scholarly journals Development and validation of the self-management Barriers and Supports Evaluation for working-aged adults with type 1 diabetes mellitus

2022 ◽  
Vol 10 (1) ◽  
pp. e002583
Author(s):  
Elizabeth M Planalp ◽  
Harald Kliems ◽  
Betty A Chewning ◽  
Mari Palta ◽  
Tamara J LeCaire ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Mean Squared Error ◽  
Strong Association ◽  
Self Management ◽  
Patient Specific ◽  
Factor Analyses ◽  
Behavioral Skills

IntroductionTo optimize type 1 diabetes mellitus self-management, experts recommend a person-centered approach, in which care is tailored to meet people’s needs and preferences. Existing tools for tailoring type 1 diabetes mellitus education and support are limited by narrow focus, lack of strong association with meaningful outcomes like A1c, or having been developed before widespread use of modern diabetes technology. To facilitate comprehensive, effective tailoring for today’s working-aged adults with type 1 diabetes mellitus, we developed and validated the Barriers and Supports Evaluation (BASES).Research design and methodsParticipants 25–64 years of age with type 1 diabetes mellitus were recruited from clinics and a population-based registry. Content analysis of semistructured interviews (n=33) yielded a pool of 136 items, further refined to 70 candidate items on a 5-point Likert scale through cognitive interviewing and piloting. To develop and validate the tool, factor analyses were applied to responses to candidate items (n=392). Additional survey data included demographics and the Diabetes-Specific Quality of Life (QOL) Scale-Revised. To evaluate concurrent validity, hemoglobin A1c (HbA1c) values and QOL scores were regressed on domain scores.ResultsFactor analyses yielded 5 domains encompassing 30 items: Learning Opportunities, Costs and Insurance, Family and Friends, Coping and Behavioral Skills, and Diabetes Provider Interactions. Models exhibited good to adequate fit (Comparative Fit Index >0.88 and Root Mean Squared Error of Approximation <0.06). All domains demonstrated significant associations with HbA1c and QOL in the expected direction, except Family and Friends. Coping and Behavioral Skills had the strongest associations with both HbA1c and QOL.ConclusionsThe BASES is a valid, comprehensive, person-centered tool that can tailor diabetes support and education to individuals’ needs in a modern practice environment, improving effectiveness and uptake of services. Clinicians could use the tool to uncover patient-specific barriers that limit success in achieving HbA1c goals and optimal QOL.

scholarly journals Autoantibodies to thyroid peroxidase in patients with type 1 diabetes in Taiwan

1998 ◽  
pp. 44-48 ◽  
Author(s):  
CC Chang ◽  
CN Huang ◽  
LM Chuang
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Thyroid Autoimmunity ◽  
Strong Association ◽  
Thyroid Peroxidase ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Type 1 Diabetic Patients

OBJECTIVE: Type 1 diabetes mellitus is frequently associated with autoimmune thyroid disease (ATD). Genetic susceptibility to autoantibody formation in association with ATD and type 1 diabetes mellitus has been described with varying frequencies, but there is still debate about the situation in the Chinese population. We have, therefore, investigated the prevalence of anti-thyroid peroxidase (anti-TPO) in type 1 diabetic patients, and compared the effect of anti-glutamate decarboxylase (anti-GAD) on the thyroid autoimmunity in patients with type 1 diabetes mellitus in Taiwan. SUBJECTS AND METHODS: Two hundred and forty-three subjects with type 1 diabetes mellitus and seventy unrelated normal controls were recruited for the detection of anti-TPO. Two hundred and seventeen sera from two hundred and forty-three type 1 diabetic patients were tested for anti-GAD. RIA and immunoprecipitation were used for anti-TPO and anti-GAD detection respectively. RESULTS: The intra-assay and interassay coefficients of variation of anti-TPO detected by the RIA method ranged from 5.5% to 11.1%. Among 243 type 1 diabetic patients, 53 (21.8%) were positive for anti-TPO. Compared with those without thyroid autoimmunity, there was a female preponderance for the type 1 diabetic patients with thyroid autoimmunity (female:male, 99:91 vs 37:16 respectively). Among the type 1 diabetic patients with thyroid autoimmunity, anti-TPO tended to occur in those of older age or with long-standing disease. The frequency of anti-GAD was 45.6%, (99 of 217), without gender preponderance (males:females, 18.0% vs 27.61%). Compared with those with negative anti-GAD, no significant difference of anti-TPO positivity for the type 1 diabetic patients with positive anti-GAD was found. CONCLUSION: Our data indicated that the RIA method for anti-TPO detection is sensitive and precise for routine clinical use. The presence of anti-TPO in 21.8% of our type 1 diabetic patients confirmed the strong association of ATD and type 1 diabetes mellitus without ethnic differences. The absence of correlation between anti-TPO and anti-GAD in our type 1 diabetic patients suggested genetic heterogeneity in the role of autoimmunity of type 1 diabetes mellitus and ATD among races.

