlands
| | - J Speight
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Melbourne, Victoria, Australia
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van Linde ME, Braamse AMJ, Collette EH, Hoogendoorn AW, Snoek FJ, Verheul HMW, Dekker J. Clinical assessment of emotions in patients with cancer: Diagnostic accuracy compared with two reference standards. Psychooncology 2020; 29:775-780. [PMID: 32011016 PMCID: PMC7216973 DOI: 10.1002/pon.5347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Previous research has suggested that clinical assessment of emotions in patients with cancer is suboptimal. However, it is a possibility that well-trained and experienced doctors and nurses do recognize emotions but that they do not evaluate all emotions as necessitating professional mental health care. This implies that the sensitivity of clinical assessment should be tested against the need for professional mental health care as reference standard, instead of emotional distress. We hypothesized that the observed sensitivity of clinical assessment of emotions would be higher when tested against need for professional mental health care as reference standard, compared with emotional distress as reference standard. PATIENTS AND METHODS A consecutive series of patients starting with chemotherapy were recruited during their routine clinical care, at a department of medical oncology. Clinical assessment of emotions by medical oncologists and nurses was derived from the patient file. Emotional distress and need for professional mental health care were assessed using the Distress Thermometer and Problem List. RESULTS Clinical assessment resulted in notes on emotions in 42.2% of the patient files with 36.2% of patients experiencing emotional distress and 10.8% expressing a need for professional mental health care (N = 185). As expected, the sensitivity of clinical assessment of emotions was higher with the reference standard "need for professional mental health care" compared with "emotional distress" (P < .001). For specificity, equivalent results were obtained with the two reference standards (P = .63). CONCLUSIONS Clinical assessment of emotions in patients with cancer may be more accurate than previously concluded.
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Affiliation(s)
- Myra E van Linde
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Annemarie M J Braamse
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Emma H Collette
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Adriaan W Hoogendoorn
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joost Dekker
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Abstract
Editor's Note: This article was adapted from the address Dr. Snoek delivered as the recipient of the American Diabetes Association's Richard R. Rubin Award for 2019. This award recognizes a behavioral researcher who has made outstanding, innovative contributions to the study and understanding of the behavioral aspects of diabetes in diverse populations. Dr. Snoek delivered the address in June 2019 at the Association's 79th Scientific Sessions in San Francisco, CA.
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Affiliation(s)
- Frank J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
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Brouwer A, van Raalte DH, Rutters F, Elders PJM, Snoek FJ, Beekman ATF, Bremmer MA. Sleep and HbA 1c in Patients With Type 2 Diabetes: Which Sleep Characteristics Matter Most? Diabetes Care 2020; 43:235-243. [PMID: 31719053 DOI: 10.2337/dc19-0550] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/07/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Poor sleep has been identified as a risk factor for poor glycemic control in individuals with type 2 diabetes (T2D). As optimal sleep can be characterized in several ways, we evaluated which sleep characteristics are most strongly associated with glycated hemoglobin A1c (HbA1c). RESEARCH DESIGN AND METHODS A total of 172 patients with T2D completed 7-day wrist-actigraphy and sleep questionnaires. Linear regression was used to evaluate associations between sleep measures (total sleep duration, variability in sleep duration, midsleep time, variability in midsleep time, sleep efficiency, subjective sleep quality, and subjective insomnia symptoms) and HbA1c, individually and in concert. RESULTS Variability in sleep duration was individually most strongly associated with HbA1c (β = 0.239; P = 0.002; R 2 = 4.9%), followed by total sleep duration (U-shaped: β = 1.161/β2 = 1.044; P = 0.017/0.032; R 2 = 4.3%), subjective sleep quality (β = 0.191; P = 0.012; R 2 = 3.6%), variability in midsleep time (β = 0.184; P = 0.016; R 2 = 3.4%), and sleep efficiency (β = -0.150; R 2 = 2.3%). Midsleep time and subjective insomnia symptoms were not associated with HbA1c. In combination, variability in sleep duration, total sleep duration, and subjective sleep quality were significantly associated with HbA1c, together explaining 10.3% of the variance in HbA1c. Analyses adjusted for covariates provided similar results, although the strength of associations was generally decreased and showing total sleep duration and subjective sleep quality to be most strongly associated with HbA1c, together explaining 6.0% of the variance in HbA1c. CONCLUSIONS Sleep in general may be a modifiable factor of importance for patients with T2D. The prevention of sleep curtailment may serve as a primary focus in the sleep-centered management of T2D.
