Metabolic Control and Illness Perceptions in Adolescents with Type 1 Diabetes

Background. Disturbed eating behavior and psychosocial variables have been found to influence metabolic control, but little is known about how these variables interact or how they influence metabolic control, separately and combined.Objective. To explore associations between metabolic control (measured by HbA1c) and eating disorder psychopathology, coping strategies, illness perceptions, and insulin beliefs in adolescents with type 1 diabetes.Methods. A total of 105 patients (41.9% males) with type 1 diabetes (12–20 years) were interviewed with the Child Eating Disorder Examination. In addition, self-report psychosocial questionnaires were completed. Clinical data, including HbA1c, was obtained from the Norwegian Childhood Diabetes Registry.Results. Significant gender differences were demonstrated. Among females, HbA1c correlated significantly with eating restriction (.29,p< .05), the illness perception dimensionsconsequences, personal control, coherence,andconcern(ranging from .33 to .48), and the coping strategyventilating negative feelings(−.26,p< .05). Illness perceptionpersonal controlcontributed significantly to HbA1c in a regression model, explaining 23% of the variance among females (β.48,p< .001). None of the variables were significantly associated with HbA1c among males.Conclusions. Illness perceptions appear to be important contributors to metabolic control in females, but not males, with type 1 diabetes.

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The impact of psychological aspects, age, and BMI on eating disorder psychopathology among adult males and females with type 1 diabetes

Health Psychology Open ◽

10.1177/2055102920975969 ◽

2020 ◽

Vol 7 (2) ◽

pp. 205510292097596

Author(s):

Line Wisting ◽

Cecilie Siegwarth ◽

Torild Skrivarhaug ◽

Knut Dahl-Jørgensen ◽

Øyvind Rø

Keyword(s):

Type 1 Diabetes ◽

Eating Disorder ◽

Illness Perceptions ◽

Personal Control ◽

Psychological Aspects ◽

Adult Males ◽

Eating Disorder Psychopathology ◽

Clinical Awareness ◽

The Impact

This study investigated correlates of eating disorder (ED) psychopathology among adults with type 1 diabetes (T1D). A total of 282 males ( n = 112) and females ( n = 170) with T1D (18–79 years) participated. Overall, psychological aspects (i.e. illness perceptions, coping strategies, insulin beliefs, anxiety, and depression) were associated with ED psychopathology. Associations were generally stronger among females than males. In a regression model, age, BMI, personal control, and anxiety explained 51% of the variance in ED psychopathology among females, whereas BMI, personal control, and anxiety explained 47% of the variance among males. Greater clinical awareness of health psychological aspects may contribute to reduce the risk of developing ED.

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Disturbed eating, illness perceptions, and coping among adults with type 1 diabetes on intensified insulin treatment, and their associations with metabolic control

Journal of Health Psychology ◽

10.1177/1359105319840688 ◽

2019 ◽

pp. 135910531984068 ◽

Cited By ~ 2

Author(s):

Line Wisting ◽

Astrid Rø ◽

Torild Skrivarhaug ◽

Knut Dahl-Jørgensen ◽

Øyvind Rø

Keyword(s):

Type 1 Diabetes ◽

Metabolic Control ◽

Insulin Treatment ◽

Illness Perceptions ◽

Disturbed Eating ◽

Intensified Insulin Treatment ◽

And Coping

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Depression, obesity, and smoking were independently associated with inadequate glycemic control in patients with type 1 diabetes

Acta Endocrinologica ◽

10.1530/eje-13-0137 ◽

2013 ◽

Vol 168 (6) ◽

pp. 861-869 ◽

Cited By ~ 35

Author(s):

