Associations of depression and diabetes distress with self-management behavior and glycemic control.

2020 ◽  
Author(s):  
Andreas Schmitt ◽  
Eileen Bendig ◽  
Harald Baumeister ◽  
Norbert Hermanns ◽  
Bernhard Kulzer
Keyword(s):  
Glycemic Control ◽  
Self Management ◽  
Diabetes Distress ◽  
Management Behavior

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.

FC06-02 - Psychsocial profile of diabetic adolescent patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 1841-1841
Author(s):  
H. Dessoki ◽  
S. Ahmed ◽  
A. El Bakry ◽  
M. Emad
Keyword(s):  
Body Image ◽  
Glycemic Control ◽  
Coping Strategies ◽  
Glycosylated Hemoglobin ◽  
Self Esteem ◽  
Structured Interview ◽  
Self Management ◽  
Management Behavior ◽  
Uncontrolled Diabetes ◽  
Significant Difference

A study of adolescents with diabetes found that one third had psychiatric disorders, most involving internalizing symptoms; other studies have shown that diabetic youth have greater rates of depression and that those with depression have poor glycemic control.ObjectiveTo investigate the effect of cognitive and emotional response to disease and treatment on diabetes self-management behavior. To study the effect of psychosocial factors as self-esteem, body image, different coping strategies and family factors on diabetes self-management behavior and subsequent glycemic control in diabetic adolescents.MethodCross-sectional study which includes 37 controlled and 30 uncontrolled diabetic adolescents recruited from Abou El-Rich Hospital, All participants were subjected to Semi structured interview, Personal Models of Diabetes Questionnaire, Body Image Scale, Coopersmith Self Esteem Inventory, Taxonomy of Children's Coping Strategies and assessment of Glycosylated Hemoglobin.ResultsPerceived seriousness of diabetes is higher in the group of uncontrolled diabetes (p < 0.001). Higher self-esteem in the group of controlled diabetes (14.91 ± 3.43) compared to the group of uncontrolled diabetes (10.33 ± 4.74). There was highly statistical significant difference regarding Coopersmith Self- Esteem Inventory (p < 0.001).ConclusionLower self-esteem was more prevalent among uncontrolled diabetic adolescents. In the group of uncontrolled diabetes early age of onset, and longer duration of illness were associated significantly with lower self-esteem.

scholarly journals Diabetes Distress Among Dyads of Patients and Their Health Supporters: Links With Functional Support, Metabolic Outcomes, and Cardiac Risk

2020 ◽  
Author(s):  
Aaron A Lee ◽  
Michele Heisler ◽  
Ranak Trivedi ◽  
D Scott Obrosky ◽  
Maria K Mor ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Hdl Cholesterol ◽  
Cardiac Risk ◽  
Self Management ◽  
Diabetes Distress ◽  
Glucose Testing ◽  
Diabetes Outcomes ◽  
The United Kingdom ◽  
Metabolic Outcomes ◽  
Patients With Diabetes

Abstract Background Patients with diabetes (PWD) often experience diabetes distress which is associated with worse self-management and glycemic control. In contrast, PWD who receive support from family and friends (supporters) have better diabetes outcomes. Purpose To examine the associations of PWD diabetes distress and supporters’ distress about PWDs’ diabetes with supporters’ roles and PWD cardiometabolic outcomes. Methods We used baseline data from 239 adults with Type 2 diabetes and their supporters participating in a longitudinal trial. PWD and supporter diabetes distress (high vs. low) were determined using the Problem Areas in Diabetes Scale-5. Outcomes included PWD-reported help from supporters with self-care activities, supporter-reported strain, PWD metabolic outcomes (glycemic control [HbA1c], systolic blood pressure [SBP], and non-HDL cholesterol) and 5 and 10 year risk of cardiac event (calculated using the United Kingdom Prospective Diabetes Study algorithm). Results PWDs with high diabetes distress were more likely to report that their supporters helped with taking medications, coordinating medical care, and home glucose testing (p’s &lt; .05), but not more likely to report help with diet or exercise. High supporter distress was associated with greater supporter strain (p &lt; .001). High supporter diabetes distress was associated with higher PWD HbA1c (p = .045), non-HDL cholesterol (p = .011), and 5 (p = .002) and 10 year (p = .001) cardiac risk. Conclusions Adults with high diabetes distress report more supporter help with medically focused self-management but not with diet and exercise. Supporter distress about PWD diabetes was consistently associated with worse outcomes. PWD diabetes distress had mixed associations with their diabetes outcomes.

scholarly journals Investigating the Association Between Diabetes Distress and Self-Management Behaviors

2018 ◽  
Vol 12 (6) ◽  
pp. 1116-1124 ◽  
Author(s):  
Aneesah Khan ◽  
Pratik Choudhary
Keyword(s):  
Glycemic Control ◽  
Glucose Monitoring ◽  
Self Management ◽  
Diabetes Distress ◽  
Self Monitoring ◽  
High Distress ◽  
Future Work ◽  
Distress Scale ◽  
The Impact ◽  
Management Behaviors