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Affiliation(s)
- Annelies Brouwer
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Daniel H van Raalte
- Department of Internal Medicine, Diabetes Center, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Petra J M Elders
- Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit and University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Marijke A Bremmer
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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Harreiter J, Desoye G, van Poppel MNM, Kautzky-Willer A, Dunne F, Corcoy R, Devlieger R, Simmons D, Adelantado JM, Damm P, Mathiesen ER, Jensen DM, Anderson LLT, Lapolla A, Dalfrà MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Hill DJ, Snoek FJ. The Effects of Lifestyle and/or Vitamin D Supplementation Interventions on Pregnancy Outcomes: What Have We Learned from the DALI Studies? Curr Diab Rep 2019; 19:162. [PMID: 31845115 DOI: 10.1007/s11892-019-1282-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW The DALI (vitamin D and lifestyle intervention in the prevention of gestational diabetes mellitus (GDM)) study aimed to prevent GDM with lifestyle interventions or Vitamin D supplementation (1600 IU/day). This review summarizes the learnings from the DALI studies among pregnant women with a BMI ≥ 29 kg/m2. RECENT FINDINGS Women diagnosed with GDM earlier in pregnancy had a worse metabolic profile than those diagnosed later. A combined physical activity (PA) and healthy eating (HE) lifestyle intervention improved both behaviours, limited gestational weight gain (GWG) and was cost-effective. Although GDM risk was unchanged, neonatal adiposity was reduced due to less sedentary time. Neither PA nor HE alone limited GWG or GDM risk. Fasting glucose was higher with HE only intervention, and lower with Vitamin D supplementation. Our combined intervention did not prevent GDM, but was cost-effective, limited GWG and reduced neonatal adiposity.
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Affiliation(s)
- Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | | | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | | | - Rosa Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England.
- School of Medicine, Macarthur Clinical School, Western Sydney University, Locked Bag 1797, Campbelltown, NSW, 2751, Australia.
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Perrin N, Bodicoat DH, Davies MJ, Robertson N, Snoek FJ, Khunti K. Effectiveness of psychoeducational interventions for the treatment of diabetes-specific emotional distress and glycaemic control in people with type 2 diabetes: A systematic review and meta-analysis. Prim Care Diabetes 2019; 13:556-567. [PMID: 31040069 DOI: 10.1016/j.pcd.2019.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 11/26/2018] [Accepted: 04/02/2019] [Indexed: 01/28/2023]
Abstract
AIMS Psychological comorbidity, such as depression and/or diabetes-specific emotional distress (DSD), is highly prevalent in people with type 2 diabetes (T2DM) and associated with poorer treatment outcomes. While treatments for depression are well established, interventions specifically designed for DSD are sparse. The aim of this study was to determine interventions that successfully address DSD and HbA1c in people with T2DM. METHODS Seven databases were searched to identify potentially relevant studies. Eligible studies were selected and appraised independently by two reviewers. Multiple meta-analyses and meta-regression analyses were performed to synthesise the data; the primary analyses determined the effect of interventions on DSD, with secondary analyses assessing the effect on HbA1c. RESULTS Thirty-two studies (n = 5206) provided sufficient DSD data, of which 23 (n = 3818) reported data for HbA1c. Meta-analyses demonstrated that interventions significantly reduced DSD (p = 0.034) and HbA1c (p = 0.006) compared to controls, although subgroup meta-analyses and meta-regression to explore specific intervention characteristics that might mediate this effect yielded non-significant findings. CONCLUSIONS The findings demonstrate that existing interventions successfully reduce DSD and HbA1c in people with T2DM. While promising, deductions should be interpreted tentatively, highlighting a stark need for further focused exploration of how best to treat psychological comorbidity in people with T2DM.
