scholarly journals Experiences From a Coaching Program for Parents of Children and Adolescents With Type 1 Diabetes Developed Through Experienced-Based Co-Design (EBCD)

2020 ◽  
Vol 7 (6) ◽  
pp. 1181-1188
Author(s):  
Kerstin Ramfelt ◽  
Christina Petersson ◽  
Karin Åkesson
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Qualitative Content Analysis ◽  
Pediatric Diabetes ◽  
Increased Risk ◽  
The Family ◽  
Parental Coaching ◽  
Coach Program

Many children and adolescents with type 1 diabetes (T1D) have difficulties reaching the national treatment goal for HbA1c (long-term blood sugar) which is associated with increased risk for complications. This makes it important to explore what patients and their caregivers describe important in coping with everyday life. The study has been conducted within a pediatric diabetes team in the south of Sweden. The aim was to explore how Experienced-Based Co-Design (EBCD) can be used to identify, test, and evaluate improvement efforts in order to support the family with a child with T1D. A modified variant of EBCD based on focus groups, workshops, and interviews with stakeholders was used. The improvement proposal parental coaching was tested and was appreciated by the participants. The qualitative content analysis of the interviews showed that the coaching program contributed to better confidence and self-efficacy. Both coaches and coachees described that the coaching contributed to better competence and a feeling of hope after attending the coach program. Experienced-Based Co-Design gave an opportunity to explore what´s important to improve, based on experiences and needs of several stakeholders.

scholarly journals Retinal vascular fractals predict long-term microvascular complications in type 1 diabetes mellitus: the Danish Cohort of Pediatric Diabetes 1987 (DCPD1987)

Diabetologia ◽  
2014 ◽  
Vol 57 (10) ◽  
pp. 2215-2221 ◽  
Author(s):  
Rebecca Broe ◽  
Malin L. Rasmussen ◽  
Ulrik Frydkjaer-Olsen ◽  
Birthe S. Olsen ◽  
Henrik B. Mortensen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Pediatric Diabetes ◽  
Danish Cohort

Peculiarities of the microsocial environment in the formation of adjustment disorderin children with type 1 diabetes mellitus

2021 ◽  
pp. 27-34
Author(s):  
E. А. Mуkhailova ◽  
D. A. Mitelov
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Emotional Disorders ◽  
Family Relationships ◽  
Psychological Health ◽  
Neuropsychiatric Complications ◽  
The Family

Currently, there is a global trend towards an increase in the incidence of type 1 diabetes mellitus (DM 1) among children and adolescents. It is characterized by a lifelong progressive course, manifested by endocrine and somatic disorders, as well as neurological and mental complications. The risk of the development of emotional disorders, cognitive dysfunction, adjustment disorder is largely determined by the microsocial environment of a child with DM 1. Objective — to study role of family in the formation of the disorders inmental and psychological health of children and adolescents with severe DM 1. Materials and methods. Examinations involved 285 patients with DM 1(126 children and 159 adolescents). The investigation design included clinical and psychopathological method, pathopsychological method, socio­psychological interviewing of a child and his/her family, test “Family sociogram”, projective picture tests “House­tree­man”, “Me and my disease”, “Kinetic picture of the family”. Results. It has been established that the level of psychological health of family of a child with DM 1 corresponded to the normal indicator in 20 % of cases. The factors have been determined that destabilize psychological health of the family, typology of family relationships with a sick child and their role in the formation of persistent neuropsychiatric complications. The factors of the microsocial environment affecting the formation of socio­psychological maladjustment of a child with DM were determined. The following risk factors of the formation of mental and neurological disorders in DM 1 children have been identified: the age of endocrine disease (DM)onset less than 7 years, the disease duration ≥ 5 years, frequent fluctuations in of glycemialevel, unsatisfactory self-control of the disease, late diagnosis of early and late complications related to the central nervous system, insufficient compliance, pathological types of family sociogram. An alternative method for diagnosing psychological problems in children and adolescents with diabetes ­ the use of projective methods has shown a high information content of target detection for the correction of emotional and behavioral disorders in the conditions of system «Life with diabetes».Conclusions. Socio-psychological patterns of maladaptation of children and adolescents with type 1 diabetes mellitushave been identified, which is important for determining the strategy of therapeutic intervention, socio-psychological support and prevention of social handicap.

scholarly journals Socio-cultural aspects of type 1 diabetes in Egypt: Where are we and where do we need to be?

