The Empowerment Ladder: Understanding transition across leadership stages in individuals with type 1 diabetes and other noncommunicable diseases

2021 ◽  
pp. 001789692098383
Author(s):  
Mark Thomaz Ugliara Barone ◽  
Matheus Chaluppe ◽  
Pedro Ripoli ◽  
Bruna Talita Patricio ◽  
Bruna Letícia Souza Lima ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Active Role ◽  
Health Condition ◽  
Noncommunicable Diseases ◽  
Youth Leaders ◽  
Before And After ◽  
The Difference ◽  
Stage 1 ◽  
Internal And External Factors

Background: Acceptance and adjustment to lifelong noncommunicable diseases (NCDs) pose a great challenge for individuals living with these conditions. Diabetes is one of the most prevalent NCDs, with type 1 diabetes usually diagnosed during childhood. Self-leadership is linked to internal and external factors that may motivate individuals with NCDs to play an active role as changemakers in their community or society. The Young Leaders in Diabetes (YLD) training, created to equip young people with skills that would benefit the population to which they belong, uses the Empowerment Ladder as a framework to identify their position relative to three leadership stages (self, community and society). Objective: To describe the stages and the ‘climbing’ process of the Empowerment Ladder and assess its suitability as a framework for use in a leadership training context. Method: From among 29 youth leaders who participated, 15 were selected (5 men and 10 women) and had their community engagement and activity analysed before and after training. Individuals were positioned on the Empowerment Ladder according to their past and current roles and activities. The difference between pre- and post-training test grades (delta scores) was calculated. Results: Post-training scores were significantly higher than pre-training scores (8.9 ± 0.54 vs 7.6 ± 1.08, p = .00084). Most individuals moved to a higher step on the Empowerment Ladder; however, three individuals, with delta scores lower than the median (0.1, 0.15 and 0.85) remained at their pre-YLD training level. Only one individual moved from Stage 1 (self) to Stage 3 (society). Another individual occupied two different steps at Stages 1 and 2 simultaneously because, although they demonstrated community leadership, they had not yet accepted their own health condition. Conclusion: The Empowerment Ladder proved a useful tool for identifying stages from self to broader levels of leadership in individuals living with type 1 diabetes. These initial findings need to be validated with a larger population, which includes other NCD groups.

scholarly journals FUNCTIONING OF NO-CYCLE IN THE SALIVA OF CHILDREN WITH TYPE 1 DIABETES MELLITUS

2021 ◽  
Vol 78 (4) ◽  
pp. 34-39
Author(s):  
Iryna Kuz ◽  
Oleh Akimov ◽  
Vitalii Kostenko ◽  
Olga Sheshukova ◽  
Alina Maksymenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
No Synthase ◽  
Tissue Homogenate ◽  
Before And After ◽  
Systemic Factor ◽  
The Difference ◽  
Microsoft Office