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Affiliation(s)
- N Perrin
- Division of Rural Health and Wellbeing, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, United Kingdom.
| | - D H Bodicoat
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - M J Davies
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - N Robertson
- School of Psychology, University of Leicester, Leicester, United Kingdom
| | - F J Snoek
- Department of Medical Psychology, VU University Medical Centre, Department of Medical Psychology, Academic Medical centre, Amsterdam, Netherlands
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
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Harreiter J, Simmons D, Desoye G, Corcoy R, Adelantado JM, Devlieger R, Galjaard S, Damm P, Mathiesen ER, Jensen DM, Andersen LLT, Dunne F, Lapolla A, Dalfra MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Mantaj U, Hill D, Jelsma JGM, Snoek FJ, Leutner M, Lackinger C, Worda C, Bancher-Todesca D, Scharnagl H, van Poppel MNM, Kautzky-Willer A. Nutritional Lifestyle Intervention in Obese Pregnant Women, Including Lower Carbohydrate Intake, Is Associated With Increased Maternal Free Fatty Acids, 3-β-Hydroxybutyrate, and Fasting Glucose Concentrations: A Secondary Factorial Analysis of the European Multicenter, Randomized Controlled DALI Lifestyle Intervention Trial. Diabetes Care 2019; 42:1380-1389. [PMID: 31182492 DOI: 10.2337/dc19-0418] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/12/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE In our randomized controlled trial, we investigated the impact of healthy eating (HE) aiming for restricted gestational weight gain (GWG) and physical activity (PA) interventions on maternal and neonatal lipid metabolism. RESEARCH DESIGN AND METHODS Obese pregnant women (n = 436) were included before 20 weeks' gestation and underwent glucose testing (oral glucose tolerance test) and lipid profiling at baseline and 24-28 and 35-37 gestational weeks after an at least 10-h overnight fast. This secondary analysis had a factorial design with comparison of HE (n = 221) versus no HE (n = 215) and PA (n = 218) versus no PA (n = 218). Maternal changes in triglycerides (TG), LDL cholesterol, HDL cholesterol, free fatty acids (FFAs), and leptin from baseline to end of pregnancy and neonatal outcomes were analyzed using general linear models with adjustment for relevant parameters. RESULTS At 24-28 weeks' gestation, FFAs (mean ± SD, 0.60 ± 0.19 vs. 0.55 ± 0.17 mmol/L, P < 0.01) were increased after adjustment for FFA at baseline, maternal age, BMI at time of examination, gestational week, insulin resistance, self-reported food intake, self-reported physical activity, and maternal smoking, and GWG was lower (3.3 ± 2.6 vs. 4.3 ± 2.8 kg, P < 0.001, adjusted mean differences -1.0 [95% CI -1.5; -0.5]) in HE versus no HE. Fasting glucose levels (4.7 ± 0.4 vs. 4.6 ± 0.4 mmol/L, P < 0.05) and 3-β-hydroxybutyrate (3BHB) (0.082 ± 0.065 vs. 0.068 ± 0.067 mmol/L, P < 0.05) were higher in HE. Significant negative associations between carbohydrate intake and FFA, 3BHB, and fasting glucose at 24-28 weeks' gestation were observed. No differences between groups were found in oral glucose tolerance test or leptin or TG levels at any time. Furthermore, in PA versus no PA, no similar changes were found. In cord blood, elevated FFA levels were found in HE after full adjustment (0.34 ± 0.22 vs. 0.29 ± 0.16 mmol/L, P = 0.01). CONCLUSIONS HE intervention was associated with reduced GWG, higher FFAs, higher 3BHB, and higher fasting glucose at 24-28 weeks of gestation, suggesting induction of lipolysis. Increased FFA was negatively associated with carbohydrate intake and was also observed in cord blood. These findings support the hypothesis that maternal antenatal dietary restriction including carbohydrates is associated with increased FFA mobilization.
