Diabetes distress and glycaemic control in young adults with type 1 diabetes: associations by use of insulin pumps and continuous glucose monitors

2021 ◽  
Author(s):  
Kathryn E. Nagel ◽  
Tracy Dearth‐Wesley ◽  
Allison N. Herman ◽  
Hannah G. Smith ◽  
Robert C. Whitaker
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Glycaemic Control ◽  
Diabetes Distress ◽  
Insulin Pumps ◽  
Continuous Glucose Monitors

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.

Patient Perceptions of Using the OmniPod System Compared with Conventional Insulin Pumps in Young Adults with Type 1 Diabetes

2012 ◽  
Vol 14 (5) ◽  
pp. 411-417 ◽  
Author(s):  
Yael Lebenthal ◽  
Liora Lazar ◽  
Hadassa Benzaquen ◽  
Shlomit Shalitin ◽  
Moshe Phillip
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Patient Perceptions ◽  
Insulin Pumps

Consideration of Insulin Pumps or Continuous Glucose Monitors by Adolescents With Type 1 Diabetes and Their Parents

2016 ◽  
Vol 42 (4) ◽  
pp. 395-407 ◽  
Author(s):  
Tim Wysocki ◽  
Fiona Hirschfeld ◽  
Louis Miller ◽  
Neil Izenberg ◽  
Steven A. Dowshen ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pumps ◽  
Continuous Glucose Monitors

scholarly journals Impact of COVID 19 National Lockdown on Glycaemic Control in Children and Adolescents With Type 1 Diabetes (T1DM): A Retrospective Review at a Large UK Teaching Hospital

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A344-A344
Author(s):  
Neil Richard Lawrence ◽  
Anuja Natarajan ◽  
Razia Petkar ◽  
Lovlin Joseph
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Children And Adolescents ◽  
Social Life ◽  
Glucose Monitoring ◽  
Peer Pressure ◽  
Monitoring Data ◽  
Teaching Hospitals ◽  
Continuous Glucose Monitors

Abstract Introduction: The coronavirus disease global pandemic led to national lockdown in the United Kingdom on 23rd March 2020. We compared the glycaemic control of children and adolescents with Type 1 diabetes (T1DM) at Doncaster & Bassetlaw Teaching Hospitals in the 12 weeks prior to the lockdown, to the 12 weeks following lockdown. Methods: HbA1c result 3 months following lockdown was compared to the last HbA1C prior to lockdown. Data from Continuous Glucose Monitors (CGMs), Flash Glucose Systems (FGS) and those performing Self-Monitoring of Blood Glucose (SMBG) were compared alongside changes to patient contact that occurred. Results: In 264 patients under 20 years of age across both hospitals in the Trust, face-to-face consultations decreased (245 vs 151, 39%), and remote consultations increased (1751 vs 2269, 30%) (χ 2 p<0.001). Excluding those within a year of diagnosis, 122 had paired HbA1c results, and 80 had more than 70% of glucose monitoring data available. HbA1c levels decreased (67.4 mmol/mol vs 61.3 mmol/mol, p<0.001) and glucose monitoring data showed lower mean glucose after lockdown (9.7mmol/L vs 9.5mmol/L, p=0.034) with lower standard deviation (4.4mmol/L vs 4.2mmol/L, p<0.001). Proportion of time in range (3.9mmol/L to 10mmol/L) increased (n=47, 55.2% vs 58.0%, p=0.017), with no change to time below range (4.8% vs 5.0%, p=0.495). Conclusion: Glycaemic control improved in the 12 weeks following national lockdown. This demonstrates the difficulties faced by patients and carers managing T1DM around school pressures, meals away from home, social life and peer pressure. Increased remote contact with patients with T1DM has not been detrimental to glycaemic control.

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