Eva O Melin ◽

Maria Thunander ◽

Ralph Svensson ◽

Mona Landin-Olsson ◽

Hans O Thulesius

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Physical Inactivity ◽

Depression Scale ◽

Self Report ◽

Cross Sectional ◽

Diabetes Registry ◽

Control Of Diabetes ◽

Inadequate Glycemic Control

ObjectiveThe aim of this study was to explore the associations between inadequate glycemic control of diabetes and psychological, anthropometric, and lifestyle variables in a population-based cohort of type 1 diabetes patients.DesignCross-sectional study.MethodsIn this study, 292 patients with type 1 diabetes, aged 18–59 years, participated. Psychological data were assessed by self-report instruments: Hospital Anxiety and Depression Scale and Toronto Alexithymia Scale-20. Anthropometrics, blood analyses, data from medical records, and data from the Swedish National Diabetes Registry were collected.ResultsSelf-reported depression (adjusted odds ratio (AOR) 4.8), obesity (AOR 4.3), and smoking (AOR 3.0) were independently associated with inadequate glycemic control of diabetes (HbA1c>8.6%). Gender-stratified analyses showed that self-reported depression (AOR 19.8) and obesity (AOR 7.0) in women and smoking in men (AOR 4.2) were associated with HbA1c>8.6%. Alexithymia, antidepressant medication, and physical inactivity were associated with HbA1c>8.6% only in bivariate analyses. Alexithymia, self-rated anxiety, physical inactivity, and absence of abdominal obesity were associated with self-reported depression.ConclusionsDepression was the only psychological factor independently associated with HbA1c>8.6%. The association was of comparable importance as obesity and smoking, well-known risk factors for inadequate glycemic control and diabetes complications. The association between depression and HbA1c>8.6% was particularly strong for women. Alexithymia, which is a relatively stable personality trait, was associated with depression. In the future care of patients with diabetes, psychological aspects should be considered alongside anthropometrics and lifestyle factors in order to achieve the goals for HbA1c.

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Family functioning and quality of life in adolescents with type 1 diabetes: The role of dissimilarity in illness representations and school support

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104519895054 ◽

2019 ◽

Vol 25 (2) ◽

pp. 494-506

Author(s):

Ana C Almeida ◽

M Engrácia Leandro ◽

M Graça Pereira

Keyword(s):

Quality Of Life ◽

Type 1 Diabetes ◽

Family Functioning ◽

Illness Perceptions ◽

Illness Perception ◽

Negative Relationship ◽

School Support ◽

The Impact

This study analyzed the impact of dissimilarities in illness perceptions between parents and adolescents, school support, and family functioning on quality of life of adolescents with type 1 diabetes (T1D). A total of 100 adolescents diagnosed with T1D for at least 1 year and a primary caregiver participated in the study (N=200). Adolescents answered the Diabetes Quality of Life and the School Support Questionnaire, and parents answered the general functioning subscale of the Family Assessment Device. Both answered the Brief-Illness Perception Questionnaire, regarding the adolescents’ diabetes. The interception effect of dissimilarities regarding identity and concerns perceptions toward diabetes, between parents and adolescents, and school support in the relationship between family functioning and quality of life was significant and explained 27% and 32% of the variance, respectively. The results showed a negative relationship between family functioning and quality of life when school support was low and dissimilarities in identity and concerns perceptions were high. Therefore, to increase quality of life of adolescents with T1D, intervention programs should include family, teachers, school staff, and peers to improve their knowledge of diabetes and support to adolescents.

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Cognitive functions and glycemic control in children and adolescents with type 1 diabetes

Psychological Medicine ◽

10.1017/s0033291709005777 ◽

2009 ◽

Vol 40 (1) ◽

pp. 95-103 ◽

Cited By ~ 35

Author(s):

S. Ohmann ◽

C. Popow ◽

B. Rami ◽

M. König ◽

S. Blaas ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Metabolic Control ◽

Child Behavior Checklist ◽

Diabetes Management ◽

Social Activity ◽

Self Report ◽

Patients With Diabetes

BackgroundThe relationship between metabolic control and cognitive function in adolescents with type 1 diabetes (DM type 1) is not clear. We compared the quality of glycemic control (GC) and cognitive measures in adolescents with DM type 1 to find out if the quality of diabetes management is related to cognitive impairment.MethodWe assessed executive functions (EFs) and other neuropsychological and psychosocial variables in 70 adolescent patients with DM type 1 and 20 age-matched controls. Patients were divided into two groups according to their last hemoglobin A1c (HbA1c): acceptable (HbA1c 5.9–8.0%, mean 6.9%, 36 patients, mean age 14 years) and non-optimal (HbA1c 8.2–11.6%, mean 9.3%, 34 patients, mean age 15.6 years).ResultsWe found impaired EFs, mainly problems of concept formation (p=0.038), cognitive flexibility (p=0.011) and anticipation (p=0.000), in the patients with DM type 1. Both groups did not differ in intelligence, most assessed EFs and adjustment to chronic illness (Youth Self-Report; YSR). Younger patients (<15 years) were cognitively less flexible. GC was worse in older patients and in patients with longer duration of the disease. We also found significant differences between patients with diabetes and controls concerning somatic complaints, internalizing problems (Child Behavior Checklist; CBCL) and social activity (CBCL and YSR).ConclusionsDM type 1 is associated with cognitive deficits in adolescents independent of the quality of metabolic control and the duration of the disease. These deficits are probably related to the disease, especially in patients with early-onset diabetes.