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Affiliation(s)
- Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England.,Macarthur Clinical School, Western Sydney University, Sydney, New South Wales, Australia
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Rosa Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomaterials and Nanotechnology, CIBER Bioengineering, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan M Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Roland Devlieger
- Department of Development and Regeneration, KU Leuven, University Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,Department of Obstetrics, Gynecology, and Fertility, GZA Sint-Augustinus Wilrijk, Antwerpen, Belgium
| | - Sander Galjaard
- Department of Development and Regeneration, KU Leuven, University Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.,The Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.,The Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health, University of Southern Denmark, Sønderborg, Denmark
| | - Lise Lotte T Andersen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health, University of Southern Denmark, Sønderborg, Denmark
| | - Fidelma Dunne
- Galway Diabetes Research Centre and National University of Ireland, Galway, Ireland
| | | | | | | | - Ewa Wender-Ozegowska
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Zawiejska
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | - Urszula Mantaj
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | - David Hill
- Recherche en Santé Lawson SA, St. Gallen, Switzerland
| | - Judith G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Michael Leutner
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | | | - Christof Worda
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Dagmar Bancher-Todesca
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Mireille N M van Poppel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.,Institute of Sport Science, University of Graz, Graz, Austria
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
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Schmidt CB, Voorhorst I, van de Gaar VHW, Keukens A, Potter van Loon BJ, Snoek FJ, Honig A. Diabetes distress is associated with adverse pregnancy outcomes in women with gestational diabetes: a prospective cohort study. BMC Pregnancy Childbirth 2019; 19:223. [PMID: 31269913 PMCID: PMC6610799 DOI: 10.1186/s12884-019-2376-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/24/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Around 12% of pregnant women develop gestational diabetes mellitus (GDM), which is associated with increased health risks for both mother and child and pre- and postpartum depression. Little is known about the relationship of GDM with diabetes-specific emotional distress (diabetes distress). The aims of this study are to assess the prevalence of diabetes distress in GDM and its association with adverse pregnancy outcomes. METHODS A prospective cohort study was carried out in an Amsterdam based teaching hospital with an ethnic diverse population. Women diagnosed with GDM completed a set of questionnaires at three time points. Questionnaires consisted of Problem Areas in Diabetes Scale 5 (PAID-5) for diabetes distress (T0-T1), Patient Health Questionnaire 9 (PHQ-9) for depressive symptoms (T0-T2), and questions to assess adverse pregnancy outcomes (T2). Adverse pregnancy outcomes (collected via self-report and if feasible from the medical records) were defined as hypertension, pre-eclampsia, caesarean section, severe perineal tearing, postpartum hemorrhage, postpartum depression, shoulder dystocia, neonatal hospitalization, macrosomia, jaundice, hypoglycemia and other (among which low heart rate, fever, hypoxia). Adverse pregnancy outcomes were dichotomized into none and 1 or more. Additional information was collected from the medical charts. Missing data were imputed via predictive mean matching and a multivariable logistic regression analysis was performed with diabetes distress, depressive symptoms, socioeconomic status, parity and ethnicity as predictors and age, HbA1c, and BMI as covariates. RESULTS A total of 100 women were included, mean age 32.5 (4.1), mean BMI 26.7 (4.8), 71% were of non-Dutch ethnic background. Elevated diabetes distress (PAID score ≥ 8) was reported by 36% of the women. Multivariable logistic regression analyses revealed that both high diabetes distress (OR 4.70, p = .02) and parity (OR 0.21, p = .02) but not antepartum depressive symptoms were related to adverse pregnancy outcomes. CONCLUSIONS Diabetes distress is likely in women with GDM and our findings suggest an association between both diabetes distress, parity and adverse pregnancy outcomes in women with GDM. This warrants replication and further research into the underlying mechanisms explaining the impact of diabetes distress in GDM and potential interventions to reduce distress.
