Characterizing cognitive problem-solving strategies in patients’ everyday life: The case of patients with Type 1 diabetes

2021 ◽  
Vol 13 (1) ◽  
pp. 10201
Author(s):  
David Naudin ◽  
Heloise Haliday ◽  
Chantal Legrand ◽  
Gérard Reach ◽  
Rémi Gagnayre
Keyword(s):  
Type 1 Diabetes ◽  
Executive Functions ◽  
Short Term Memory ◽  
Cognitive Strategies ◽  
Treatment Compliance ◽  
Cognitive Problem ◽  
Clinical Vignettes ◽  
Multiple Case ◽  
Action Strategies

Introduction: Numerous quantitative studies have shown the importance of executive functions (planning, attention, inhibition, and short-term memory) for diabetes treatment compliance. Those studies also point to the paucity of data on action strategies employed by persons with diabetes. The aim of this study is to characterize the action strategies used in six situations typically encountered by persons with Type 1 diabetes (no comorbidities). Methods: This qualitative multiple-case study concerns adult patients with no comorbidities. Eighteen patients were presented with six clinical vignettes portraying emblematic situations and then interviewed. After categorization, the 108 situations were used to produce an intra-case and then an inter-case synthesis. Results: The study identified three groups of patients with three distinct strategies for dealing with a variety of situations. The first group used executive functions to adhere to pre-established patterns and avoid situations of uncertainty, while the second group was more likely to use it to adapt to the unexpected. The third group had no operational routines or habits and few rules. Unable to rely on habits, those patients had to proceed by trial-and-error, thus placing themselves in risky situations. Conclusion: Determining the type of cognitive strategies used by a given patient could be helpful in improving that patient’s self-knowledge. By including a personalized analysis of action strategies and potential alternatives, patient education programs could help patients better prepare for unexpected situations.

scholarly journals Neurophysiological Evidence for a Compensatory Activity during a Simple Oddball Task in Adolescents with Type 1 Diabetes Mellitus

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Tereza Vitvarová ◽  
David Neumann ◽  
Radka Šimáková ◽  
Jan Kremláček
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Reaction Time ◽  
Executive Functions ◽  
Type 1 Diabetes Mellitus ◽  
Cognitive Processing ◽  
Peak Time ◽  
Oddball Task ◽  
Related Potentials

Objective. The poor metabolic control in type 1 diabetes mellitus (T1D) has a negative impact on the developing brain. Hyperglycemia and glycemic fluctuations disrupt mainly executive functions. To assess a hypothesized deficit of the executive functions, we evaluated visual processing and reaction time in an oddball task. Methods. Oddball visual event-related potentials (ERPs), reaction time, and pattern-reversal visual evoked potentials (VEPs) were examined in a cohort of twenty-two 12- to 18-year-old T1D patients without diabetic retinopathy at normal glycemia and in nineteen 10- to 21-year-old healthy controls. Results. The P100 peak time of the VEPs was significantly prolonged in T1D patients compared with the control group (p<0.017). In contrast to the deteriorated sensory response, the area under the curve of the P3b component of the ERPs was significantly larger (p=0.035) in patients, while reaction time in the same task did not differ between groups (p=0.713). Conclusions. The deterioration on a sensory level, enhanced activity during cognitive processing, and balanced behavioral response support the view that neuroplasticity counterbalances the neural impairment by enhanced cognitive processing to achieve normal behavioral performance in T1D adolescents.

scholarly journals Longitudinal Evaluation of Cognitive Functioning in Young Children with Type 1 Diabetes over 18 Months

2016 ◽  
Vol 22 (3) ◽  
pp. 293-302 ◽  
Author(s):  
M. Allison Cato ◽  
Nelly Mauras ◽  
Paul Mazaika ◽  
Craig Kollman ◽  
Peiyao Cheng ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Executive Functions ◽  
Age Of Onset ◽  
Cognitive Domain ◽  
Verbal Iq ◽  
Chronic Hyperglycemia ◽  
History Of

AbstractObjectives:Decrements in cognitive function may already be evident in young children with type 1 diabetes (T1D). Here we report prospectively acquired cognitive results over 18 months in a large cohort of young children with and without T1D.Methods:A total of 144 children with T1D (mean HbA1c: 7.9%) and 70 age-matched healthy controls (mean age both groups 8.5 years; median diabetes duration 3.9 years; mean age of onset 4.1 years) underwent neuropsychological testing at baseline and after 18-months of follow-up. We hypothesized that group differences observed at baseline would be more pronounced after 18 months, particularly in those T1D patients with greatest exposure to glycemic extremes.Results:Cognitive domain scores did not differ between groups at the 18 month testing session and did not change differently between groups over the follow-up period. However, within the T1D group, a history of diabetic ketoacidosis (DKA) was correlated with lower Verbal IQ and greater hyperglycemia exposure (HbA1c area under the curve) was inversely correlated to executive functions test performance. In addition, those with a history of both types of exposure performed most poorly on measures of executive function.Conclusions:The subtle cognitive differences between T1D children and nondiabetic controls observed at baseline were not observed 18 months later. Within the T1D group, as at baseline, relationships between cognition (Verbal IQ and executive functions) and glycemic variables (chronic hyperglycemia and DKA history) were evident. Continued longitudinal study of this T1D cohort and their carefully matched healthy comparison group is planned. (JINS, 2016,21, 293–302)

