scholarly journals Longitudinal associations between family conflict, parent engagement, and metabolic control in children with recent-onset type 1 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. e002461
Author(s):  
Hannah Case ◽  
David D Williams ◽  
Shideh Majidi ◽  
Diana Ferro ◽  
Mark Allen Clements ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Family Conflict ◽  
Mixed Models ◽  
Repeated Measures ◽  
Parent Engagement ◽  
Linear Mixed Models ◽  
Initial Study ◽  
School Age Children ◽  
Related Family

IntroductionWe prospectively investigated the associations between diabetes-related family conflict, parent engagement in child type 1 diabetes (T1D) care, and child glycated hemoglobin (HbA1c) in 127 families of school-age children who we recruited within the first year of their T1D diagnosis.Research design and methodsParents completed the Diabetes Family Conflict Scale-Revised (DFCS-R) to assess for diabetes-related family conflict and the Diabetes Self-Management Questionnaire-Brief (DSMQ-Brief) to assess parent engagement in child T1D care at the initial study visit (T1) and at 12 (T2) and 27 (T3) months later. We also collected child HbA1c at these time points. Our analyses included Pearson correlations and repeated measures linear mixed models controlling for child age, sex, and T1D duration at T1.ResultsParents’ DFCS-R scores negatively correlated with DSMQ-Brief scores (r=−0.13, p<0.05) and positively correlated with children’s HbA1c (r=0.26, p<0.001). In our linear mixed models, parents’ DSMQ-Brief scores were unchanged at T2 (β=−0.71, 95% CI −1.59 to 0.16) and higher at T3 (β=8.01, 95% CI 6.89 to 9.13) compared with T1, and there was an association between increasing DFCS-R and decreasing DSMQ-Brief scores (β=−0.14, 95% CI −0.21 to −0.06). Child HbA1c values were significantly higher at T2 (β=0.66, 95% CI 0.38 to 0.94) and T3 (β=0.95, 95% CI 0.63 to 1.27) compared with T1, and there was an association between increasing DFCS-R scores and increasing child HbA1c (β=0.04, 95% CI 0.02 to 0.06).ConclusionsIncreasing diabetes-specific family conflict early in T1D may associate with decreasing parent engagement in child T1D care and increasing child HbA1c, suggesting a need to assess and intervene on diabetes-specific family conflict.Trial registration numberNCT03698708.

scholarly journals Flash monitor initiation is associated with improvements in HbA1c levels and DKA rates among people with type 1 diabetes in Scotland: a retrospective nationwide observational study

Diabetologia ◽  
2021 ◽  
Author(s):  
Anita Jeyam ◽  
Fraser W. Gibb ◽  
John A. McKnight ◽  
Joseph E. O’Reilly ◽  
Thomas M. Caparrotta ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Mixed Models ◽  
Rate Ratio ◽  
Linear Mixed Models ◽  
Credible Interval ◽  
Mortality Data ◽  
Diabetes Registry ◽  
Time Period ◽  
Event Rates

Abstract Aims/hypothesis We assessed the real-world effect of flash monitor (FM) usage on HbA1c levels and diabetic ketoacidosis (DKA) and severe hospitalised hypoglycaemia (SHH) rates among people with type 1 diabetes in Scotland and across sociodemographic strata within this population. Methods This study was retrospective, observational and registry based. Using the national diabetes registry, 14,682 individuals using an FM at any point between 2014 and mid-2020 were identified. Within-person change from baseline in HbA1c following FM initiation was modelled using linear mixed models accounting for within-person pre-exposure trajectory. DKA and SHH events were captured through linkage to hospital admission and mortality data. The difference in DKA and SHH rates between FM-exposed and -unexposed person-time was assessed among users, using generalised linear mixed models with a Poisson likelihood. In a sensitivity analysis, we tested whether changes in these outcomes were seen in an age-, sex- and baseline HbA1c-matched sample of non-users over the same time period. Results Prevalence of ever-FM use was 45.9% by mid-2020, with large variations by age and socioeconomic status: 64.3% among children aged <13 years vs 32.7% among those aged ≥65 years; and 54.4% vs 36.2% in the least-deprived vs most-deprived quintile. Overall, the median (IQR) within-person change in HbA1c in the year following FM initiation was −2.5 (−9.0, 2.5) mmol/mol (−0.2 [−0.8, 0.2]%). The change varied widely by pre-usage HbA1c: −15.5 (−31.0, −4.0) mmol/mol (−1.4 [−2.8, −0.4]%) in those with HbA1c > 84 mmol/mol [9.8%] and 1.0 (−2.0, 5.5) mmol/mol (0.1 [−0.2, 0.5]%) in those with HbA1c < 54 mmol/mol (7.1%); the corresponding estimated fold change (95% CI) was 0.77 (0.76, 0.78) and 1.08 (1.07, 1.09). Significant reductions in HbA1c were found in all age bands, sexes and socioeconomic strata, and regardless of prior/current pump use, completion of a diabetes education programme or early FM adoption. Variation between the strata of these factors beyond that driven by differing HbA1c at baseline was slight. No change in HbA1c in matched non-users was observed in the same time period (median [IQR] within-person change = 0.5 [−5.0, 5.5] mmol/mol [0.0 (−0.5, 0.5)%]). DKA rates decreased after FM initiation overall and in all strata apart from the adolescents. Estimated overall reduction in DKA event rates (rate ratio) was 0.59 [95% credible interval (CrI) 0.53, 0.64]) after FM vs before FM initiation, accounting for pre-exposure trend. Finally, among those at higher risk for SHH, estimated reduction in event rates was rate ratio 0.25 (95%CrI 0.20, 0.32) after FM vs before FM initiation. Conclusions/interpretation FM initiation is associated with clinically important reductions in HbA1c and striking reduction in DKA rate. Increasing uptake among the socioeconomically disadvantaged offers considerable potential for tightening the current socioeconomic disparities in glycaemia-related outcomes. Graphical abstract

