Diabetes Self-Management Education and Support to Improve Outcomes for Children and Young Adults With Type 1 Diabetes: An Umbrella Review of Systematic Reviews

2021 ◽  
pp. 263501062110318
Author(s):  
Latika Rohilla ◽  
Sukhpal Kaur ◽  
Mona Duggal ◽  
Prahbhjot Malhi ◽  
Bhavneet Bharti ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Systematic Reviews ◽  
Management Education ◽  
Psychosocial Outcomes ◽  
Self Management ◽  
Umbrella Review ◽  
Related Research ◽  
Children And Young Adults

Purpose The objectives of this umbrella review were to describe various aspects of diabetes self-management education and support (DSMES)-related interventions and their effect on clinical, behavioral, and psychosocial outcomes among children and young adults with type 1 diabetes (T1DM) and identify gaps in current DSMES-related research. Methods An umbrella review of systematic reviews on DSMES interventions was conducted in accordance with the PRISMA 2009 statement. Four international medical databases were searched for eligible review articles published in English in the last 10 years that dealt with children and youths with T1DM and were conducted in accordance with a priori protocol. Results Out of the 234 citations screened, only 8 systematic reviews representing 166 studies were considered eligible for further analysis. Glycemic management (A1C) is the most common outcome variable (108 studies). Common behavioral and psychosocial outcome variables examined are episodes of hypoglycemia (27 studies) and diabetic ketoacidosis (21 studies) and self-care behavior and generic quality of life (20 studies each). Several gaps in DSMES-related research studies are identified, including uneven geographical distribution of study population, methodological weaknesses in study designs, missing important outcome variables, use of nonstandardized assessment tools, and lack of assessment of the sustainability of effects. Conclusion The effects of DSMES interventions on clinical, behavioral, and psychosocial outcomes are varied. The heterogeneity of implementation and evaluation makes it difficult to draw clear conclusions about elements of DSMES that are most effective. There is a need for long-term assessment of the psychosocial and behavioral outcomes using validated and generalizable instruments.

scholarly journals Transfer in care and diabetes distress in young adults with type 1 diabetes mellitus

2021 ◽  
Vol 9 (2) ◽  
pp. e002603
Author(s):  
Jane Sattoe ◽  
Mariëlle Peeters ◽  
Madelon Bronner ◽  
AnneLoes van Staa
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Young Adults ◽  
Type 1 Diabetes Mellitus ◽  
Short Form ◽  
Psychosocial Outcomes ◽  
Self Management ◽  
Diabetes Distress ◽  
Adult Care

IntroductionDiabetes distress (DD) is a serious problem in many people with diabetes and is associated with unfavorable clinical and psychosocial outcomes in children and adults. Little is known about DD in young adults (YAs) with type 1 diabetes mellitus (T1DM) who transferred to adult care. This study aimed to explore the differences between YAs with/without DD regarding transfer experiences, self-management and health-related quality of life (HRQoL).Research design and methodsCross-sectional online questionnaire completed by YAs with T1DM after transfer. DD was measured with the short-form Problem Areas in Diabetes scale. Descriptive analyses were followed by t-tests and χ2 tests to explore differences between the groups with/without DD. Effect sizes were calculated.ResultsOf 164 respondents with mean age 22.7 (±1.56) years, 60.7% was female. The total sample scored low on DD (6.52±4.67; range: 0–17), but 57 (34.8%) had a score ≥8, indicating DD. YAs with DD felt less ready to transfer to adult care than those without DD and scored lower on alliance between pediatric and adult care and reception in adult care. They also reported poorer self-management skills and lower HRQoL in all domains of functioning.ConclusionsMore than one-third YAs experienced DD after transfer; this was associated with less favorable transition, self-management and psychosocial outcomes. Transfer in care seems to be a source of DD. Systematic screening on DD and attention for YAs’ worries is recommended in both pediatric and adult care.

