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.

Virtual Group Appointments Reduce Distress and Improve Care Management in Young Adults with Type 1 Diabetes

2021 ◽  
pp. 193229682110357
Author(s):  
Daniel I. Bisno ◽  
Mark W. Reid ◽  
Jennifer L. Fogel ◽  
Elizabeth A. Pyatak ◽  
Shideh Majidi ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Controlled Trial ◽  
Self Management ◽  
Diabetes Distress ◽  
Care Providers ◽  
Virtual Group ◽  
Distress Scale ◽  
The Impact

Purpose: The purpose of this study was to analyze the impact of virtual group appointments (VGA) on self-reported health-related outcomes and care activities for young adults (YA) with type 1 diabetes (T1D). Methods: Fifty-three YA (ages 18-25 years) with T1D participated in a randomized controlled trial (RCT) of the Colorado Young Adults with T1D (CoYoT1) Clinic intervention, encompassing telehealth (TH) with or without VGA. Both new patients ( n = 32) and those who participated in a pilot phase ( n = 26) were randomized to CoYoT1 Clinic (TH+VGA; n = 23) or TH-only ( n = 35) and followed for 1 year. YA completed the Diabetes Distress Scale (DDS), Diabetes Strengths and Resilience (D-STAR), Self-Efficacy in Diabetes (SED), Self-Management of Type 1 Diabetes in Adolescence (SMOD-A), Center for Epidemiologic Studies Depression (CES-D), and EuroQol (EQ-5D) scales at baseline and study end. Results: YA were 67% female, 84% white, 10% Latinx, and the mean age was 20.4 years old. At study end, participants in CoYoT1 Clinic reported significantly reduced diabetes distress compared to those in TH-only, who reported increased levels [Effect Size (ES) = −0.40, P = .02]. Specifically, CoYoT1 Clinic participants reported relative reductions in Physician (ES = −2.87, P = .02) and Regimen-related distress (ES = −0.35, P = .01). In addition, participants in CoYoT1 Clinic reported improved self-management of T1D-related problem solving (ES = 0.47, P = .051) and communication with care providers (ES = 0.39, P = .07). Conclusions: Virtual group attendance in CoYoT1 Clinic was associated with significant improvements in diabetes-related distress. Long-term exposure to VGA should be investigated in YA with T1D and other pediatric chronic conditions.

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

Internal structure and psychometric properties of Diabetes Distress Scale for Type 1 Diabetes

Psychiatriki ◽  
2020 ◽  
Vol 31 (4) ◽  
pp. 302-309
Author(s):  
F. Griva ◽  
P. Thomakos ◽  
O. Kepaptsoglou ◽  
M. Ginieri-Coccossis ◽  
Α. Mitrakou ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Psychometric Properties ◽  
Internal Structure ◽  
Diabetes Distress ◽  
Distress Scale ◽  
Diabetes Distress Scale

scholarly journals Effect of 6 Months of Flash Glucose Monitoring in Youth With Type 1 Diabetes and High-Risk Glycemic Control: A Randomized Controlled Trial

Diabetes Care ◽  
2020 ◽  
Vol 43 (10) ◽  
pp. 2388-2395 ◽  
Author(s):  
Sara E. Boucher ◽  
Andrew R. Gray ◽  
Esko J. Wiltshire ◽  
Martin I. de Bock ◽  
Barbara C. Galland ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Type 1 Diabetes ◽  
High Risk ◽  
Glycemic Control ◽  
Controlled Trial ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Randomized Controlled

scholarly journals The Self-Management Experiences of Adolescents with Type 1 Diabetes: A Descriptive Phenomenology Study

2020 ◽  
Vol 17 (14) ◽  
pp. 5132
Author(s):  
Li-Chen Hung ◽  
Chu-Yu Huang ◽  
Fu-Sung Lo ◽  
Su-Fen Cheng
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Phenomenological Study ◽  
Medical Center ◽  
Self Management ◽  
Good Glycemic Control ◽  
Descriptive Phenomenology ◽  
Parental Assistance ◽  
Colaizzi's Method

Many adolescents with type 1 diabetes experience challenges in achieving good glycemic control and have insufficient understanding in executing interventions for glycemic control. This study aimed to understand self-management experiences of adolescents with type 1 diabetes in Taiwan. In this descriptive phenomenological study, we conducted in-depth interviews with 18 adolescents with type 1 diabetes from the pediatric outpatient clinic of a medical center. Data were analyzed using the Colaizzi’s method. Four themes were identified: (1) misconception regarding self-management of blood glucose; (2) conflict between depending on and breaking away from parental assistance for glycemic control; (3) encounter with disruptions in glycemic control regimen due to the presence of schedule changes; and (4) lack of motivation to achieve good glycemic control. The findings indicated that the misconceptions of adolescents with type 1 diabetes about managing glycemic levels resulted from an insufficient understanding of self-management of diabetes. In Taiwan, the heavy emphasis of academic achievement and changes of schedules during breaks tended to disrupt the regimen for glycemic control. Healthcare professionals are encouraged to provide individualized education focusing on the adolescents’ misconceptions regarding self-management of diabetes.

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