scholarly journals Parental Self-Control as a Moderator of the Association Between Family Conflict and Type 1 Diabetes Management

2019 ◽  
Vol 44 (8) ◽  
pp. 999-1008 ◽  
Author(s):  
MaryJane S Campbell ◽  
Cynthia A Berg ◽  
Deborah J Wiebe
Keyword(s):  
Type 1 Diabetes ◽  
Family Conflict ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Self Control ◽  
Mothers And Fathers ◽  
Time Points ◽  
Related Family ◽  
Lower Adherence

Abstract Objective To examine whether parental self-control (i.e., parents’ ability to regulate their emotions, cognitions, and behaviors) moderates the detrimental association between type 1 diabetes (T1D)-specific family conflict and adherence and HbA1c, such that conflict is most detrimental when parental self-control is low. Methods One hundred and forty-nine adolescents diagnosed with T1D (Mage = 14.09; 53% female) reported on their T1D-specific conflict with their mothers and fathers and their adherence to the T1D regimen at two time points (6 months apart). Mothers and fathers reported on their self-control. Glycated hemoglobin (HbA1c) was obtained from the medical record at both time points. Results Higher adolescent-reported conflict with father was associated concurrently with higher HbA1c and lower adherence only for fathers with low self-control (ps < .05). Higher adolescent-reported conflict with mother was also associated concurrently with lower adherence only for mothers with lower self-control (p < .05); no significant moderation was found for mothers’ self-control in predicting HbA1c. Longitudinal analyses indicated family conflict with mother predicted changes in adherence and HbA1c, but there were no significant moderating effects of either mother or father self-control. Conclusions Lower parental self-control may prevent parents from handling diabetes-related family conflict in a productive manner. We discuss the implications of parental self-control as an intervention target for health care professionals working with adolescents with T1D and their families.

Explaining the family conflict-glycemic control link through psychological variables in adolescents with type 1 diabetes

2011 ◽  
Vol 34 (4) ◽  
pp. 268-274 ◽  
Author(s):  
Michele Herzer ◽  
Anthony Vesco ◽  
Lisa M. Ingerski ◽  
Lawrence M. Dolan ◽  
Korey K. Hood
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Family Conflict ◽  
Psychological Variables ◽  
The Family

scholarly journals Report Quality of Generalized Linear Mixed Models in Psychology: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Roser Bono ◽  
Rafael Alarcón ◽  
María J. Blanca
Keyword(s):  
Systematic Review ◽  
Mixed Models ◽  
Repeated Measures ◽  
Web Of Science ◽  
Generalized Linear Mixed Models ◽  
Linear Mixed Models ◽  
Journal Citation Reports ◽  
Report Quality ◽  
Fixed And Random Effects

Generalized linear mixed models (GLMMs) estimate fixed and random effects and are especially useful when the dependent variable is binary, ordinal, count or quantitative but not normally distributed. They are also useful when the dependent variable involves repeated measures, since GLMMs can model autocorrelation. This study aimed to determine how and how often GLMMs are used in psychology and to summarize how the information about them is presented in published articles. Our focus in this respect was mainly on frequentist models. In order to review studies applying GLMMs in psychology we searched the Web of Science for articles published over the period 2014–2018. A total of 316 empirical articles were selected for trend study from 2014 to 2018. We then conducted a systematic review of 118 GLMM analyses from 80 empirical articles indexed in Journal Citation Reports during 2018 in order to evaluate report quality. Results showed that the use of GLMMs increased over time and that 86.4% of articles were published in first- or second-quartile journals. Although GLMMs have, in recent years, been increasingly used in psychology, most of the important information about them was not stated in the majority of articles. Report quality needs to be improved in line with current recommendations for the use of GLMMs.