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Affiliation(s)
- Charlotte B. Schmidt
- Department of Psychiatry, OLVG, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Ilse Voorhorst
- Department of Psychiatry, OLVG, Amsterdam, the Netherlands
| | | | - Anne Keukens
- Department of Gynaecology, OLVG, Amsterdam, the Netherlands
| | | | - Frank J. Snoek
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Adriaan Honig
- Department of Psychiatry, OLVG, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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45
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van Poppel MNM, Simmons D, Devlieger R, van Assche FA, Jans G, Galjaard S, Corcoy R, Adelantado JM, Dunne F, Harreiter J, Kautzky-Willer A, Damm P, Mathiesen ER, Jensen DM, Andersen LL, Tanvig M, Lapolla A, Dalfra MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Hill D, Snoek FJ, Jelsma JGM, Desoye G. A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity: the DALI randomised controlled trial. Diabetologia 2019; 62:915-925. [PMID: 30840112 PMCID: PMC6509072 DOI: 10.1007/s00125-019-4842-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/06/2019] [Indexed: 12/17/2022]
Abstract
AIMS/HYPOTHESIS Offspring of obese women are at increased risk of features of the metabolic syndrome, including obesity and diabetes. Lifestyle intervention in pregnancy might reduce adverse effects of maternal obesity on neonatal adiposity. METHODS In the Vitamin D And Lifestyle Intervention for Gestational Diabetes Mellitus (GDM) Prevention (DALI) lifestyle trial, 436 women with a BMI ≥29 kg/m2 were randomly assigned to counselling on healthy eating (HE), physical activity (PA) or HE&PA, or to usual care (UC). In secondary analyses of the lifestyle trial, intervention effects on neonatal outcomes (head, abdominal, arm and leg circumferences and skinfold thicknesses, estimated fat mass, fat percentage, fat-free mass and cord blood leptin) were assessed using multilevel regression analyses. Mediation of intervention effects by lifestyle and gestational weight gain was assessed. RESULTS Outcomes were available from 334 neonates. A reduction in sum of skinfolds (-1.8 mm; 95% CI -3.5, -0.2; p = 0.03), fat mass (-63 g; 95% CI -124, -2; p = 0.04), fat percentage (-1.2%; 95% CI -2.4%, -0.04%; p = 0.04) and leptin (-3.80 μg/l; 95% CI -7.15, -0.45; p = 0.03) was found in the HE&PA group, and reduced leptin in female neonates in the PA group (-5.79 μg/l; 95% CI -11.43, -0.14; p = 0.05) compared with UC. Reduced sedentary time, but not gestational weight gain, mediated intervention effects on leptin in both the HE&PA and PA groups. CONCLUSIONS/INTERPRETATION The HE&PA intervention resulted in reduced adiposity in neonates. Reduced sedentary time seemed to drive the intervention effect on cord blood leptin. Implications for future adiposity and diabetes risk of the offspring need to be elucidated. TRIAL REGISTRATION ISRCTN70595832.
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Affiliation(s)
- Mireille N M van Poppel
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria.
| | - David Simmons
- Macarthur Clinical School, Western Sydney University, Sydney, NSW, Australia
- Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Roland Devlieger
- Department of Development and Regeneration: Pregnancy, Fetus and Neonate, KU Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - F Andre van Assche
- Department of Development and Regeneration: Pregnancy, Fetus and Neonate, KU Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Goele Jans
- Department of Development and Regeneration: Pregnancy, Fetus and Neonate, KU Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Sander Galjaard
- Department of Development and Regeneration: Pregnancy, Fetus and Neonate, KU Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
- Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Rosa Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Juan M Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Fidelma Dunne
- Galway Diabetes Research Centre, National University of Ireland, Galway, Ireland
- College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland
| | - Jürgen Harreiter
- Gender Medicine Unit, Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Lise-Lotte Andersen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Mette Tanvig
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- , Region of Southern Denmark, Denmark
| | - Annunziata Lapolla
- Dipartimento di Medicina, Università Degli Studi di Padova, Padua, Italy
| | - Maria G Dalfra
- Dipartimento di Medicina, Università Degli Studi di Padova, Padua, Italy
| | - Alessandra Bertolotto
- Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | | | - David Hill
- Recherche en Santé Lawson SA, Bronschhofen, Switzerland
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
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Wieringa TH, Rodriguez-Gutierrez R, Spencer-Bonilla G, de Wit M, Ponce OJ, Sanchez-Herrera MF, Espinoza NR, Zisman-Ilani Y, Kunneman M, Schoonmade LJ, Montori VM, Snoek FJ. Decision aids that facilitate elements of shared decision making in chronic illnesses: a systematic review. Syst Rev 2019; 8:121. [PMID: 31109357 PMCID: PMC6528254 DOI: 10.1186/s13643-019-1034-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 04/29/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Shared decision making (SDM) is a patient-centered approach in which clinicians and patients work together to find and choose the best course of action for each patient's particular situation. Six SDM key elements can be identified: situation diagnosis, choice awareness, option clarification, discussion of harms and benefits, deliberation of patient preferences, and making the decision. The International Patient Decision Aid Standards (IPDAS) require that a decision aid (DA) support these key elements. Yet, the extent to which DAs support these six key SDM elements and how this relates to their impact remain unknown. METHODS We searched bibliographic databases (from inception until November 2017), reference lists of included studies, trial registries, and experts for randomized controlled trials of DAs in patients with cardiovascular, or chronic respiratory conditions or diabetes. Reviewers worked in duplicate and independently selected studies for inclusion, extracted trial, and DA characteristics, and evaluated the quality of each trial. RESULTS DAs most commonly clarified options (20 of 20; 100%) and discussed their harms and benefits (18 of 20; 90%; unclear in two DAs); all six elements were clearly supported in 4 DAs (20%). We found no association between the presence of these elements and SDM outcomes. CONCLUSIONS DAs for selected chronic conditions are mostly designed to transfer information about options and their harms and benefits. The extent to which their support of SDM key elements relates to their impact on SDM outcomes could not be ascertained. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42016050320 .
