scholarly journals Risk perception and communal coping in families affected by type 2 diabetes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 693-693
Author(s):  
Jielu Lin ◽  
Melissa Zajdel ◽  
Melanie Myers ◽  
Laura Koehly
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Changes ◽  
Diabetes Diagnosis ◽  
Communal Coping ◽  
Black African ◽  
African Heritage ◽  
Coping Process ◽  
Population Type ◽  
Shared Risk

Abstract Despite a recent decline, rates of type 2 diabetes remain high among older adults. Preventing and delaying the onset of the condition with lifestyle changes is key to reducing disease burden in the population. Type 2 diabetes is a complex disease, likely a result from the joint effect of genetic, socio-environmental and lifestyle risk factors that are clustered in families. As such, the prevention of type 2 diabetes is a communal coping process, where individuals communicate about risk and establish routines to facilitate one another’s health habits and compliance with therapeutics. This poster investigates how such a process is affected by one’s perception of risk based on his/her knowledge about family health history (FHH). We collected family network data from families of different racial backgrounds in the greater Cincinnati area (28 white and 17 black/ African American households; 127 participants). The analysis focuses on how the density of diabetes diagnosis in one’s FHH affects communication about shared risk for type 2 diabetes and encouragement to maintain or adopt a healthy lifestyle. Results suggest a higher concentration of diabetes diagnosis in one’s FHH is associated with a higher number of risk communication ties in all families. With regards to encouragement ties, high rates of diabetes diagnosis in FHH are associated with an increased number of encouragement ties only in families of black/African heritage. The findings highlight the need and promise of using FHH to motivate co-encouragement to maintain/adopt a healthier lifestyle in families of black/African heritage.

scholarly journals Type 2 Diabetes in Children: A Growing Epidemic

2006 ◽  
Vol 11 (4) ◽  
pp. 212-222 ◽  
Author(s):  
Erin L. St. Onge ◽  
Carol A. Motycka ◽  
Renee L. Rose
Keyword(s):  
Type 2 Diabetes ◽  
Eating Habits ◽  
Pediatric Population ◽  
Lifestyle Changes ◽  
Obesity And Diabetes ◽  
Population Type ◽  
Children Obesity ◽  
Healthy Eating Habits ◽  
Diabetes And Obesity

In the pediatric population, type 2 diabetes has become a growing concern. A correlation appears to exist among type 2 diabetes in children, obesity, and a sedentary lifestyle. If obesity and diabetes are left untreated, conditions such as cardiovascular disease, nephropathy, and retinopathy may result as well. These conditions indicate the incredible strain on the health care system caused by diabetes and obesity. This strain may be eased by logical treatments such as exercise and healthy eating habits for the child and family. However, these lifestyle changes are not always effective in controlling blood sugar. When lifestyle changes do not yield positive results, the clinician must decide which (if any) pharmacological treatments are safe to use in the pediatric population. Orlistat and sibutramine have been studied in children as treatments for obesity and appear to be safe and effective for this population. Metformin and insulin are among the medications approved to treat diabetes in children and adolescents. Healthcare practitioners must play a role in educating parents and their children about the effects of obesity on the development of diseases like diabetes, as well as various therapies used to manage diabetes. In addition, healthcare practitioners can assist patients and their parents in understanding the benefits and risks of medications used in the treatment of the disease, assistance that may result in them making informed decisions regarding their overall health.

scholarly journals An examination of the communal coping process in recently diagnosed diabetes

2018 ◽  
Vol 36 (4) ◽  
pp. 1297-1316 ◽  
Author(s):  
Meredith Van Vleet ◽  
Vicki S. Helgeson ◽  
Howard J. Seltman ◽  
Mary T. Korytkowski ◽  
Leslie R. M. Hausmann
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Distress ◽  
Long Term Outcomes ◽  
Communal Coping ◽  
Support Provision ◽  
Problem Resolution ◽  
Coping Process ◽  
Diagnosed Diabetes