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The associations of self-care, illness perceptions and psychological distress with metabolic control in Singaporean adolescents with Type 1 Diabetes Mellitus

Health Psychology and Behavioral Medicine ◽

10.1080/21642850.2015.1115728 ◽

2016 ◽

Vol 4 (1) ◽

pp. 1-14 ◽

Cited By ~ 5

Author(s):

Cherie Shu Yun Goh ◽

Amir Mohamed ◽

Yung Seng Lee ◽

Kah Yin Loke ◽

Hwee Lin Wee ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Psychological Distress ◽

Type 1 Diabetes Mellitus ◽

Metabolic Control ◽

Illness Perceptions ◽

Self Care

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Illness perception of adolescents with well-controlled type 1 diabetes mellitus

Health Psychology Open ◽

10.1177/2055102918799968 ◽

2018 ◽

Vol 5 (2) ◽

pp. 205510291879996 ◽

Cited By ~ 3

Author(s):

Deborah Jonker ◽

Elmari Deacon ◽

Esme van Rensburg ◽

David Segal

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Diabetes Care ◽

Illness Perceptions ◽

Diabetes Management ◽

Illness Perception ◽

Care Plan ◽

Care Plans

In this study, to explore the illness perceptions of adolescents with well-controlled type 1 diabetes mellitus in South Africa, semi-structured interviews were conducted with nine, purposively selected adolescents (mean = 13.9 years; median = 12). Themes that emerged from the thematic analysis include the following: accepting diabetes and the diabetes care plan as part of their lives; viewing diabetes as manageable and as their responsibility; and the important role of gaining information on diabetes and diabetes management. These perceptions contributed to adherence to diabetes care plans and should be explored and developed among adolescents with type 1 diabetes mellitus to improve their diabetes management.

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‘It kinda sucks’: Illness perception of a group of South African adolescents with type 1 diabetes mellitus

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v13i1.2782 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Schvaugn Lesage ◽

Elmari Deacon ◽

Esmé Van Rensburg ◽

David Segal

Keyword(s):

At Risk ◽

Type 1 Diabetes ◽

Glycaemic Control ◽

Illness Perceptions ◽

Diabetes Management ◽

Illness Perception ◽

The Body ◽

Poor Glycaemic Control ◽

Care Plans

Background: Living with diabetes is challenging, especially for adolescents at risk of poor glycaemic control. Understanding the illness perceptions of this group is important to be able to develop interventions for this growing population in need.Aim: This study explored the illness perception amongst adolescents living with type 1 diabetes (T1D) and how these perceptions interacted with the management of T1D.Setting: This study was conducted at a medical centre providing care for adolescents living with T1D in Parktown, South Africa.Methods: A qualitative, explorative design with semi-structured interviews was followed. A non-random purposive sampling method was utilised. The illness perception amongst eight adolescents, aged 12–18 years, at risk of poor glycaemic control, was analysed through thematic analysis.Results: Two subthemes related to illness perception were generated, namely (1) illness perception of T1D is negative and (2) living with T1D leads to a sense of being different. Furthermore, two subthemes were generated in relation to how illness perceptions interacted with diabetes management, namely (3) management of T1D is challenging and (4) management of T1D is motivated by fear.Conclusion: This group of adolescents with at-risk glycaemic control believed that T1D is difficult to manage, leading to a largely negative perception of the disease. This study contributes to the body of literature on adolescents where illness perception may play a role in adhering to diabetes care plans. This research may give additional insights into the awareness of illness perception in designing successful interventions.

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