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Affiliation(s)
- Thomas H Wieringa
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - Rene Rodriguez-Gutierrez
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Division of Endocrinology, Department of Internal Medicine, "Dr. Jose E. González" University Hospital, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico.,Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic, KER Unit México, "Dr. Jose E. González" University Hospital, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Gabriela Spencer-Bonilla
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Maartje de Wit
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Oscar J Ponce
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | | | - Nataly R Espinoza
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | | | - Marleen Kunneman
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Victor M Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
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47
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Polonsky WH, Fisher L, Hessler D, Stuckey H, Snoek FJ, Tang T, Hermanns N, Mundet X, Silva M, Sturt J, Okazaki K, Hadjiyianni I, Cao D, Ivanova J, Desai U, Perez-Nieves M. Identifying solutions to psychological insulin resistance: An international study. J Diabetes Complications 2019; 33:307-314. [PMID: 30709604 DOI: 10.1016/j.jdiacomp.2019.01.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/16/2018] [Accepted: 01/08/2019] [Indexed: 02/06/2023]
Abstract
AIMS To identify actions of healthcare professionals (HCPs) that facilitate the transition to insulin therapy (IT) in type 2 diabetes (T2D) adults. METHODS Included were T2Ds in seven countries (n = 594) who reported initial IT reluctance but eventually began IT. An online survey included 38 possible HCP actions: T2Ds indicated which may have occurred and their helpfulness. Also reported were delays in IT start after initial recommendation and any period of IT discontinuation. RESULTS Exploratory factor analysis of HCP actions yielded five factors: "Explained Insulin Benefits" (EIB), "Dispelled Insulin Myths" (DIM), "Demonstrated the Injection Process" (DIP), "Collaborative Style" (CS) and "Authoritarian Style" (AS). Highest levels of helpfulness occurred for DIP, EIB and CS; lowest for AS. Participants who rated DIP as helpful were less likely to delay IT than those who rated DIP as less helpful (OR = 0.75, p = 0.01); participants who rated CS and EIB as helpful were less likely to interrupt IT than those who rated these as less helpful (OR = 0.55, p < 0.01; OR = 0.51, p = 0.01, respectively). CONCLUSIONS Three key HCP actions to facilitate IT initiation were identified as helpful and were associated with more successful initiation and persistence. These findings may aid the development of interventions to address reluctance to initiating IT.