Communal coping, which involves a shared illness appraisal and engaging in collaboration when illness-related problems arise, is likely beneficial for individuals with type 2 diabetes. The purpose of this work was to examine the process by which communal coping may lead to such benefits. First, we hypothesized that illness-related interactions characterized by more communal coping would involve greater spouse support provision and greater patient receptivity to support. Second, we hypothesized that such interactions would lead to greater perceived problem resolution and more positive perceptions of the interaction. Third, we expected communal coping to predict changes in long-term diabetes outcomes—increased self-efficacy, improved self-care, and reduced diabetes distress—6 months later. Finally, we predicted that these long-term links would be partially explained by the immediate interaction outcomes. We tested these hypotheses in a sample of 123 persons with recently diagnosed type 2 diabetes and their spouses. Patient and spouse communal coping was observed in the laboratory during a diabetes stressor discussion, and patients reported outcomes immediately after the discussion and 6 months later. Results were largely consistent with hypotheses, but spouse communal coping was more consistently linked to support outcomes, and only patient communal coping was linked to changes in long-term outcomes. This work contributes to the literature indicating communal coping is beneficial for individuals with chronic illness and provides insight into the process by which communal coping exerts these effects.

Outcomes of a digitally delivered, culturally-sensitive behaviour change platform for BAME adults with type 2 diabetes: 1 year health and engagement outcomes (Preprint)

2020 ◽  
Author(s):  
Charlotte Summers
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Health Outcomes ◽  
Behavioural Change ◽  
Culturally Sensitive ◽  
Lifestyle Changes ◽  
Haemoglobin A1c ◽  
Central Asian ◽  
Increased Risk

BACKGROUND People from Black, Asian and Minority Ethnic (BAME) groups are known to have an increased risk of developing type 2 diabetes and face greater barriers to accessing healthcare resources compared to their “white British” counterparts. The main mediators of lifestyle behavioural change are gender, generation, geography, genes, God/religion, and gaps in knowledge and economic resources. Dietary and cultural practices of these individuals significantly vary according to gender, generation, geographical origin and religion. Recognition of these factors and implementing culturally sensitive interventions for type 2 diabetes prevention and management is essential in increasing knowledge of healthy eating, engagement in physical activity and improving health outcomes in BAME communities. Few health apps are tailored for BAME populations, and BAME communities are considered hard-to-reach. OBJECTIVE Our objective was to establish whether the Low Carb Program is a viable scalable solution that can be used as an effective tailored type 2 diabetes intervention for BAME communities. We hypothesized that by taking into account cultural sensitivities, providing the platform in native languages and personalising the platform in accordance with known barriers to health disparities including gender, generation, dietary preferences and religion, the app would engage BAME communities and improve type 2 diabetes related health outcomes. METHODS The study used a quasi-experimental research design comprised of an open-label, single-arm, pre-post intervention using a sample of convenience. All 705 adults with type 2 diabetes who had activated their referral to the Low Carb Program as a result of an NHS consultation between September 2018 and March 2019 were followed for a period of 12 months; mean age 54.61 (SD 16.69) years; 58.2% (410/705) women; 45.1% (318/705) white, 28.5% (201/705) Indian/Pakistani/Bangladeshi/Other Central Asian, 10.8% (76/705) Arab, 6.2% (44/705) Mixed/Multiple ethnic groups, 6% (43/705) black, 1.8% (13/705) other, (7/705) 1% Chinese/Japanese/Other East Asian. Mean starting glycated haemoglobin A1c (HbA1c) 7.99% (SD 2.05%); mean body weight 88.96kg (SD 23.25kg). RESULTS Of the 705 study participants, 513 (72.76%) had completed the Low Carb Program at 12 months. There were statistically significant reductions in body weight and HbA1c in white, Indian/Pakistani/Bangladeshi/Other Central Asian, Arabic and black participants with the most significant differences in the Indian/Pakistani/Bangladeshi/Other Central Asian population HbA1c -1.18% (SD 1.49%) and weight 8.03kg (SD 10.65kg). 82.9% of all participants (419/705) of all participants lost at least 5% of their body weight. CONCLUSIONS Offering the culturally tailored Low Carb Program that empowers members to make dietary and lifestyle changes to different BAME groups is an effective and engaging tool in the management of type 2 diabetes. Most importantly, BAME populations in particular people from Indian/Pakistani/Bangladeshi and Arabic groups who achieve better health outcomes than their white counterparts.

