scholarly journals Lower gastrointestinal symptoms are associated with worse glycemic control and quality of life in type 1 diabetes mellitus

2018 ◽  
Vol 6 (1) ◽  
pp. e000514 ◽  
Author(s):  
John S Leeds ◽  
Marios Hadjivassiliou ◽  
Solomon Tesfaye ◽  
David S Sanders

ObjectivesLower gastrointestinal symptoms are not well characterized in people with type 1 diabetes, and the effects on quality of life and glycemic control are unknown. This study aimed to determine the prevalence of lower gastrointestinal symptoms and the effects on glycemic control and quality of life, and to investigate for underlying causes.Research design and methodsThis is a prospective, cohort study in secondary care. Patients with type 1 diabetes completed a gastrointestinal symptom questionnaire and the Short Form 36 V.2 quality of life questionnaire and had their hemoglobin A1c measured. Patients with diarrhea were offered reassessment and investigation as per the national guidelines. Controls without diabetes were used to compare symptom prevalence and quality of life scores.Results 706 with type 1 diabetes (mean age 41.9 years) and 604 controls (mean age 41.9 years) were enrolled. Gastrointestinal symptoms were significantly more frequent in type 1 diabetes compared with controls, in particular constipation (OR 2.4), diarrhea (OR 2.5), alternating bowel habit (OR 2.1), abdominal pain (OR 1.4), floating stools (OR 2.7), bloating (OR 1.4) and flatulence (OR 1.3) (all p<0.05). Previous pancreatitis was more frequent in type 1 diabetes (OR 4.6), but other gastrointestinal conditions were not. Gastrointestinal symptoms were associated with poorer glycemic control (p<0.01) and worse quality of life particularly in those with diarrhea. Investigation of those with diarrhea, including those with alternating bowel habit, (n=105), identified a cause in 72.3% with subsequent change in management.ConclusionsGastrointestinal symptoms are twice as common in type 1 diabetes and associated with poorer quality of life and glycemic control. Investigation of diarrhea in people with type 1 diabetes leads to a high yield of treatable conditions and a change in management in about three-quarters.

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Elvira Estorninos ◽  
Rachel Lawenko ◽  
Katherine Buluran ◽  
Yipu Chen ◽  
Jowena Lebumfacil ◽  
...  

Abstract Objectives Health-related quality of life (QoL) is an important component of overall wellbeing. The study aimed to describe the parent-perceived infant quality of life of exclusively breastfed infants along with their mother's physical and mental health in a Filipino cohort. Methods Healthy term infants, who were exclusively breastfed since birth and whose mothers had decided to exclusively breastfeed until 6 months (m) of age, were enrolled at 21–26 days of age from a single center in the Philippines. Parents completed the Infant Toddler Quality of Life Questionnaire (ITQoL) and the Short Form Health Survey (SF-36v2) (assessing maternal QoL) at enrollment and when infants were 2.5 m, 4 m, and 6 m of age. Infants’ anthropometrics were measured and parents completed gastrointestinal (GI) diaries and Infant Gastrointestinal Symptoms Questionnaire (IGSQ) throughout the study. Results Among 75 enrolled infants, 70 completed the study at age 6 m. Infant QoL mean scores were high throughout the study (range 0–100 for each concept; Table 1). Nonetheless, noticeable improvements were observed between enrollment and 2.5 m, especially in the infant-focused concept of Temperament and Moods as well as in all three parent-focused concepts (Emotional, Time, and Family Cohesion) which measure impact of child's health on parents. Between 2.5 and 6 m, the scores remained relatively stable. For maternal QoL mean scores (scores standardized to Mean = 50, SD = 10 for each scale; Table 1), noticeable improvements were observed between enrollment and 2.5 m, with Physical Health showing more pronounced improvements. The Role-Emotional scale, which measures role limitations due to emotional problems, showed the lowest scores. From enrollment to age 6 m, mean z-scores for weight-for-age, length-for-age and head circumference-for-age stably tracked WHO Growth Standards. Additionally, infant stool consistency became more formed, and incidences of spitting up/vomiting and flatulence decreased. The overall GI burden also decreased (IGSQ index score: range 13–65; 15.8 ± 3.2 at enrollment and 14.0 ± 1.2 at 6 m). Conclusions In a cohort of exclusively breastfed Filipino mother-infant dyads, parent-perceived infant health-related quality of life was high and comparable to that reported in literature1. Maternal quality of life, particularly their perceived state of emotional well-being, warrants further investigation. Funding Sources Nestec Ltd. Supporting Tables, Images and/or Graphs


2020 ◽  
Vol 11 ◽  
pp. 204201882095014
Author(s):  
Zekai Wu ◽  
Sihui Luo ◽  
Xueying Zheng ◽  
Yan Bi ◽  
Wen Xu ◽  
...  