Introduction. The presence of type 1 diabetes mellitus in children is a major risk factor for periodontal disease. The aim of research work was to determine the activity of NO-synthase and arginase in saliva in children age with insulin-dependent diabetes mellitus. Materials and methods We examined 82 children including 56 children with type 1 diabetes mellitus and 26 children without somatic diseases. NO-synthase (NOS) activity was determined by the difference in nitrite concentration before and after incubation of tissue homogenate. Determining arginase activity was based on analysis the difference in the concentration of L-ornithine before and after incubation in phosphate buffer solution. Statistical processing was performed using Microsoft Office Excel. Research results and their discussion The violation of the indicators’ balance between groups 1 and 3 showed us a decrease in regenerative capacity in the mucous membrane in persons with type 1 diabetes mellitus. Increased ARG activity in group 4 children may lead to rivarly between NOS and ARG for L-arginine. Increased ARG activity in groups 2 and 4 compared with group 1 indicated an adaptive response aimed at repairing gum damage. Based on this, increased NO production from NOS is a consequence of insulin deficiency (systemic factor). Conclusions. The combination of systemic factor (type 1 diabetes mellitus) and local (chronic catarrhal gingivitis) leads to dysregulation of the NO-cycle and increasing of competition between NOS and ARG. ФУНКЦИОНИРОВАНИЕ NO-ЦИКЛА В СЛЮНЕ У ДЕТЕЙ С САХАРНЫМ ДИАБЕТОМ І ТИПА Кузь И.А., Акимов О.Е., Костенко В.А., Шешукова О.В., Максименко А.И., Писаренко Е.А. Полтавский государственный медицинский университет Вступление. Наличие у детей сахарного диабета І типа является основным фактором риска заболеваний пародонта. Целью исследования было определение активности NO-синтазы и аргиназы в слюне у детей с инсулинозависимым сахарным диабетом. Материалы и методы. Обследовано 82 ребенка, в том числе 56 детей с сахарным диабетом І типа и 26 детей без соматических заболеваний. Активность NO-синтазы (NOS) определяли по разнице в концентрации нитрита до и после инкубации гомогената ткани. Определение активности аргиназы основывалось на анализе разницы в концентрации L-орнитина до и после инкубации в фосфатном буферном растворе. Статистическая обработка проводилась с использованием Microsoft Office Excel. Результаты исследований и их обсуждение. Нарушение баланса показателей между 1 и 3 группами свидетельствовало о снижении регенерационной способности слизистой оболочки у лиц с сахарным диабетом І типа. Повышенная активность ARG у детей группы 4 может привести к неравенству между NOS и ARG для L-аргинина. Повышенная активность ARG в группах 2 и 4 по сравнению с группой 1 указала на адаптивный ответ, направленный на восстановление повреждений десен. Исходя из этого, повышенная продукция NO из NOS является следствием дефицита инсулина (системный фактор). Выводы. Сочетание системного фактора (сахарный диабет І типа) и местного (хронический катаральный гингивит) приводит к нарушению регуляции NO-цикла и усилению конкуренции между NOS и ARG.

scholarly journals Specific features of pregnancy in patients with type 1 diabetes in the prepubertal period. Results of a 15-year long clinical observation

2009 ◽  
Vol 12 (4) ◽  
pp. 28-31
Author(s):  
Lyubov' Leonidovna Bolotskaya ◽  
Natalya Vladimirovna Efremova ◽  
Yury Ivanovich Suntsov
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Complications ◽  
Insulin Dose ◽  
Research Centre ◽  
Nocturnal Hypoglycemia ◽  
Significant Difference ◽  
Before And After ◽  
Pregnancy And Delivery ◽  
The Difference

Aim. To evaluate effect of different factors on pregnancy course in patients with type 1 diabetes mellitus developing in the prepubertal period. Materials and methods. The study based at Endocrinological Research Centre included 77 women with prepubertal diabetes 18 of whom developedpregnancy that ended in delivery. Results. As per 2009, the age of the patients is 26,6?4,6 years. They became pregnant at 23,2?3,3 years and had had diabetes since the age of9,6?4,8 years. Their HbA1c level before and after pregnancy was 8,6?1,4 and 6,8?1,6% respectively, the difference being insignificant (p=0,3).Significant difference was documented between these HbA1c levels and that during pregnancy (p=0,0004 and 0.003 respectively). Nine (56,2%) patientsused ultrashort-acting insulin analogs and the remaining 7 (43,7%) recombinant human insulins. The mean insulin dose was 43,7?11 U/din the 1st trimester, 51,8?13,7 U/d in the 2bd trimester, and 45,3?10,8 U/d after delivery. 16 (88%) of the patients reported frequent hypoglycemia,five (27,8%) of them had episodes of severe daytime and nocturnal hypoglycemia. 11 (61%) developed microvascular diabetic complications beforepregnancy, with 9 (50%) having DR and 4 (22,2%) DN (microalbuminuria). The delivery occurred on weeks 36-37 in 7 (38,9%) women. Naturaland cesarean section deliveries took place in one and 17 (94,4%) patients respectively. Conclusion. Long-term follow-up of patients wit DM1 in accordance with algorithms of specialized medical aid to DM1 patients in Russia at a multidisciplinaryendocrinological centre decreases the risk of pregnancy and delivery complications and that of microvascular diabetic complications

Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

Open Medicine ◽  
2009 ◽  
Vol 4 (4) ◽  
pp. 415-422
Author(s):  
Kamile Gul ◽  
Ihsan Ustun ◽  
Yusuf Aydin ◽  
Dilek Berker ◽  
Halil Erol ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Statistical Significance ◽  
Control Group ◽  
Acid Decarboxylase ◽  
Thyroid Peroxidase ◽  
The Difference ◽  
Type 1 Dm

AbstractThe aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

The effect of the COVID-19 pandemic on metabolic control in children with type 1 diabetes: a single-center experience

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emre Sarıkaya ◽  
Dilek Çiçek ◽  
Ebru Gök ◽  
Leyla Kara ◽  
Uğur Berber ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Metabolic Control ◽  
Glycosylated Hemoglobin ◽  
Emergency Admissions ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After ◽  
One Year

Abstract Objectives Coronavirus disease 2019 has caused a major epidemic worldwide, and lockdowns became necessary in all countries to prevent its spread. This study aimed to evaluate the effects of staying-at-home practices on the metabolic control of children and adolescents with type 1 diabetes during the pandemic period. Materials and Methods Eighty-nine patients younger than 18 years old who were diagnosed with type 1 diabetes at least one year before the declaration of the pandemic were included in the study. The last visit data of the patients before and after the declaration of the pandemic, and the frequency of presentation of diabetes-related emergencies from one year after diagnosis of type 1 diabetes to the declaration of the pandemic, and from the declaration of the pandemic to the last visit after the pandemic declaration were compared. Results The total number of patients was 89, and 48 (53.9%) were boys. The mean (± standard deviation [SD]) age at diagnosis was 8.4 ± 3.7 years (boys 7.9 ± 3.6 years; girls 8.9 ± 3.9 years). There was no statistically significant difference when the SD values of the anthropometric measurements, and the glycosylated hemoglobin (HbA1c) and lipid profile tests were compared. However, the frequency of admission to the emergency service related to diabetes was significantly different. Conclusions Although the pandemic did not significantly affect the metabolic and glycemic controls of the children with type 1 diabetes included in this study, an increase in the frequency of diabetes-related emergency admissions was noted.

The Diabetes Simulation Challenge: Enhancing Patient Perspective-Taking for Medical Students

2022 ◽  
Author(s):  
Emily Shaffer-Hudkins ◽  
Sara Hinojosa Orbeck ◽  
Kathy Bradley-Klug ◽  
Nicole Johnson
Keyword(s):  
Type 1 Diabetes ◽  
Medical Students ◽  
Perspective Taking ◽  
Patient Centered Care ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Patient Centered ◽  
Training Tool ◽  
Centered Care

The Diabetes Simulation Challenge is a unique training tool to foster empathy, a key facet of patient-centered care, for medical students. Thirty-two medical students participated in a 24-hour perspective-taking activity as part of their curriculum, during which they simulated some common experiences of living with a chronic health condition, specifically type 1 diabetes. Students’ written reflections were analyzed using a phenomenological qualitative approach to provide a composite description of the experience. An exhaustive, iterative method of thematic analysis that included manual coding was used to determine whether this activity led to expressions of empathy or thoughts and beliefs consistent with patient-centered health care. Nine unique themes emerged, six of which indicated that students adopted the perspective of an individual with a chronic illness. Most of the students’ reflections illustrated an understanding of the behavioral, social, and emotional challenges related to living with type 1 diabetes, as well as increased empathy toward individuals with the disease. Medical students who aim to provide patient-centered care benefited from this perspective-taking exercise, and training programs should consider using such methods to extend learning beyond traditional didactic education.