scholarly journals Association between cardiometabolic disease and severe COVID-19: a nationwide case–control study of patients requiring invasive mechanical ventilation

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044486 ◽  
Author(s):  
Per Svensson ◽  
Robin Hofmann ◽  
Henrike Häbel ◽  
Tomas Jernberg ◽  
Per Nordberg
Keyword(s):  
Type 2 Diabetes ◽  
Mechanical Ventilation ◽  
Case Control Study ◽  
Invasive Mechanical Ventilation ◽  
Population Based ◽  
Case Control ◽  
Population Type ◽  
Susceptible Patient ◽  
Control Study

AimsThe risks associated with diabetes, obesity and hypertension for severe COVID-19 may be confounded and differ by sociodemographic background. We assessed the risks associated with cardiometabolic factors for severe COVID-19 when accounting for socioeconomic factors and in subgroups by age, sex and region of birth.Methods and resultsIn this nationwide case–control study, 1.086 patients admitted to intensive care with COVID-19 requiring mechanical ventilation (cases), and 10.860 population-based controls matched for age, sex and district of residency were included from mandatory national registries. ORs with 95% CIs for associations between severe COVID-19 and exposures with adjustment for confounders were estimated using logistic regression. The median age was 62 years (IQR 52–70), and 3003 (24.9%) were women. Type 2 diabetes (OR, 2.3 (95% CI 1.9 to 2.7)), hypertension (OR, 1.7 (95% CI 1.5 to 2.0)), obesity (OR, 3.1 (95% CI 2.4 to 4.0)) and chronic kidney disease (OR, 2.5 (95% CI 1.7 to 3.7)) were all associated with severe COVID-19. In the younger subgroup (below 57 years), ORs were significantly higher for all cardiometabolic risk factors. The risk associated with type 2 diabetes was higher in women (p=0.001) and in patients with a region of birth outside European Union(EU) (p=0.004).ConclusionDiabetes, obesity and hypertension were all independently associated with severe COVID-19 with stronger associations in the younger population. Type 2 diabetes implied a greater risk among women and in non-EU immigrants. These findings, originating from high-quality Swedish registries, may be important to direct preventive measures such as vaccination to susceptible patient groups.Trial registration numberClinicaltrial.gov (NCT04426084).

scholarly journals The TELE-DD project on treatment nonadherence in the population with type 2 diabetes and comorbid depression

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Juan Francisco Roy ◽  
María Luisa Lozano del Hoyo ◽  
Fernando Urcola-Pardo ◽  
Alicia Monreal-Bartolomé ◽  
Diana Cecilia Gracia Ruiz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Phase I ◽  
Clinical Depression ◽  
Point Prevalence ◽  
Diabetic Patients ◽  
Comorbid Depression ◽  
Shared Risk

