Fear of hypoglycemia, anxiety, and subjective well-being in parents of children and adolescents with type 1 diabetes

This study explored the association between parental fear of hypoglycemia, anxiety, and subjective well-being in parents of children and adolescents with type 1 diabetes. A total of 120 mothers and 79 fathers participated. Mothers’ and fathers’ fear of hypoglycemia was significantly associated with anxiety and negative affect as well as with worse glycemic control in child. Paired-samples t-test showed that mothers were more involved in diabetes management and reported more fear and anxiety compared to fathers, but they did not differ in worries about hypoglycemia. The findings suggest screening for fear of hypoglycemia and subjective well-being in all parents regardless of whether their child experienced severe hypoglycemia.

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The associations between mental health, health-related quality of life and insulin pump therapy among children and adolescents with type 1 diabetes

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0130 ◽

2018 ◽

Vol 31 (10) ◽

pp. 1065-1072 ◽

Cited By ~ 2

Author(s):

Brigitta Munkácsi ◽

Gábor Papp ◽

Enikő Felszeghy ◽

Karolina Eszter Kovács ◽

Beáta Erika Nagy

Keyword(s):

Mental Health ◽

Type 1 Diabetes ◽

Children And Adolescents ◽

Mental Health Problems ◽

Well Being ◽

Health Problems ◽

Insulin Pump Therapy ◽

Control Group ◽

Subjective Well Being

Abstract Background Diabetes has previously been linked to mental health problems in children and adolescents, but more recent studies have yielded mixed findings. The aim of the current study was to compare symptoms of mental health problems in children and adolescents with and without type 1 diabetes (T1DM). Methods Life quality, subjective well-being, self-rated health, depression and somatic symptoms in children and adolescents with diabetes (n=130) were measured and compared to the results of a socio-demographically joined control group (n=177) which consists of healthy children and adolescents. Results A significant difference could be observed between the groups in well-being and depressive symptoms as according to the results, the research sample namely the children with T1DM could be described with significantly higher subjective well-being and mood, but with less physical symptoms and lower level of depression as those in the control group. Conclusions These findings suggest that T1DM is not associated with an increased risk of psychosocial problems, and confirm that even a severe disease of a child can lead to personal growth.

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Problems in diabetes managment in school setting in children and adolescents with type 1 diabetes in Serbia

Vojnosanitetski pregled ◽

10.2298/vsp150203007j ◽

2016 ◽

Vol 73 (3) ◽

pp. 273-276

Author(s):

Maja Jesic ◽

Tatjana Milenkovic ◽

Katarina Mitrovic ◽

Sladjana Todorovic ◽

Vera Zdravkovic ◽

...

Keyword(s):

Type 1 Diabetes ◽

Children And Adolescents ◽

Diabetes Management ◽

School Setting ◽

Severe Hypoglycemia ◽

Public Hospitals ◽

General Situation ◽

Age Group ◽

Self Reporting Questionnaire

Background/Aim. Children with type 1 diabetes typically spend one-third of the day in school and they should achieve the same level of diabetes management there as they do outside the school environment. The aim of this study was to identify problems in diabetes management in children with type 1 diabetes at school according to the perceptions reported by children and parents. Methods. This crosssectional survey was carried out at nine public hospitals in Serbia with a cohort of 6-18-year old children/adolescents. The parents were personally informed about the objectives of the survey and the necessity to involve their children. The self-reporting questionnaire included demographic information as well as some questions that helped to evaluate the general situation of children with type 1 diabetes at school. Results. The obtained results show that not all children test blood glucose levels at school (50% of children in the 6-10- year-old age group and 67.3% in the age group over 11 years) and that not all children receive insulin at school (81.1% vs 18.9%, and 57.7% vs 42.3%, respectively). The frequency of severe hypoglycemia was 2.7% in children and 3.3% in adolescents. A high proportion of teachers did not have diabetes training. Conclusion. This brief report about problems in children and adolescents with type 1 diabetes at school in Serbia indicates what happens in the school setting and suggests how to improve control of this disease and facilitate the complete integration of children with diabetes at school.