scholarly journals Skin microvascular reactivity correlates to clinical microangiopathy in type 1 diabetes: A pilot study

2020 ◽  
Vol 17 (3) ◽  
pp. 147916412092830
Author(s):  
Sara Tehrani ◽  
Karin Bergen ◽  
Louisa Azizi ◽  
Gun Jörneskog
Keyword(s):  
Type 1 Diabetes ◽  
Sodium Nitroprusside ◽  
Repeated Measures ◽  
Doppler Imaging ◽  
Healthy Controls ◽  
Microvascular Reactivity ◽  
Repeated Measures Analysis ◽  
Peak Flux ◽  
Forearm Skin

Aim: The aim of this study was to investigate the correlation between skin microvascular reactivity and clinical microangiopathy in patients with type 1 diabetes. Methods: We included 61 patients with type 1 diabetes, that is, 31 patients with and 30 without clinical microangiopathy, and 31 healthy controls. A microangiopathy scoring system was introduced for comparison of data between patients with microangiopathy. Responses to iontophoresis of acetylcholine and sodium nitroprusside were assessed by laser Doppler imaging. Results: Patients with microangiopathy had reduced acetylcholine- and sodium nitroprusside-mediated flux in forearm skin microcirculation compared to healthy controls ( p = 0.03 and p < 0.001, respectively, repeated measures analysis of variance), whereas no significant differences were found between patients without microangiopathy and controls. Skin reactivity was reduced in patients with microangiopathy compared to patients without microangiopathy: 1.43 ± 0.38 versus 1.59 ± 0.39 arbitrary units for acetylcholine-mediated peak flux and 1.44 ± 0.46 versus 1.74 ± 0.34 arbitrary units for sodium nitroprusside-mediated peak flux ( p < 0.05 for both). A tendency of gradual decrease in acetylcholine and sodium nitroprusside responses was found in patients with increasing microangiopathy scores. Conclusion: We conclude that skin microvascular reactivity is associated with clinical microangiopathy in patients with type 1 diabetes. Impaired skin microvascular function in type 1 diabetes seems to be multifactorial and involves both endothelial-dependent and endothelial-independent pathways. We introduce a novel microangiopathy score that could easily be used in a clinical setting for comparison of patients with various degrees of microangiopathy.

scholarly journals General Quality of Life in Youth With Type 1 Diabetes: Relationship to patient management and diabetes-specific family conflict

Diabetes Care ◽  
2003 ◽  
Vol 26 (11) ◽  
pp. 3067-3073 ◽  
Author(s):  
L. M.B. Laffel ◽  
A. Connell ◽  
L. Vangsness ◽  
A. Goebel-Fabbri ◽  
A. Mansfield ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Family Conflict ◽  
Patient Management ◽  
General Quality

scholarly journals The Relationship between Diabetes Family Conflict and Parental Conflict on Problem Recognition in Illness Self-Management among Individuals with Type 1 Diabetes Mellitus

2021 ◽  
Vol 18 (17) ◽  
pp. 8914
Author(s):  
Mi-Kyoung Cho ◽  
Mi Young Kim
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Regression Model ◽  
Family Conflict ◽  
Conflict Behavior ◽  
Self Management ◽  
Parental Conflict ◽  
Diabetes Family ◽  
The Relationship

We investigated the relationship between diabetes family conflict and parental conflict on problem recognition in illness self-management (PRISM) among individuals with type 1 diabetes mellitus (T1DM). We employed a descriptive research design. Participants were 243 individuals with T1DM who completed online questionnaires. Data were analyzed with descriptive statistics, correlations, and multiple regression analyses. Results revealed that barriers were felt in all areas (understanding and organizing care, regimen pain and bother, healthcare team interaction, family interaction, and peer interaction), especially peer interaction. The significant influencing factors in the regression model for the total PRISM score of individuals with T1DM were conflict behavior toward mothers (t = 4.44, p < 0.001), diabetes family conflict (t = 5.77, p < 0.001), conflict behavior toward fathers (t = 2.58, p = 0.011), women (t = 2.67, p = 0.008), non-religious (t = −2.33, p = 0.020), and diabetic complications (t = 2.17, p = 0.031). The explanatory power of the constructed regression model for PRISM was 42.0% (F = 30.12, p < 0.001). To promote self-management among individuals with T1DM, the development of interventions that promote improved peer interactions, a family-centered approach, and a program that can minimize conflicts between families and parents are required.

Sign in / Sign up

Export Citation Format

Share Document