Background: Previous studies show that the use of do-it-yourself artificial pancreas system (DIYAPS) may be associated with better glycemic control characterized by improved estimated hemoglobin A1c (eHbA1c) and time in range among adults with type 1 diabetes (T1D). However, few studies have demonstrated the changes in laboratory-measured HbA1c, which is a more accepted index for glycemic control, after using a DIYAPS. Methods: This is a retrospective before-after study approaching patients who reported self-use of AndroidAPS. The main inclusion criteria included: T1D; aged ⩾18 years; having complete record of ⩾3 months of continuous AndroidAPS use; with laboratory-measured HbA1c and quality of life scale data before and after 3 months of AndroidAPS use; and not pregnant. The primary outcome was the change in HbA1c between baseline and 3 months after initiation of AndroidAPS use. Results: Overall, 15 patients (10 females) were included; the median age was 32.2 years (range: 19.2–69.4), median diabetes duration was 9.7 years (range: 1.8–23.7) and median baseline HbA1c was 7.3% (range: 6.4–10.1). The 3 months of AndroidAPS use was associated with substantial reductions in HbA1c [6.79% (SD: 1.29) versus 7.63% (SD: 1.06), p = 0.002] and glycemic variability when compared with sensor-augmented pump therapy. A lower level of fear of hypoglycemia [22.13 points (SD: 6.87) versus 26.27 points (SD: 5.82), p = 0.010] was also observed after using AndroidAPS. Conclusions: The 3 months of AndroidAPS use was associated with significant improvements in glucose management and quality of life among adults with T1D.


2020 ◽  
pp. 193229682097842
Author(s):  
William H. Polonsky ◽  
Addie L. Fortmann

Background: To examine caregivers’ experiences with real-time continuous glucose monitoring (RT-CGM) data sharing and its impact on quality of life (QoL) and health outcomes. Methods: Parents of children with type 1 diabetes (T1D) ( N = 303) and spouses/partners of T1D adults ( N = 212) using the Dexcom G5 Mobile or G6 RT-CGM system and who were actively following their T1Ds’ RT-CGM data completed a survey examining their perceived value of data sharing, the impact of sharing on their own QoL and their child/partner’s health, and how they used RT-CGM data to support their T1Ds’ diabetes management. Regression analyses examined whether their actions were linked to reported changes in QoL and health outcomes. Results: Respondents were predominantly non-Hispanic White (91.1% parents; 88.7% partners), female (78.2% parents; 54.7% partners), and college-educated (65.3% parents; 61.8% partners). The majority reported that data sharing had enhanced hypoglycemic confidence (97.7% parents; 98.1% partners), overall well-being (60.4% parents; 63.2% partners), and sleep quality (78.0% parents; 61.3% partners). Of note, three positive caregiver actions were broadly consistent and significant predictors of QoL and health benefits for both parents and partners: celebrating success related to glycemic control, providing encouragement when glycemic control is challenging, and teamwork discussions about how the caregiver should respond to out-of-range values. Conclusions: RT-CGM data sharing was associated with a range of QoL and health benefits for caregivers. Degree of benefits was influenced by the collaborative actions taken by caregivers to support their child’s or partner’s diabetes management. To determine the most effective strategies for collaborative data sharing, longitudinal trials are needed.


Mindfulness ◽  
2016 ◽  
Vol 7 (5) ◽  
pp. 1227-1237 ◽  
Author(s):  
Inge J. P. Serkel-Schrama ◽  
Jolanda de Vries ◽  
Anke M. Nieuwesteeg ◽  
Frans Pouwer ◽  
Ivan Nyklíček ◽  
...  