AbstractDiabetic patients have increased depression rates, diminished quality of life, and higher death rates due to depression comorbidity or diabetes complications. Treatment adherence (TA) and the maintenance of an adequate and competent self-care are crucial factors to reach optimal glycaemic control and stable quality of life in these patients. In this report, we present the baseline population analyses in phase I of the TELE-DD project, a three-phased population-based study in 23 Health Centres from the Aragonian Health Service Sector II in Zaragoza, Spain. The objectives of the present report are: (1) to determine the point prevalence of T2D and clinical depression comorbidity and treatment nonadherence; (2) to test if HbA1c and LDL-C, as primary DM outcomes, are related to TA in this population; and (3) to test if these DM primary outcomes are associated with TA independently of shared risk factors for DM and depression, and patients’ health behaviours. A population of 7,271 patients with type-2 diabetes and comorbid clinical depression was investigated for inclusion. Individuals with confirmed diagnoses and drug treatment for both illnesses (n = 3340) were included in the current phase I. A point prevalence of 1.9% was found for the T2D-depression comorbidity. The prevalence of patients nonadherent to treatment for these diseases was 35.4%. Multivariate analyses confirmed that lower diabetes duration, increased yearly PCS visits, HbA1c and LDL-C levels were independently related to treatment nonadherence. These findings informed the development of a telephonic monitoring platform for treatment of nonadherence for people with diabetes and comorbid depression and further trial, cost-effectiveness, and prognostic studies (phases II and III).

scholarly journals I am a rock; I am an island: Implications of avoidant attachment for communal coping in adults with type 2 diabetes

2019 ◽  
Vol 36 (11-12) ◽  
pp. 3711-3732
Author(s):  
Meredith Van Vleet ◽  
Vicki S. Helgeson
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Illness ◽  
Boundary Conditions ◽  
Relationship Quality ◽  
Current Investigation ◽  
Heterosexual Couples ◽  
Communal Coping ◽  
Diabetes Outcomes ◽  
Avoidant Attachment

Accumulating evidence indicates that communal coping is beneficial for individuals with chronic illness. The current investigation examined attachment as a moderator of the effects of communal coping in a sample of persons with type 2 diabetes. We hypothesized that patient communal coping would be associated with higher relationship quality, lower distress, and better diabetes outcomes for patients low in avoidant attachment, but it would not be beneficial for patients high in avoidant attachment. Patient communal coping was coded from videotaped interactions in which 86 heterosexual couples discussed difficulties managing diabetes. The results indicated that patient communal coping was beneficial when avoidant attachment was low. When avoidant attachment was high, patient communal coping was related to lower relationship quality and higher distress and was unrelated to diabetes outcomes. This work sheds light on potential boundary conditions of communal coping’s benefits, which will be important to consider in future communal coping interventions.

scholarly journals The development of multimorbidity during 16 years after diagnosis of type 2 diabetes

2018 ◽  
Vol 8 (1) ◽  
pp. 2235042X1880165 ◽  
Author(s):  
Sandra Pouplier ◽  
Maria Åhlander Olsen ◽  
Tora Grauers Willadsen ◽  
Håkon Sandholdt ◽  
Volkert Siersma ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Disease ◽  
Diabetes Care ◽  
Cox Regression ◽  
Neurological Diseases ◽  
Gastrointestinal Diseases ◽  
Diabetes Diagnosis ◽  
Prevalent Disease ◽  
Diabetes Patients

Objective: The aims of this study were to (1) quantify the development and composition of multimorbidity (MM) during 16 years following the diagnosis of type 2 diabetes and (2) evaluate whether the effectiveness of structured personal diabetes care differed between patients with and without MM. Research design and methods: One thousand three hundred eighty-one patients with newly diagnosed type 2 diabetes were randomized to receive either structured personal diabetes care or routine diabetes care. Patients were followed up for 19 years in Danish nationwide registries for the occurrence of outcomes. We analyzed the prevalence and degree of MM based on 10 well-defined disease groups. The effect of structured personal care in diabetes patients with and without MM was analyzed with Cox regression models. Results: The proportion of patients with MM increased from 31.6% at diabetes diagnosis to 80.4% after 16 years. The proportion of cardiovascular and gastrointestinal diseases in surviving patients decreased, while, for example, musculoskeletal, eye, and neurological diseases increased. The effect of the intervention was not different between type 2 diabetes patients with or without coexisting chronic disease. Conclusions: In general, the proportion of patients with MM increased after diabetes diagnosis, but the composition of chronic disease changed during the 16 years. We found cardiovascular and musculoskeletal disease to be the most prevalent disease groups during all 16 years of follow-up. The post hoc analysis of the intervention showed that its effectiveness was not different among patients who developed MM compared to those who continued to have diabetes alone.