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Anxiety, depression, and glycemic control during Covid-19 pandemic in youths with type 1 diabetes

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0153 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Maria Cusinato ◽

Mariangela Martino ◽

Alex Sartori ◽

Claudia Gabrielli ◽

Laura Tassara ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Psychological Impact ◽

Glucose Monitoring ◽

Severe Hypoglycemia ◽

Well Being ◽

Glucose Variability ◽

Threshold Score ◽

The Impact

Abstract Objectives Our study aims to assess the impact of lockdown during the coronavirus disease 2019 pandemic on glycemic control and psychological well-being in youths with type 1 diabetes. Methods We compared glycemic metrics during lockdown with the same period of 2019. The psychological impact was evaluated with the Test of Anxiety and Depression. Results We analyzed metrics of 117 adolescents (87% on Multiple Daily Injections and 100% were flash glucose monitoring/continuous glucose monitoring users). During the lockdown, we observed an increase of the percentage of time in range (TIR) (p<0.001), with a significant reduction of time in moderate (p=0.002), and severe hypoglycemia (p=0.001), as well as the percentage of time in hyperglycemia (p<0.001). Glucose variability did not differ (p=0.863). The glucose management indicator was lower (p=0.001). 7% of youths reached the threshold-score (≥115) for anxiety and 16% for depression. A higher score was associated with lower TIR [p=0.028, p=0.012]. Conclusions Glycemic control improved during the first lockdown period with respect to the previous year. Symptoms of depression and anxiety were associated with worse glycemic control; future researches are necessary to establish if this improvement is transient and if psychological difficulties will increase during the prolonged pandemic situation.

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Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0009 ◽

2019 ◽

Vol 32 (8) ◽

pp. 843-849 ◽

Cited By ~ 1

Author(s):

Kholoud Mohamed ◽

Dalia Al-Abdulrazzaq ◽

Amel Fayed ◽

Eman El Busairi ◽

Faisal Al Shawaf ◽

...

Keyword(s):

Type 1 Diabetes ◽

Children And Adolescents ◽

Diabetes Management ◽

Insulin Pump ◽

Control Level ◽

Insulin Pump Therapy ◽

Insulin Regimen ◽

Pump Therapy ◽

Significant Difference

Abstract Background To evaluate the safety of fasting during the holy month of Ramadan among children and adolescent with type 1 diabetes (T1D). Methods A retrospective cohort study of 50 children and adolescents with T1D whose mean age was 12.7 ± 2.1 years was conducted. Twenty-seven patients (54%) were on multiple daily injections (MDI) insulin regimen and 23 (46%) were on insulin pump therapy. Before fasting for Ramadan, children and their families were evaluated and educated about diabetes management during Ramadan. Hemoglobin A1c (HbA1c), weight, number of days fasted, hypoglycemia and hyperglycemia episodes, and emergency hospital visits were collected and analyzed after completing the month. Participants were compared according to the insulin treatment regimen and their glycemic control level before Ramadan. Results The children were able to fast 20 ± 9.9 days of Ramadan, and the most common cause for breaking the fast was mild hypoglycemia (7.8% among all cases). There was no significant difference between the two insulin regimen groups in breaking fast days, frequency of hypo- or hyperglycemia, weight and HbA1c changes post Ramadan. Patients with HbA1c ≤ 8.5% were able to fast more days during Ramadan with significantly less-frequent hypoglycemic attacks as compared to patients with HbA1c > 8.5 (1.2 ± 1.5 vs. 3.3 ± 2.9 days of hypoglycemia, p = 0.01, respectively). Conclusions Fasting for children with T1D above the age of 10 years is feasible and safe in both pump and non-pump users, and well-controlled patients are less likely to develop complications. Education of the families and their children before Ramadan, along with intensive monitoring of fasting children during the month are crucial.

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Challenges Imposed By Hypoglycemia in Adults With Type 1 Diabetes

Clinical Nursing Research ◽

10.1177/1054773818774702 ◽

2018 ◽

Vol 28 (8) ◽

pp. 947-967

Author(s):

Pamela Martyn-Nemeth ◽

Jennifer Duffecy ◽

Cynthia Fritschi ◽

Laurie Quinn

Keyword(s):

Type 1 Diabetes ◽

Life Stress ◽

Diabetes Management ◽

Management Strategies ◽

Safety Net ◽

Loss Of Control ◽

Work Demands ◽

Fear Of Hypoglycemia ◽

High Degree

Little is known regarding how hypoglycemia and associated fears influence day-to-day life among adults with type 1 diabetes (T1DM) who use contemporary diabetes management strategies. To address this gap, we performed an exploratory qualitative study with five focus groups of 30 people aged 20 to 57 years with T1DM. Sessions were audiotaped and transcribed, and then analyzed. Eight themes emerged: (a) hypoglycemic worry, (b) unpredictability and loss of control, (c) contending with life stress, (d) exercise benefits and challenges, (e) a changed relationship with food, (f) sleep fears, (g) a love/hate relationship with technology, and (h) coping strategies to make it better. Fear of hypoglycemia, diabetes management, and work demands confer a high degree of stress. Challenges surround food, exercise, and sleep. Technology is important but does not relieve fear of hypoglycemia. Developing strong coping skills and creating a safety net of support are necessary.

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