Executive Functions and Adherence to Continuous Glucose Monitoring in Children and Adolescents with Type 1 Diabetes

2020 ◽  
Vol 22 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Alon Farfel ◽  
Alon Liberman ◽  
Michal Yackobovitch-Gavan ◽  
Moshe Phillip ◽  
Revital Nimri
Keyword(s):  
Type 1 Diabetes ◽  
Executive Functions ◽  
Children And Adolescents ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring

scholarly journals The Empowerment of Adolescents with Type 1 Diabetes Is Associated with Their Executive Functions

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Włodzimierz Łuczyński ◽  
Izabela Łazarczyk ◽  
Ilona Szlachcikowska ◽  
Żaneta Kiernozek ◽  
Anna Kaczmarek ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Executive Function ◽  
Executive Functions ◽  
Disease Duration ◽  
Readiness To Change ◽  
Diabetes Education ◽  
One Year ◽  
Diabetes Empowerment ◽  
The Relationship

Background. Adolescence is a difficult period for young people with type 1 diabetes mellitus (T1DM), both in psychological and clinical terms. Empowerment therapy may support these patients, provided they are ready to change and have adequate executive functions to facilitate this change. Therefore, we hypothesise that the readiness of adolescents with T1DM to change is related to clinical features and/or their executive functions. Methods. Using the Diabetes Empowerment Scale and the Behavioural Rating Inventory of Executive Function, we evaluated patients with T1DM duration of more than one year from three Polish diabetes centres of the PolPeDiab study group (N = 146). We related the data to features associated with disease and treatment and compared the results to those of adolescents without diabetes (N = 110). Results. We observed that adolescents with T1DM had a higher rate of abnormal results in executive function tests than their peers without diabetes (p > 0.05). Diabetes empowerment in this group of patients decreased with disease duration (r = -0.25, p = 0.006) and increased with deteriorating metabolic control (HbA1c; r = 0.25, p = 0.006). The greater the deficiencies in executive functions among adolescents with T1DM, the greater their readiness to change. The relationship between executive functions and diabetes empowerment is partially gender-differentiated. Conclusions. To conclude, we propose individualized diabetes education in this group of patients based on the assessment of readiness to change and executive functions.

scholarly journals Cognitive Functioning in Young Children with Type 1 Diabetes

2014 ◽  
Vol 20 (2) ◽  
pp. 238-247 ◽  
Author(s):  
M. Allison Cato ◽  
Nelly Mauras ◽  
Jodie Ambrosino ◽  
Aiden Bondurant ◽  
Amy L. Conrad ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Children ◽  
Executive Functions ◽  
Cognitive Functioning ◽  
Learning And Memory ◽  
Processing Speed ◽  
Somatic Symptoms ◽  
Onset Age ◽  
Cognitive Domains

AbstractThe aim of this study was to assess cognitive functioning in children with type 1 diabetes (T1D) and examine whether glycemic history influences cognitive function. Neuropsychological evaluation of 216 children (healthy controls,n= 72; T1D,n= 144) ages 4–10 years across five DirecNet sites. Cognitive domains included IQ, Executive Functions, Learning and Memory, and Processing Speed. Behavioral, mood, parental IQ data, and T1D glycemic history since diagnosis were collected. The cohorts did not differ in age, gender or parent IQ. Median T1D duration was 2.5 years and average onset age was 4 years. After covarying age, gender, and parental IQ, the IQ and the Executive Functions domain scores trended lower (bothp= .02, not statistically significant adjusting for multiple comparisons) with T1D relative to controls. Children with T1D were rated by parents as having more depressive and somatic symptoms (p< .001). Learning and memory (p= .46) and processing speed (p= .25) were similar. Trends in the data supported that the degree of hyperglycemia was associated with Executive Functions, and to a lesser extent, Child IQ and Learning and Memory. Differences in cognition are subtle in young children with T1D within 2 years of onset. Longitudinal evaluations will help determine whether these findings change or become more pronounced with time. (JINS, 2014,20, 238–247)

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