Abstract #200: Suboptimal Glycemic Levels in a Patient with Type 1 Diabetes. The Impact of Diabetes Distress and Psychosocial Factors on Diabetes Self-Management

2017 ◽  
Vol 23 ◽  
pp. 29
Author(s):  
Maximilien Rappaport ◽  
Mary de Groot
Keyword(s):  
Type 1 Diabetes ◽  
Psychosocial Factors ◽  
Self Management ◽  
Diabetes Distress ◽  
The Impact

scholarly journals Experience of living with type 1 diabetes in a low-income country: a qualitative study from Liberia

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049738
Author(s):  
Alma J Adler ◽  
Celina Trujillo ◽  
Leah Schwartz ◽  
Laura Drown ◽  
Jacquelin Pierre ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Qualitative Study ◽  
Economic Impact ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Self Management ◽  
Diabetes Distress ◽  
Low Middle Income Countries ◽  
The Impact

IntroductionWhile epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challenges, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in sub-Saharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region.MethodsWe conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and self-management, and barriers and facilitators for accessing T1D care.ResultsThis study found T1D to have a major psychosocial and economic impact on patients and caregivers, who reported stigma, diabetes distress and food insecurity. Patients, caregivers and providers possessed the knowledge necessary to effectively manage T1D but insufficient community awareness leads to delayed diagnosis, often in an emergency department. Most patients reported receiving free services and materials, though the cost of transportation to clinic visits and recommended foods is a barrier to disease management. Many providers noted the lack of national T1D-specific guidelines and registries. Policy-makers reported a lack of prioritisation of and resources for T1D. These barriers, combined with scarcity and expense of appropriate foods, pose severe barriers for self-management of T1D.ConclusionT1D was found to have a significant impact on patients and caregivers, and informants identified several key individual and systems-level barriers to effective T1D care in Liberia. Addressing these concerns is vital for designing sustainable and effective programmes for treating patients living with T1D.

Virtual Group Appointments Reduce Distress and Improve Care Management in Young Adults with Type 1 Diabetes

2021 ◽  
pp. 193229682110357
Author(s):  
Daniel I. Bisno ◽  
Mark W. Reid ◽  
Jennifer L. Fogel ◽  
Elizabeth A. Pyatak ◽  
Shideh Majidi ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Controlled Trial ◽  
Self Management ◽  
Diabetes Distress ◽  
Care Providers ◽  
Virtual Group ◽  
Distress Scale ◽  
The Impact

Purpose: The purpose of this study was to analyze the impact of virtual group appointments (VGA) on self-reported health-related outcomes and care activities for young adults (YA) with type 1 diabetes (T1D). Methods: Fifty-three YA (ages 18-25 years) with T1D participated in a randomized controlled trial (RCT) of the Colorado Young Adults with T1D (CoYoT1) Clinic intervention, encompassing telehealth (TH) with or without VGA. Both new patients ( n = 32) and those who participated in a pilot phase ( n = 26) were randomized to CoYoT1 Clinic (TH+VGA; n = 23) or TH-only ( n = 35) and followed for 1 year. YA completed the Diabetes Distress Scale (DDS), Diabetes Strengths and Resilience (D-STAR), Self-Efficacy in Diabetes (SED), Self-Management of Type 1 Diabetes in Adolescence (SMOD-A), Center for Epidemiologic Studies Depression (CES-D), and EuroQol (EQ-5D) scales at baseline and study end. Results: YA were 67% female, 84% white, 10% Latinx, and the mean age was 20.4 years old. At study end, participants in CoYoT1 Clinic reported significantly reduced diabetes distress compared to those in TH-only, who reported increased levels [Effect Size (ES) = −0.40, P = .02]. Specifically, CoYoT1 Clinic participants reported relative reductions in Physician (ES = −2.87, P = .02) and Regimen-related distress (ES = −0.35, P = .01). In addition, participants in CoYoT1 Clinic reported improved self-management of T1D-related problem solving (ES = 0.47, P = .051) and communication with care providers (ES = 0.39, P = .07). Conclusions: Virtual group attendance in CoYoT1 Clinic was associated with significant improvements in diabetes-related distress. Long-term exposure to VGA should be investigated in YA with T1D and other pediatric chronic conditions.