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Affiliation(s)
- William H Polonsky
- University of California, San Diego, La Jolla, CA, USA; Behavioral Diabetes Institute, San Diego, CA, USA.
| | - Lawrence Fisher
- University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Frank J Snoek
- Amsterdam University Medical Centers, VU University, Amsterdam, the Netherlands
| | - Tricia Tang
- University of British Columbia, Vancouver, Canada
| | | | - Xavier Mundet
- Universitat Autonoma de Barcelona, Bellaterra, Spain
| | - Maria Silva
- Instituto Multidisciplinar de Medicina, Sao Paulo, Brazil
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48
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Brouwer A, van Raalte DH, Nguyen HT, Rutters F, van de Ven PM, Elders PJM, Moll AC, Van Someren EJW, Snoek FJ, Beekman ATF, Bremmer MA. Effects of Light Therapy on Mood and Insulin Sensitivity in Patients With Type 2 Diabetes and Depression: Results From a Randomized Placebo-Controlled Trial. Diabetes Care 2019; 42:529-538. [PMID: 30796110 DOI: 10.2337/dc18-1732] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/19/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Depression is common in patients with type 2 diabetes and adversely affects quality of life and diabetes outcomes. We assessed whether light therapy, an antidepressant, improves mood and insulin sensitivity in patients with depression and type 2 diabetes. RESEARCH DESIGN AND METHODS This randomized, double-blind, placebo-controlled trial included 83 patients with depression and type 2 diabetes. The intervention comprised 4 weeks of light therapy (10,000 lux) or placebo light therapy daily at home. Primary outcomes included depressive symptoms (Inventory of Depressive Symptomatology [IDS]) and insulin sensitivity (M-value derived from the results of a hyperinsulinemic-euglycemic clamp). Secondary outcomes were related psychological and glucometabolic measures. RESULTS Intention-to-treat analysis showed that light therapy was not superior to placebo in reducing depressive symptoms (-3.9 IDS points [95% CI -9.0 to 1.2]; P = 0.248) and had no effect on insulin sensitivity (0.15 mg/kg*min [95% CI -0.41 to 0.70]; P = 0.608). Analyses incorporating only those participants who accurately adhered to the light therapy protocol (n = 51) provided similar results, but did suggest positive effects of light therapy on depression response rates (≥50% reduction in IDS points) (26% more response; P = 0.031). Prespecified analysis showed effect moderation by baseline insulin sensitivity (P = 0.009) and use of glucose-lowering medication (P = 0.023). Light therapy did not affect depressive symptoms in participants with higher insulin sensitivity or those who use only oral glucose-lowering medication or none at all, but it did produce a relevant effect in participants with lower insulin sensitivity (-12.9 IDS points [95% CI -21.6 to -4.2]; P = 0.017) and a trend toward effectiveness in those using insulin (-12.2 IDS points [95% CI -21.3 to -3.1]; P = 0.094). Light therapy was well tolerated. CONCLUSIONS Although this trial is essentially inconclusive, secondary analyses indicate that light therapy might be a promising treatment for depression among a subgroup of highly insulin-resistant individuals with type 2 diabetes.
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Affiliation(s)
- Annelies Brouwer
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Daniel H van Raalte
- Amsterdam UMC, Vrije Universiteit, Department of Internal Medicine, Diabetes Center, Amsterdam, the Netherlands
| | - Hoang-Ton Nguyen
- Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, Vrije Universiteit, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Peter M van de Ven
- Amsterdam UMC, Vrije Universiteit, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Petra J M Elders
- Amsterdam UMC, Vrije Universiteit, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Annette C Moll
- Amsterdam UMC, Vrije Universiteit, Department of Ophthalmology, Amsterdam, the Netherlands
| | - Eus J W Van Someren
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands.,Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, the Netherlands.,Amsterdam UMC, Vrije Universiteit, Department of Integrative Neurophysiology, Centre for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Vrije Universiteit and University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Marijke A Bremmer
- Amsterdam UMC, Vrije Universiteit, and GGZ inGeest, Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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49
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Emanuel AL, van Duinkerken E, Wattjes MP, Klein M, Barkhof F, Snoek FJ, Diamant M, Eringa EC, IJzerman RG, Serné EH. The presence of cerebral white matter lesions and lower skin microvascular perfusion predicts lower cognitive performance in type 1 diabetes patients with retinopathy but not in healthy controls-A longitudinal study. Microcirculation 2019; 26:e12530. [PMID: 30659710 PMCID: PMC6593465 DOI: 10.1111/micc.12530] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/07/2019] [Accepted: 01/15/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Cognitive impairments in type 1 diabetes may result from hyperglycemia-associated cerebral microangiopathy. We aimed to identify cerebral microangiopathy and skin microvascular dysfunction-as a surrogate marker for generalized microvascular function-as predictors of cognitive performance over time. METHODS In this prospective cohort study, 25 type 1 diabetes patients with proliferative retinopathy and 25 matched healthy controls underwent neurocognitive testing at baseline and after follow-up (3.8 ± 0.8 years). At baseline, 1.5-T cerebral magnetic resonance imaging was used to detect WML and cerebral microbleeds. Skin capillary perfusion was assessed by means of capillary microscopy. RESULTS In type 1 diabetes patients, but not in healthy controls, the presence of WML (ß = -0.419; P = 0.037) as well as lower skin capillary perfusion (baseline: ß = 0.753; P < 0.001; peak hyperemia: ß = 0.743; P = 0.001; venous occlusion: ß = 0.675; P = 0.003; capillary recruitment: ß = 0.549; P = 0.022) at baseline was associated with lower cognitive performance over time, independent of age, sex, HbA1c, and severe hypoglycemia. The relationship between WML and lower cognitive performance was significantly reduced after adjusting for capillary perfusion. CONCLUSIONS These data fit the hypothesis that cerebral microangiopathy is a manifestation of generalized microvascular dysfunction, leading to lower cognitive performance.