Agent-based modeling for the self-management of chronic diseases: An exploratory study

SIMULATION ◽  
2017 ◽  
Vol 93 (9) ◽  
pp. 781-793 ◽  
Author(s):  
Sara Montagna ◽  
Andrea Omicini
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Chronic Diseases ◽  
Agent Based Modeling ◽  
Self Management ◽  
Agent Based ◽  
Management Interventions ◽  
The Impact

The impact of mobile technologies on healthcare is particularly evident in the case of self-management of chronic diseases, where they can decrease spending and improve life quality of patients. We propose the adoption of agent-based modeling and simulation techniques as built-in tools to dynamically monitor the state of patient health and provide recommendations for self-management. To demonstrate the feasibility of our proposal we focus on Type 1 diabetes mellitus as our case study, and provide simulation results where the dynamic evolution of signal parameters is shown in the case of healthy and Type 1 diabetes mellitus patients, focussing in particular on the beneficial effects that self-management interventions have on plasma glucose values.

Design of a Self-Management Program for Children Aged 6-12 Years with Type 1 Diabetes Mellitus at the Community Hospital Herdecke, Germany

2017 ◽  
Vol 24 (4) ◽  
pp. 255-263 ◽  
Author(s):  
Bettina Berger ◽  
Dominik Sethe ◽  
Dörte Hilgard ◽  
David Martin ◽  
Peter Heusser
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Self Efficacy ◽  
Management Program ◽  
Learning Goals ◽  
Self Management ◽  
Aim Analysis ◽  
Endogenous Insulin

Background: Children with type 1 diabetes mellitus (T1DM) must replace lacking endogenous insulin by daily insulin injections or insulin pumps. Standards of treatment include educational programs enabling self-management. The program ‘Herdecker Kids with Diabetes' (HeKiDi) is based on an anthroposophic understanding of the human being and intends to provide an individualized, patient-oriented approach to developing diabetes-related and comprehensive human competencies. Aim: Analysis of the HeKiDi program for children (6-12 years) with T1DM as the first part of an evaluation of a complex intervention. Methods: Ethnographic approach, following the Consolidated Criteria for Reporting Qualitative Research (COREQ), including field observations and interviews with responsible persons, content analysis of materials for determining the structure and the curriculum, presented according to the Template for Intervention Description and Replication (TIDieR). Results: The curriculum follows the standard but adds a learning circle between the child and the therapeutic team comprising 3 stages: (1) perception of the abilities and needs of the individual child supported by adult mentors themselves suffering from T1DM, (2) reflection within the therapeutic team, and (3) daily feedback to the child. Curricular Learning Objectives: Children feel recognized and supported in their individual developmental and diabetes-related competencies and develop motoric, artistic, communicative, and social skills to strengthen their self-efficacy and to understand T1DM as a lifelong awareness process. Conclusions: The curriculum including its associated learning goals and methods was presented. The program was explained and shown to be reproducible. Whether this program truly leads to better outcomes in regard to self-efficacy and hemoglobin A1c (HbA1c, glycated hemoglobin) and how parents and children perceive this will have to be assessed using a comparative interventional study.

Children With Type 1 Diabetes Mellitus: Self-Management Experiences in School

2017 ◽  
Vol 87 (8) ◽  
pp. 623-629 ◽  
Author(s):  
Valéria de Cássia Sparapani ◽  
Raphael D.R. Liberatore ◽  
Elaine B.C. Damião ◽  
Isa R. de Oliveira Dantas ◽  
Rosangela A.A. de Camargo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Self Management
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