scholarly journals Feasibility study of real-time online text-based CBT to support self-management for people with type 1 diabetes: the Diabetes On-line Therapy (DOT) Study

2021 ◽  
Vol 9 (1) ◽  
pp. e001934
Author(s):  
Anne M Doherty ◽  
Anne Herrmann-Werner ◽  
Arann Rowe ◽  
Jennie Brown ◽  
Scott Weich ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Real Time ◽  
Instant Messaging ◽  
Controlled Trial ◽  
Self Management ◽  
Diabetes Distress ◽  
The Mean ◽  
Distress Scale

IntroductionThis study examines the feasibility of conducting diabetes-focused cognitive–behavioral therapy (CBT) via a secure online real-time instant messaging system intervention to support self-management and improve glycemic control in people with type 1 diabetes.Research design and methodsWe used a pre–post uncontrolled intervention design over 12 months. We recruited adults with type 1 diabetes and suboptimal glycemic control (HbA1c ≥69 mmol/mol (DCCT 8.5%) for 12 months) across four hospitals in London. The intervention comprised 10 sessions of diabetes-focused CBT delivered by diabetes specialist nurses. The primary outcomes were number of eligible patients, rates of recruitment and follow-up, number of sessions completed and SD of the main outcome measure, change in HbA1c over 12 months. We measured the feasibility of collecting secondary outcomes, that is, depression measured using Patient Health Questionnaire-9 (PHQ-9), anxiety measured Generalised Anxiety Disorder (GAD) and the Diabetes Distress Scale (DDS).ResultsWe screened 3177 patients, of whom 638 were potentially eligible, from whom 71 (11.1%) were recruited. The mean age was 28.1 (13.1) years, and the mean HbA1c was 84.6 mmol/mol (17.8), DCCT 9.9%. Forty-six (65%) patients had at least 1 session and 29 (41%) completed all sessions. There was a significant reduction in HbA1c over 12 months (mean difference −6.2 (2.3) mmol/mol, DCCT 0.6%, p=0.038). The change scores in PHQ-9, GAD and DDS also improved.ConclusionsIt would be feasible to conduct a full-scale text-based synchronized real-time diabetes-focused CBT as an efficacy randomized controlled trial.

Agent-based modeling for the self-management of chronic diseases: An exploratory study

SIMULATION ◽  
2017 ◽  
Vol 93 (9) ◽  
pp. 781-793 ◽  
Author(s):  
Sara Montagna ◽  
Andrea Omicini
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Chronic Diseases ◽  
Agent Based Modeling ◽  
Self Management ◽  
Agent Based ◽  
Management Interventions ◽  
The Impact

The impact of mobile technologies on healthcare is particularly evident in the case of self-management of chronic diseases, where they can decrease spending and improve life quality of patients. We propose the adoption of agent-based modeling and simulation techniques as built-in tools to dynamically monitor the state of patient health and provide recommendations for self-management. To demonstrate the feasibility of our proposal we focus on Type 1 diabetes mellitus as our case study, and provide simulation results where the dynamic evolution of signal parameters is shown in the case of healthy and Type 1 diabetes mellitus patients, focussing in particular on the beneficial effects that self-management interventions have on plasma glucose values.