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Affiliation(s)
- Anna L Emanuel
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | - Eelco van Duinkerken
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | - Mike P Wattjes
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Martin Klein
- Department of Medical Psychology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Michaela Diamant
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Etto C Eringa
- Department of Physiology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Richard G IJzerman
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Erik H Serné
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
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50
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Vloemans AF, Eilander MMA, Rotteveel J, Bakker-van Waarde WM, Houdijk ECAM, Nuboer R, Winterdijk P, Snoek FJ, De Wit M. Youth With Type 1 Diabetes Taking Responsibility for Self-Management: The Importance of Executive Functioning in Achieving Glycemic Control: Results From the Longitudinal DINO Study. Diabetes Care 2019; 42:225-231. [PMID: 30552132 DOI: 10.2337/dc18-1143] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 10/18/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Successful self-management of type 1 diabetes requires cognitive skills such as executive functioning (EF). In the transition to adolescence, youth take over responsibility for diabetes management. We set out to test: 1) the association between EF and glycemic control over time and 2) whether this association was moderated by: a) youth, shared, or parent responsibility for diabetes management and b) youth's age. RESEARCH DESIGN AND METHODS Within the Diabetes IN DevelOpment study (DINO), parents of youth with type 1 diabetes (8-15 years at baseline; N = 174) completed a yearly assessment over 4 years. Glycemic control (HbA1c) was derived from hospital charts. Youth's EF was measured using the Behavior Rating Inventory of Executive Functioning (BRIEF)-parent report. The Diabetes Family Responsibility Questionnaire (DFRQ)-parent report was used to assess diabetes responsibility (youth, shared, and parent). Linear generalized estimating equations were used to analyze data including youth's sex, age, and age of diabetes onset as covariates. RESULTS Relatively more EF problems are significantly associated with higher HbA1c over time (β = 0.190; P = 0.002). More EF problems in combination with less youth responsibility (β = 0.501; P = 0.048) or more parental responsibility (β = -0.767; P = 0.006) are significantly associated with better glycemic control over time. Only age significantly moderates the relationship among EF problems, shared responsibility, and glycemic control (β = -0.024; P = 0.019). CONCLUSIONS Poorer EF is associated with worse glycemic control over time, and this association is moderated by responsibility for diabetes management tasks. This points to the importance of EF when youth take over responsibility for diabetes management in order to achieve glycemic control.
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Affiliation(s)
- Anne F Vloemans
- Department of Medical Psychology, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Minke M A Eilander
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, the Netherlands
| | - Joost Rotteveel
- Department of Pediatrics, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Willie M Bakker-van Waarde
- Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Euphemia C A M Houdijk
- Department of Pediatrics, Juliana Children's Hospital/HagaHospital, The Hague, the Netherlands
| | - Roos Nuboer
- Department of Pediatrics, Meander Medical Center, Amersfoort, the Netherlands
| | - Per Winterdijk
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, the Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.,Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Maartje De Wit
- Department of Medical Psychology, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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