scholarly journals Relationship Between Diabetes, Stress, and Self-Management to Inform Chronic Disease Product Development: Retrospective Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Jessica S Yu ◽  
Tong Xu ◽  
Roberta A James ◽  
Wei Lu ◽  
Julia E Hoffman
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Product Development ◽  
Behavioral Health ◽  
Diabetes Management ◽  
Self Management ◽  
Diabetes Distress ◽  
Data Set ◽  
Diabetes Empowerment ◽  
Health Diagnosis

BACKGROUND Technology is rapidly advancing our understanding of how people with diabetes mellitus experience stress. OBJECTIVE The aim of this study was to explore the relationship between stress and sequelae of diabetes mellitus within a unique data set composed of adults enrolled in a digital diabetes management program, Livongo, in order to inform intervention and product development. METHODS Participants included 3263 adults under age 65 who were diagnosed with diabetes mellitus and had access to Livongo through their employer between June 2015 and August 2018. Data were collected at time of enrollment and 12 months thereafter, which included demographic information, glycemic control, presence of stress, diabetes distress, diabetes empowerment, behavioral health diagnosis, and utilization of behavioral health-related medication and services. Analysis of variance and chi-square tests compared variables across groups that were based on presence of stress and behavioral health diagnosis or utilization. RESULTS Fifty-five percent of participants (1808/3263) reported stress at the time of at least 1 blood glucose reading. Fifty-two percent of participants (940/1808) also received at least 1 behavioral health diagnosis or intervention. Compared to their peers, participants with stress reported greater diabetes distress, lower diabetes empowerment, greater insulin use, and poorer glycemic control. Participants with stress and a behavioral health diagnosis/utilization additionally had higher body mass index and duration of illness. CONCLUSIONS Stress among people with diabetes mellitus is associated with reduced emotional and physical health. Digital products that focus on the whole person by offering both diabetes mellitus self-management tools and behavioral health skills and support can help improve disease-specific and psychosocial outcomes.

scholarly journals Relationship Between Diabetes, Stress, and Self-Management to Inform Chronic Disease Product Development: Retrospective Cross-Sectional Study

JMIR Diabetes ◽  
10.2196/20888 ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. e20888
Author(s):  
Jessica S Yu ◽  
Tong Xu ◽  
Roberta A James ◽  
Wei Lu ◽  
Julia E Hoffman
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Product Development ◽  
Behavioral Health ◽  
Diabetes Management ◽  
Self Management ◽  
Diabetes Distress ◽  
Data Set ◽  
Diabetes Empowerment ◽  
Health Diagnosis

Background Technology is rapidly advancing our understanding of how people with diabetes mellitus experience stress. Objective The aim of this study was to explore the relationship between stress and sequelae of diabetes mellitus within a unique data set composed of adults enrolled in a digital diabetes management program, Livongo, in order to inform intervention and product development. Methods Participants included 3263 adults under age 65 who were diagnosed with diabetes mellitus and had access to Livongo through their employer between June 2015 and August 2018. Data were collected at time of enrollment and 12 months thereafter, which included demographic information, glycemic control, presence of stress, diabetes distress, diabetes empowerment, behavioral health diagnosis, and utilization of behavioral health-related medication and services. Analysis of variance and chi-square tests compared variables across groups that were based on presence of stress and behavioral health diagnosis or utilization. Results Fifty-five percent of participants (1808/3263) reported stress at the time of at least 1 blood glucose reading. Fifty-two percent of participants (940/1808) also received at least 1 behavioral health diagnosis or intervention. Compared to their peers, participants with stress reported greater diabetes distress, lower diabetes empowerment, greater insulin use, and poorer glycemic control. Participants with stress and a behavioral health diagnosis/utilization additionally had higher body mass index and duration of illness. Conclusions Stress among people with diabetes mellitus is associated with reduced emotional and physical health. Digital products that focus on the whole person by offering both diabetes mellitus self-management tools and behavioral health skills and support can help improve disease-specific and psychosocial outcomes.

Associations of depression and diabetes distress with self-management behavior and glycemic control.

2020 ◽  
Author(s):  
Andreas Schmitt ◽  
Eileen Bendig ◽  
Harald Baumeister ◽  
Norbert Hermanns ◽  
Bernhard Kulzer
Keyword(s):  
Glycemic Control ◽  
Self Management ◽  
Diabetes Distress ◽  
Management Behavior

scholarly journals A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

2019 ◽  
Vol 9 (9) ◽  
pp. 98 ◽  
Author(s):  
Kisokanth G. ◽  
Indrakumar J. ◽  
Prathapan S. ◽  
Joseph J. ◽  
Ilankoon I.M.P.S.
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Management Education ◽  
Self Management ◽  
Rank Test ◽  
Diabetic Patients ◽  
Effective Measure ◽  
Before And After ◽  
Patients With Diabetes ◽  
Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

scholarly journals Feasibility study of real-time online text-based CBT to support self-management for people with type 1 diabetes: the Diabetes On-line Therapy (DOT) Study