Home Telemedicine (CoYoT1 Clinic): A Novel Approach to Improve Psychosocial Outcomes in Young Adults With Diabetes

2019 ◽  
Vol 45 (4) ◽  
pp. 420-430 ◽  
Author(s):  
Marwan Bakhach ◽  
Mark W. Reid ◽  
Elizabeth A. Pyatak ◽  
Cari Berget ◽  
Cindy Cain ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Self Efficacy ◽  
Group Home ◽  
Depression Scale ◽  
Diabetes Distress ◽  
Control Group ◽  
Distress Scale ◽  
The Impact

Purpose To assess the impact of a home telemedicine clinic model (CoYoT1 Clinic) on psychosocial and behavioral outcomes designed for young adults (YAs) with type 1 diabetes (T1D). Methods YAs self-selected to participate in the CoYoT1 Clinic or serve as a usual care control. CoYoT1 Clinic visits consisted of an individual appointment with a provider and a group appointment with other YAs with T1D using home telemedicine. Psychosocial and behavioral functioning was assessed by 4 measures: Diabetes Distress Scale, Self-Efficacy for Diabetes Scale, Self-Management of Type 1 Diabetes in Adolescence Scale, and Center for Epidemiologic Studies Depression Scale. Results Forty-two patients participated in the CoYoT1 Clinic and 39 patients served as controls. CoYoT1 participants reported lower levels of distress ( P = .03), increased diabetes self-efficacy ( P = .01), and improved ability to communicate with others about diabetes ( P = .04) over the study period compared to controls. YA males in the control group reported increases in depressive symptoms ( P = .03) during the study period, but CoYoT1 participants showed no changes. Conclusion Group home telemedicine for YAs with T1D positively affects diabetes distress, self-efficacy, and diabetes-specific communication. These positive findings have the potential to also affect the YAs’ long-term diabetes outcomes. Further investigation of the model is needed.

scholarly journals Racial-Ethnic Inequity in Young Adults With Type 1 Diabetes

2020 ◽  
Vol 105 (8) ◽  
pp. e2960-e2969 ◽  
Author(s):  
Shivani Agarwal ◽  
Lauren G Kanapka ◽  
Jennifer K Raymond ◽  
Ashby Walker ◽  
Andrea Gerard-Gonzalez ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Technology Use ◽  
Self Management ◽  
Diabetes Distress ◽  
Diabetes Technology ◽  
Racial Ethnic ◽  
Hispanic White ◽  
Hba1c Levels

Abstract Context Minority young adults (YA) currently represent the largest growing population with type 1 diabetes (T1D) and experience very poor outcomes. Modifiable drivers of disparities need to be identified, but are not well-studied. Objective To describe racial-ethnic disparities among YA with T1D and identify drivers of glycemic disparity other than socioeconomic status (SES). Design Cross-sectional multicenter collection of patient and chart-reported variables, including SES, social determinants of health, and diabetes-specific factors, with comparison between non-Hispanic White, non-Hispanic Black, and Hispanic YA and multilevel modeling to identify variables that account for glycemic disparity apart from SES. Setting Six diabetes centers across the United States. Participants A total of 300 YA with T1D (18-28 years: 33% non-Hispanic White, 32% non-Hispanic Black, and 34% Hispanic). Main Outcome Racial-ethnic disparity in HbA1c levels. Results Non-Hispanic Black and Hispanic YA had lower SES, higher HbA1c levels, and much lower diabetes technology use than non-Hispanic White YA (P < 0.001). Non-Hispanic Black YA differed from Hispanic, reporting higher diabetes distress and lower self-management (P < 0.001). After accounting for SES, differences in HbA1c levels disappeared between non-Hispanic White and Hispanic YA, whereas they remained for non-Hispanic Black YA (+ 2.26% [24 mmol/mol], P < 0.001). Diabetes technology use, diabetes distress, and disease self-management accounted for a significant portion of the remaining non-Hispanic Black–White glycemic disparity. Conclusion This study demonstrated large racial-ethnic inequity in YA with T1D, especially among non-Hispanic Black participants. Our findings reveal key opportunities for clinicians to potentially mitigate glycemic disparity in minority YA by promoting diabetes technology use, connecting with social programs, and tailoring support for disease self-management and diabetes distress to account for social contextual factors.