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 933-P
Author(s):  
MELANIE BABINSKI ◽  
REGINA DUPERVAL ◽  
JULIA E. VON OETTINGEN ◽  
KETLY ALTENOR

Author(s):  
Andrea Lukács ◽  
Péter Sasvári ◽  
András Török ◽  
László Barkai

AbstractThis study aimed to evaluate the health-related quality of life (HRQoL) of adolescents with type 1 diabetes (T1DM) on the basis of the pediatric quality of life inventory™ (PedsQL™) generic and diabetes-specific modules, and to compare it to that of healthy peers.This retrospective case-control study involved 650 participants between ages of 13 and 19 years including 296 adolescents with T1DM from four diabetes centers and 354 healthy peers matched for age and gender from three different cities of the country. Participants completed the validated PedsQL™ for assessing the HRQoL. The analysis included an independent t-test to compare the means of the total and subscales of the PedsQL™ between boys and girls as well as between a healthy group and a group with T1DM. Gender differences in exercise, insulin therapy modalities were evaluated with the Pearson χAdolescents with T1DM have similar HRQoL in all domains when compared to their healthy counterparts. Females report worse HRQoL regardless of the presence of the disease. Insulin pump therapy facilitates better glycemic control and HRQoL. Regular exercise positively correlates with the generic HRQoL in both groups; however, it has no relationship with glycemic control.Optimal metabolic control and improved HRQoL are the eventual goals of diabetes management. Despite the difficulties, adolescents with diabetes can manage their disease well and live normal lives, similar to their healthy peers. Although diabetes-related problems exist, it seems that regular exercise and staying physically active, as well as promoting insulin pump therapy where it is applicable are related to favorable HRQoL.


2021 ◽  
Vol 9 (2) ◽  
pp. 33
Author(s):  
Rishi Shukla ◽  
Manisha Gupta ◽  
Neha Agarwal ◽  
Anurag Bajpai

Background: Mindfulness Meditation (MM) is known to improve glycemic control and enhance the quality of life (QoL) in type 2 diabetes (T2D) patients. Unfortunately, the role of meditation in type 1 diabetes (T1D) has not been studied extensively. Therefore, we conducted this study to determine the effect of MM on the glycemic control and QoL in people living with T1D. Methodology: Thirty-two adults living with T1D were equally randomized into intervention (meditation) and control groups. The glycemic control and QoL were assessed at the baseline and after six months of intervention. Results: A total of thirty-two adults (15 males, 46.9%; mean age 23.8 ± 6.6 years) with type 1 diabetes (mean diabetes duration 12.7 ± 6.2 years) participated in the study. At the end of six months, a statistically significant improvement was seen in the mean blood glucose level in the control group (222.4 ± 77.8 versus 182.6 ± 52.0; p = 0.007) and the intervention group (215.3 ± 50.1 versus 193.2 ± 31.8; p = 0.008). Additionally, there was a significant reduction in the total diabetes distress score in the intervention group (1.6 ± 0.3 versus 1.3 ± 0.3; p = 0.003), while no change was observed in the control group (1.6 ± 0.7 versus 1.7 ± 0.4; p = 0.762). A statistically significant improvement was noticed in the health and functioning domain in the intervention group (p = 0.023). Conclusions: An improvement in the glycemic control and quality of life of the patients was observed in our study. MM certainly plays an important role in attaining peace of mind and helps patients to channel their energy in a positive direction.


2021 ◽  
Vol 14 ◽  
pp. 117955142199067
Author(s):  
Amir Babiker ◽  
Bothainah Al Aqeel ◽  
Sarah Marie ◽  
Hala Omer ◽  
Aban Bahabri ◽  
...  

Background: Children with type 1 diabetes (T1D) at different stages of development have age-specific needs, which can influence their perception of quality of life (QoL). In our study, we aimed to emphasize these age-specific needs and assess the perception of QoL in Saudi children with T1D, as well as their parents correlating QoL scores with children’s glycemic control. Methods: This is a cross-sectional study in which children with T1D and their parents from 2 tertiary institutes in Saudi Arabia have answered a standard diabetes-specific QoL questionnaire (PedsQL™ 3.0 diabetes module, translated in Arabic). We also reported glycated hemoglobin (HbA1c) results for these children within a month of completing the questionnaire. The QoL total aggregate and domain scores for self (children) and proxy (parents’) reports were compared and correlated with children’s HbA1c. Results: A sample was 288 self and proxy reports from 144 children with T1D of 3 age groups: 5 to 7 years (7%), 8 to 12 years (49%), and 13 to 18 years (44%), and their parents. QoL differed significantly between self and proxy reports in the total aggregate and domain scores ( P-values range from .02 to <.001). The impact on QoL was significantly higher in female patients ( P = .043). Insulin pump users had better HbA1c ( P = .007), and HbA1c level was worse in those who intended to fast at Ramadan ( P = .005). Conclusion: Children with T1D at different developmental age groups perceive QoL differently than their parents. Adjusting management as per age-specific challenges could potentially improve these children’s QoL and glycemic control.


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