2013 ◽  
Vol 01 (02) ◽  
pp. 063-065
Author(s):  
Hanan Aly
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Financial Burden ◽  
Her Family ◽  
Positive Communication ◽  
Cultural Aspects ◽  
The Family ◽  
Diabetic Individual

AbstractSocio-cultural factors play a pivotal role in the control of type 1 diabetes in children and adolescents, especially in developing countries like Egypt. The financial burden of this chronic illness, together with the modulations needed in lifestyle affect the family and school dynamics, adding further stress on the diabetic individual and his/her family. The key to improved outcome (not only in terms of glycemic control but also quality of life) has two arms. The first one is having a diabetes team with a psychologist skilled in this area for clear and positive communication with both the family and school from the time of diagnosis. The second one is the implementation of government laws to enforce the rights of diabetic children and adolescents.

scholarly journals A Comprehensive System for Identifying Patients With Type 1 Diabetes at Increased Risk for Diabetic Ketoacidosis at Texas Children's Hospital

2021 ◽  
Author(s):  
David D. Schwartz ◽  
Mili Vakharia ◽  
Serife Uysal ◽  
Kristen R. Hendrix ◽  
Kelly Fegan-Bohm ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Care ◽  
Care Center ◽  
The United States ◽  
Pediatric Endocrinology ◽  
Children's Hospital ◽  
Pediatric Diabetes ◽  
Increased Risk ◽  
Children’S Hospital

Texas Children’s Hospital, located in Houston, TX, is the largest pediatric hospital in the United States, with 973 inpatient beds and extensive outpatient clinics and services. It is the primary pediatric teaching hospital of Baylor College of Medicine. The Texas Children’s Endocrine and Diabetes Care Center is one of the largest pediatric endocrinology and diabetes centers in the country, with three inpatient facilities and seven ambulatory clinics. The service is staffed by a multidisciplinary team that includes endocrinologists, endocrine fellows, advanced practice providers, certified diabetes care and education specialists (CDCES), dietitians, social workers, and consulting psychologists. Almost 500 youth with newly diagnosed type 1 diabetes are admitted to the hospital each year, with a total pediatric diabetes population of >3,400 patients.

scholarly journals ACE I/D Polymorphism, Plasma ACE Levels, and Long-term Kidney Outcomes or All-Cause Death in Patients With Type 1 Diabetes

2021 ◽  
Author(s):  
Yawa Abouleka ◽  
Kamel Mohammedi ◽  
Charlyne Carpentier ◽  
Severine Dubois ◽  
Pierre Gourdy ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Primary Outcome ◽  
Rapid Decline ◽  
Genotype Distribution ◽  
Net Reclassification Improvement ◽  
Increased Risk ◽  
Cox Analysis

<b>Objective:</b> The D-allele of <i>ACE</i> I/D polymorphism is a risk factor for diabetic kidney disease. We assessed its contribution to long-term kidney outcomes and all-cause death in patients with long-standing type 1 diabetes. <p><b>Research Design and Methods:</b> 1155 participants from 3 French and Belgian cohorts were followed for a median (interquartile range) duration of 14 (13) years. The primary outcome was the occurrence of end-stage kidney disease (ESKD) or a 40% drop in estimated glomerular filtration rate (eGFR). Secondary outcomes were the individual components of the primary outcome, rapid decline in eGFR (steeper than -3 ml/min/1.73m<sup>2</sup>/year), incident albuminuria, all-cause death, and a composite ESKD or all-cause death. Hazard ratios (HR) for XD versus II genotype and for baseline plasma ACE levels were computed by Cox analysis. Genotype performance in stratifying the primary outcome was tested.</p> <p><b>Results:</b> Genotype distribution was 954 XD and 201 II. The primary outcome occurred in 20% of XD and 13% of II carriers: adjusted HR 2.07 (95%CI, 1.32-3.40), p=0.001. Significant associations were also observed for rapid decline in eGFR, incident albuminuria, ESKD, all-cause death, and ESKD or all-cause death. Baseline plasma ACE levels were higher in XD carriers and significantly associated with increased risk of the primary outcome. ACE genotype enhanced net reclassification improvement (0.154, 95%CI 0.007-0.279, p=0.04) and integrated discrimination improvement (0.012, 95%CI 0.001-0.021, p=0.02) for primary outcome stratification.</p> <b>Conclusions:</b> The D-allele of <i>ACE</i> I/D polymorphism was associated with increased risk of major kidney events and all-cause death in patients with long-standing type 1 diabetes.

Abstract P147: Glycemic Control and Weight in a Pediatric Diabetes Clinic Over Time: Gender Differences in Children With Type 1 Diabetes Between the Ages of 9-17 Years

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Alexandra Bodan
Keyword(s):  
Gender Differences ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Critical Time ◽  
Cvd Risk ◽  
Pediatric Diabetes ◽  
Increased Risk

Research shows women with type 1 diabetes (T1D) face a disproportionately increased risk for development of cardiovascular disease (CVD) compared to men. We posit, adolescence may be a critical time period for CVD risk development. Our study examined the effects on gender differences in Hemoglobin A1c (HbA1c) and Body Mass Index z-score (BMIz) across puberty in children with T1D in a large pediatric diabetes specialty clinic. A total of 733 T1D children (M=355, F=378) aged 9-17 with a total of 21,534 visits from the Barbara Davis Center were suitable for this retrospective cohort study. To exam HbA1c and BMIz overtime by gender we used a linear mixed model with SAS version 9.4. HbA1c increased with age in both genders (p<0.0001), but there was a greater increase in girls across adolescence (sex by age interaction, p<0.0007). BMIz increased with age in girls only (sex by age interaction, p<0.0001). Teenagers had worse glycemic control than younger children, and girls had worse glycemic control with greater obesity rates than boys. This gender difference in glycemic control and obesity during puberty may explain the increased CVD risk seen in women with T1D compared to men.

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