scholarly journals Type 2 Diabetes Mellitus. From the start – combination therapy

2018 ◽  
Vol 21 (5) ◽  
pp. 386-394 ◽  
Author(s):  
Francesco Indovina ◽  
Pierpaolo Falcetta ◽  
Stefano Del Prato
Keyword(s):  
Type 2 Diabetes ◽  
Combination Therapy ◽  
Diabetes Diagnosis ◽  
Good Glycemic Control ◽  
Chronic Hyperglycemia ◽  
Increased Risk ◽  
History Of ◽  
First Time ◽  
Early Combination Therapy

Modern treatment of T2DM requires a shift in paradigm with appropriate intensification of therapy from the very first time of diabetes diagnosis. This is supported by data showing how even a moderate delay in achieving good glycemic control can translate into a later increased risk of developing diabetic complications. The recognition of the complexity of the pathogenesis of T2DM leads to the appreciation of the importance of attacking the disease from different angles, i.e. simultaneous tackling of multiple mechanisms contributing to hyperglycemia. From the turn of century a growing number of new anti-hyperglycemic agents have been made available. As compared to the older ones, these new medicines have a more targeted mechanism of action as they act at the level of the specific pathophysiologic disturbances accounting the development and progression of hyperglycemia. Because of that drugs can be use in combination taking advantage of their complementary mechanisms of action and synergistic. If introduced earlier in the natural history of the disease combination therapy may contribute avoiding undesirable exposure to even mild chronic hyperglycemia and provide early benefits. With respect to that in this review we will discuss advantages, disadvantages and still unanswered questions related to the use of early combination therapy in type 2 diabetes.

scholarly journals THE FAMILY DOCTOR’S ROLE IN ACHIEVING TARGET LEVELS OF TREATMENT IN PATIENTS WITH TYPE 2 DIABETES

2020 ◽  
Vol 72 (2) ◽  
pp. 51-58
Author(s):  
О. Korzh ◽  
A. Titkova ◽  
M. Kochuieva ◽  
Yu. Vinnyk ◽  
L. A. Ruban ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Lifestyle Changes ◽  
Treatment Goal ◽  
Treatment Goals ◽  
Factors Associated ◽  
Triple Treatment

The aim of the study was to identify the proportion of patients with type 2 diabetes who were unable toachieve the triple treatment goal for concomitant control of blood glucose level, blood pressure, LDL and modifying factors associated with achieving triple therapy goals. The study included 675 patients with type 2 diabetes,dyslipidemia and hypertension. The analysis was performed using concurrent triple treatment goals with specific levels of HbA1c, LDL and blood pressure as the main result. The questionnaire for patients with dyslipidemiaincluded self-assessment of compliance with prescribed drugs and perceptions related to their understandingand attitude towards lifestyle changes and pharmacological treatment. The results of the analysis of the logistic regression of factors associated with the achievement of triple treatment goals showed that patients whoreceived moderate doses of statins with high intensity were less likely to achieve concurrent treatment of thegoal compared to low intensity. Younger patients were less likely to achieve the triple treatment goal than thoseover 60 years of age. Based on life expectancy, they will be more susceptible to vascular complications due to anearlier onset of the disease and a longer period of time during which these adverse events can develop. Fewerdrugs and a shorter duration of type 2 diabetes were significant factors in the triple control. It was proved thatsimultaneous control of glycemia, hypertension and lipids was achieved in 22.4% of patients, who were affectedby the intensity of statin treatment, the number of diabetic drugs and the presence of concomitant pathology.Thus, the simultaneous achievement of the triple goal is a more comprehensive mitigation measure to reduce therisk of both macro- and microvascular complications

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