scholarly journals The Impact of Diabetes Distress on the Glycemic Control Among Adolescents and Youth With Type 1 Diabetes in Two Tertiary Centers, Jeddah, Saudi Arabia

Cureus ◽  
2021 ◽  
Author(s):  
Naseem Y Alyahyawi ◽  
Ragad M Alrifay ◽  
Norah A Albadi ◽  
Maram Y Alqahtani ◽  
Raghad M Alzahrani ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Saudi Arabia ◽  
Glycemic Control ◽  
Diabetes Distress ◽  
The Impact

Parent–Child Relationship Quality as a Mediator of the Association between Perceived Stress and Diabetes Self-Management in Adolescents With Type 1 Diabetes

2020 ◽  
pp. 107484072097158
Author(s):  
Jiaxin Luo ◽  
Jia Guo ◽  
Jundi Yang ◽  
Xiancai Ou ◽  
Margaret Grey
Keyword(s):  
Type 1 Diabetes ◽  
Relationship Quality ◽  
Perceived Stress ◽  
Self Management ◽  
Parent Child Relationship ◽  
Child Relationship ◽  
The Mean ◽  
The Impact ◽  
Parent Child

Diabetes self-management is suboptimal in adolescents with type 1 diabetes (T1D), including those in China. The aim of the study was to investigate the impact of parent–child relationship quality on diabetes self-management. Data were collected by a self-report survey among 122 Chinese adolescents from April to July 2017. The data were analyzed using a one-way analysis of variance, descriptive analyses, correlation analyses, and mediation analyses. The mean age was 13.8 (range, 10–18) years, and the mean diabetes duration was 4.1 (±3.1) years. About half of the adolescents with T1D experienced high levels of perceived stress. Parent–child relationship quality mediated the associations between perceived stress and collaboration with parents, diabetes care activities, and diabetes communication on aspects of diabetes self-management ( ps < 0.05). To reduce the negative impacts of perceived stress on diabetes self-management in this population, parent–child relationship quality should be considered an important element of family-based interventions and clinical practice.

scholarly journals The impact of hypoglycemia on quality of life and related outcomes in children and adolescents with type 1 diabetes: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260896
Author(s):  
Manon Coolen ◽  
Melanie Broadley ◽  
Christel Hendrieckx ◽  
Hannah Chatwin ◽  
Mark Clowes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Adverse Outcomes ◽  
Diabetes Distress ◽  
Cochrane Library ◽  
The Impact

Objective To conduct a systematic review to examine associations between hypoglycemia and quality of life (QoL) in children and adolescents with type 1 diabetes. Methods Four databases (Medline, Cochrane Library, CINAHL, PsycINFO) were searched systematically in November 2019 and searches were updated in September 2021. Studies were eligible if they included children and/or adolescents with type 1 diabetes, reported on the association between hypoglycemia and QoL (or related outcomes), had a quantitative design, and were published in a peer-reviewed journal after 2000. A protocol was registered the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020154023). Studies were evaluated using the Joanna Briggs Institute’s critical appraisal tool. A narrative synthesis was conducted by outcome and hypoglycemia severity. Results In total, 27 studies met inclusion criteria. No hypoglycemia-specific measures of QoL were identified. Evidence for an association between SH and (domains) of generic and diabetes-specific QoL was too limited to draw conclusions, due to heterogenous definitions and operationalizations of hypoglycemia and outcomes across studies. SH was associated with greater worry about hypoglycemia, but was not clearly associated with diabetes distress, depression, anxiety, disordered eating or posttraumatic stress disorder. Although limited, some evidence suggests that more recent, more frequent, or more severe episodes of hypoglycemia may be associated with adverse outcomes and that the context in which hypoglycemia takes places might be important in relation to its impact. Conclusions There is insufficient evidence regarding the impact of hypoglycemia on QoL in children and adolescents with type 1 diabetes at this stage. There is a need for further research to examine this relationship, ideally using hypoglycemia-specific QoL measures.

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