scholarly journals Coeliac disease is associated with depression in children and young adults with type 1 diabetes: results from a multicentre diabetes registry

2021 ◽  
Author(s):  
Sascha René Tittel ◽  
◽  
Désirée Dunstheimer ◽  
Dörte Hilgard ◽  
Burkhild Knauth ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Coeliac Disease ◽  
Diabetes Patient ◽  
Routine Care ◽  
Diabetes Registry ◽  
Increased Risk ◽  
Treatment Data ◽  
Children And Young Adults

Abstract Aims To analyse the association between coeliac disease (CD) and depression in children, adolescents, and young adults with type 1 diabetes (T1D). Methods We included 79,067 T1D patients aged 6–20 years, with at least six months of diabetes duration, and treatment data between 1995 and 2019 were documented in the diabetes patient follow-up registry. We categorized patients into four groups: T1D only (n = 73,699), T1 + CD (n = 3379), T1D + depression (n = 1877), or T1D + CD + depression (n = 112). Results CD and depression were significantly associated (adjusted OR: 1.25 [1.03–1.53]). Females were more frequent in both the depression and the CD group compared with the T1D only group. Insulin pumps were used more frequently in T1D + CD and T1D + depression compared with T1D only (both p < .001). HbA1c was higher in T1D + depression (9.0% [8.9–9.0]), T1D + CD + depression (8.9% [8.6–9.2]), both compared with T1D only (8.2% [8.2–8.2], all p < .001). We found comorbid autism, attention deficit hyperactivity disorder, anxiety, schizophrenia, and eating disorders more frequently in the T1D + CD + depression group compared with T1D only (all p < .001). Conclusions CD and depression are associated in young T1D patients. The double load of T1D and CD may lead to an increased risk for depression. Depression was associated with additional psychological and neurological comorbidities. Aside from imperative CD screening after T1D diagnosis and regular intervals, depression screening might be helpful in routine care, especially in patients with diagnosed CD.

Health promotion challenges for young adults living with intellectual disability and type 1 diabetes

2021 ◽  
pp. 174462952110327
Author(s):  
Anne L Marks ◽  
Natasha Mahoney ◽  
Yu-Wei Chen ◽  
Reinie Cordier ◽  
Angus Buchanan ◽  
...  
Keyword(s):  
Health Promotion ◽  
Type 1 Diabetes ◽  
Young Adults ◽  
Intellectual Disability ◽  
Barriers And Facilitators ◽  
Self Management ◽  
Service Support ◽  
Health Support ◽  
Level Monitoring

Background: Self-management of type 1 diabetes mellitus (T1DM) can be challenging for people with intellectual disability. Often, parents provide health support due to lack of appropriate services outside the home. The study aim was to identify barriers and facilitators to T1DM self-management for young adults with intellectual disability and the implications for health promotion. Methods: Five male participants with intellectual disability, aged 17–26 years, and seven parents were interviewed between October 2017 and February 2019. Interview data were descriptively analysed. Findings: Two categories for barriers and facilitators were identified: 1) Diabetes self-management is complex (carbohydrate counting, blood glucose level monitoring, insulin therapy); 2) support for diabetes care (reliance on parents and carers, the National Disability Insurance Scheme, mainstream diabetes service support). Conclusions: Parents are critical for the support of people with intellectual disability and T1DM in the absence of disability staff with appropriate health skills.

Psychosocial outcomes in adults with type 1 diabetes following a novel ‘short course’ structured flexible MDI therapy self-management programme

2017 ◽  
Vol 34 (7) ◽  
pp. 235-239a
Author(s):  
Brigid A Knight ◽  
Ingrid J Hickman ◽  
Kristen Gibbons ◽  
Janet Taylor ◽  
Harold D McIntyre
Keyword(s):  
Type 1 Diabetes ◽  
Psychosocial Outcomes ◽  
Management Programme ◽  
Self Management ◽  
Short Course
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