Background: Diabetes distress has been linked with suboptimal glycemic control in patients with type 1 diabetes. We evaluated the effect of diabetes distress on self-management behaviors in patients using insulin pumps. Methods: We analyzed the impact of diabetes distress on self-management behaviors using pump downloads from 129 adults treated with continuous subcutaneous insulin infusion (CSII) at a single hospital clinic. Exclusion criteria were CSII treatment <6 months, pregnancy, hemoglobinopathy, and continuous glucose monitoring/sensor use. People were categorized into three groups based on the Diabetes Distress Scale-2 (DDS-2) score: < 2.5, 2.5-3.9, > 4. Results: Participants had a mean age of 45.2 ± 19.0 years; duration of diabetes 26.6 ± 16.2 years; duration of CSII 6.0 ± 3.5 years; HbA1c 8.0 ± 1.2%; and DDS-2 score 2.7 ± 1.3. Self-monitoring blood glucose (SMBG) frequency and bolus wizard usage was similar between groups. Patients with higher distress had higher HbA1c (7.7 ± 0.9 vs. 8.0 ± 0.9 vs. 8.7 ± 1.8; P = 0.004), lower frequency of set changes (4.7 ± 1.3vs. 4.8 ± 1.9 vs. 3.8 ± 1.1; P = .025), a greater number of appointments booked (5.8 ± 4.4 vs. 8.6 ± 4.8 vs. 8.1 ± 6.9; P = .021), and a greater number of appointments missed (1.9 ± 1.3 vs. 2.5 ± 1.5 vs. 3.8 ± 4.1; P = .004). Conclusions: Although in some patients, high distress may be caused by reduced self-management, in our highly trained, pump-using patients, high distress was associated with suboptimal biomedical outcomes despite appropriate self-management behaviors. Future work should further explore the relationships between diabetes distress, self-management, and glycemic control.

scholarly journals Relationship Between Diabetes, Stress, and Self-Management to Inform Chronic Disease Product Development: Retrospective Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Jessica S Yu ◽  
Tong Xu ◽  
Roberta A James ◽  
Wei Lu ◽  
Julia E Hoffman
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Product Development ◽  
Behavioral Health ◽  
Diabetes Management ◽  
Self Management ◽  
Diabetes Distress ◽  
Data Set ◽  
Diabetes Empowerment ◽  
Health Diagnosis

BACKGROUND Technology is rapidly advancing our understanding of how people with diabetes mellitus experience stress. OBJECTIVE The aim of this study was to explore the relationship between stress and sequelae of diabetes mellitus within a unique data set composed of adults enrolled in a digital diabetes management program, Livongo, in order to inform intervention and product development. METHODS Participants included 3263 adults under age 65 who were diagnosed with diabetes mellitus and had access to Livongo through their employer between June 2015 and August 2018. Data were collected at time of enrollment and 12 months thereafter, which included demographic information, glycemic control, presence of stress, diabetes distress, diabetes empowerment, behavioral health diagnosis, and utilization of behavioral health-related medication and services. Analysis of variance and chi-square tests compared variables across groups that were based on presence of stress and behavioral health diagnosis or utilization. RESULTS Fifty-five percent of participants (1808/3263) reported stress at the time of at least 1 blood glucose reading. Fifty-two percent of participants (940/1808) also received at least 1 behavioral health diagnosis or intervention. Compared to their peers, participants with stress reported greater diabetes distress, lower diabetes empowerment, greater insulin use, and poorer glycemic control. Participants with stress and a behavioral health diagnosis/utilization additionally had higher body mass index and duration of illness. CONCLUSIONS Stress among people with diabetes mellitus is associated with reduced emotional and physical health. Digital products that focus on the whole person by offering both diabetes mellitus self-management tools and behavioral health skills and support can help improve disease-specific and psychosocial outcomes.

832-P: Resilience Outstrips the Negative Impact of Diabetes Distress on Glycemic Control and Self-Management among Youth with Type 1 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 832-P
Author(s):  
DAN LUO ◽  
JINGJING XU ◽  
MIN ZHU ◽  
HONG WANG ◽  
YUBING WANG ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Negative Impact ◽  
Self Management ◽  
Diabetes Distress

scholarly journals Relationship Between Diabetes, Stress, and Self-Management to Inform Chronic Disease Product Development: Retrospective Cross-Sectional Study

JMIR Diabetes ◽  
10.2196/20888 ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. e20888
Author(s):  
Jessica S Yu ◽  
Tong Xu ◽  
Roberta A James ◽  
Wei Lu ◽  
Julia E Hoffman
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Product Development ◽  
Behavioral Health ◽  
Diabetes Management ◽  
Self Management ◽  
Diabetes Distress ◽  
Data Set ◽  
Diabetes Empowerment ◽  
Health Diagnosis

Background Technology is rapidly advancing our understanding of how people with diabetes mellitus experience stress. Objective The aim of this study was to explore the relationship between stress and sequelae of diabetes mellitus within a unique data set composed of adults enrolled in a digital diabetes management program, Livongo, in order to inform intervention and product development. Methods Participants included 3263 adults under age 65 who were diagnosed with diabetes mellitus and had access to Livongo through their employer between June 2015 and August 2018. Data were collected at time of enrollment and 12 months thereafter, which included demographic information, glycemic control, presence of stress, diabetes distress, diabetes empowerment, behavioral health diagnosis, and utilization of behavioral health-related medication and services. Analysis of variance and chi-square tests compared variables across groups that were based on presence of stress and behavioral health diagnosis or utilization. Results Fifty-five percent of participants (1808/3263) reported stress at the time of at least 1 blood glucose reading. Fifty-two percent of participants (940/1808) also received at least 1 behavioral health diagnosis or intervention. Compared to their peers, participants with stress reported greater diabetes distress, lower diabetes empowerment, greater insulin use, and poorer glycemic control. Participants with stress and a behavioral health diagnosis/utilization additionally had higher body mass index and duration of illness. Conclusions Stress among people with diabetes mellitus is associated with reduced emotional and physical health. Digital products that focus on the whole person by offering both diabetes mellitus self-management tools and behavioral health skills and support can help improve disease-specific and psychosocial outcomes.

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