scholarly journals Training adolescents with type 1 diabetes to carbohydrate counting without parents' help

2016 ◽  
Vol 29 (1) ◽  
pp. 77-84
Author(s):  
Beatriz Diniz GABRIEL ◽  
Cristiano Tulio ALBUQUERQUE ◽  
Marcella Lobato Dias CONSOLI ◽  
Patrícia Amaral Fulgêncio da Cunha MENEZES ◽  
Janice Sepúlveda REIS
Keyword(s):  
Type 1 Diabetes ◽  
Nutrition Education ◽  
Education Program ◽  
Carbohydrate Counting ◽  
New Therapy ◽  
Healthy Nutrition ◽  
Before And After ◽  
Nutrition Education Program ◽  
Diabetes Center

ABSTRACT Objective: To develop and evaluate the effectiveness of a nutrition education program to enable adolescents with type 1 diabetes to count carbohydrates without the parents' help. Methods: Nineteen adolescents with type 1 diabetes from a diabetes center participated in four fortnightly meetings of one hour, with lectures and discussions about healthy nutrition, importance of nutrients for blood glucose, portion sizes, food replacements, and carbohydrate counting therapy. All meetings ended with exercises to check the learning. Adolescents were followed for one year after the intervention. Results: All participants were 100% successful in all the steps of the program and started carbohydrate counting in the main meals. Nutritional status and total daily insulin doses before and after the study did not differ. After 12 months, 68% of the adolescents counted carbohydrates at all times, 16% did so in extra snacks, and 16% were suspended from the new therapy. Eighty percent of the parents were satisfied with the program, believing teenagers were trained in the new therapy. Conclusion: A short nutrition education program successfully trained adolescents to count carbohydrates without the parents' help.

scholarly journals Glucagon sensitivity and clearance in type 1 diabetes: insights from in vivo and in silico experiments

2015 ◽  
Vol 309 (5) ◽  
pp. E474-E486 ◽  
Author(s):  
Ling Hinshaw ◽  
Ashwini Mallad ◽  
Chiara Dalla Man ◽  
Rita Basu ◽  
Claudio Cobelli ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
In Silico ◽  
Artificial Pancreas ◽  
Glucose Production ◽  
Endogenous Glucose Production ◽  
Action Model ◽  
The Difference ◽  
Hormone Control

Glucagon use in artificial pancreas for type 1 diabetes (T1D) is being explored for prevention and rescue from hypoglycemia. However, the relationship between glucagon stimulation of endogenous glucose production (EGP) viz., hepatic glucagon sensitivity, and prevailing glucose concentrations has not been examined. To test the hypothesis that glucagon sensitivity is increased at hypoglycemia vs. euglycemia, we studied 29 subjects with T1D randomized to a hypoglycemia or euglycemia clamp. Each subject was studied at three glucagon doses at euglycemia or hypoglycemia, with EGP measured by isotope dilution technique. The peak EGP increments and the integrated EGP response increased with increasing glucagon dose during euglycemia and hypoglycemia. However, the difference in dose response based on glycemia was not significant despite higher catecholamine concentrations in the hypoglycemia group. Knowledge of glucagon's effects on EGP was used to develop an in silico glucagon action model. The model-derived output fitted the obtained data at both euglycemia and hypoglycemia for all glucagon doses tested. Glucagon clearance did not differ between glucagon doses studied in both groups. Therefore, the glucagon controller of a dual hormone control system may not need to adjust glucagon sensitivity, and hence glucagon dosing, based on glucose concentrations during euglycemia and hypoglycemia.

Prevalence of retinopathy in patients with type 1 diabetes diagnosed before and after puberty

2014 ◽  
Vol 51 (6) ◽  
pp. 1049-1054 ◽  
Author(s):  
Massimo Porta ◽  
Francesca Schellino ◽  
Marcello Montanaro ◽  
Anatolie Baltatescu ◽  
Lorenzo Borio ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Before And After
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