2021 ◽  
Vol 9 (1) ◽  
pp. e001934
Author(s):  
Anne M Doherty ◽  
Anne Herrmann-Werner ◽  
Arann Rowe ◽  
Jennie Brown ◽  
Scott Weich ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Real Time ◽  
Instant Messaging ◽  
Controlled Trial ◽  
Self Management ◽  
Diabetes Distress ◽  
The Mean ◽  
Distress Scale

IntroductionThis study examines the feasibility of conducting diabetes-focused cognitive–behavioral therapy (CBT) via a secure online real-time instant messaging system intervention to support self-management and improve glycemic control in people with type 1 diabetes.Research design and methodsWe used a pre–post uncontrolled intervention design over 12 months. We recruited adults with type 1 diabetes and suboptimal glycemic control (HbA1c ≥69 mmol/mol (DCCT 8.5%) for 12 months) across four hospitals in London. The intervention comprised 10 sessions of diabetes-focused CBT delivered by diabetes specialist nurses. The primary outcomes were number of eligible patients, rates of recruitment and follow-up, number of sessions completed and SD of the main outcome measure, change in HbA1c over 12 months. We measured the feasibility of collecting secondary outcomes, that is, depression measured using Patient Health Questionnaire-9 (PHQ-9), anxiety measured Generalised Anxiety Disorder (GAD) and the Diabetes Distress Scale (DDS).ResultsWe screened 3177 patients, of whom 638 were potentially eligible, from whom 71 (11.1%) were recruited. The mean age was 28.1 (13.1) years, and the mean HbA1c was 84.6 mmol/mol (17.8), DCCT 9.9%. Forty-six (65%) patients had at least 1 session and 29 (41%) completed all sessions. There was a significant reduction in HbA1c over 12 months (mean difference −6.2 (2.3) mmol/mol, DCCT 0.6%, p=0.038). The change scores in PHQ-9, GAD and DDS also improved.ConclusionsIt would be feasible to conduct a full-scale text-based synchronized real-time diabetes-focused CBT as an efficacy randomized controlled trial.

scholarly journals Efektivitas Mobile Health Intervention Terhadap Manajemen Diri Dan Kontrol Glikemik Pada Pasien Dengan Diabtes Melitus Tipe 2: A Systematic Review

2020 ◽  
Vol 11 (4) ◽  
pp. 342
Author(s):  
Wahyu Sukma Samudera ◽  
Novita Fajriyah ◽  
Ida Trisnawati
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Mobile Health ◽  
Controlled Trial ◽  
Health Intervention ◽  
Self Management ◽  
Diabetes Melitus

Background: Type 2 diabetes mellitus was one of non-communicable diseases that increased of prevalence in word wide, included in Indonesia. Utilization of technology as an effort of increase of diabetes treatment is important for achieving of optimum glycemic control and to prevent of complication of diabetes mellitus. However, intervention for self management in patients with diabetes mellitus at this time still not using technology based mobile health intervention. Purpose: This study aims to verify of effectiveness of mobile health intervention on self management and glycemic control in patient with type 2 diabetes mellitus. Method: Design of this studies was used systematic review of randomized controlled trial with PRISMA approach. Article search was carried out through databases: Scopus, Science Direct, and ProQuest with randomized controlled trial design within last 10 years. Results: The finding showed 407 articles have been obtained. Articles selection process were through few steps: topic selection, full text selection, design of studies and obtained 10 articles have been as appropriate of inclusion criteria. Based on results of finding of 10 articles were showed that mobile health intervention was effective in improving of glycemic control by decreasing hbA1c, fasting blood glucose, 2 hours post pandrial. Furthermore, mobile health intervention was effective in increasing of self management in patient with type 2 diabetes mellitus and increased adherence of diabetes medication. Moreover, mobile health intervention can also improve of insulin level and lipid profile in patient with type 2 diabetes mellitus. Conclusion: Mobile health intervention was effective in improving of glycemic control and self management, and giving of facilitate communication between patient and health providers Keywords: mobile health application; self management; glycemic control; diabetes mellitus ABSTRAK Latar belakang: diabetes melitus (DM) tipe 2 merupakan salah satu penyakit tidak menular yang mengalami peningkatan angka kejadian di dunia, termasuk di Indonesia. Penggunaan teknologi sebagai upaya meningkatkan manajemen diabetes melitus sangatlah penting untuk dilakukan guna mencapai kontrol glikemik optimal dan mencegah komplikasi dari Diabetes Melitus. Namun, manajemen diri pada sebagian besar pasien Diabetes Melitus saat ini masih belum menggunakan bantuan teknologi berbasis mobile health. Tujuan: Penelitian ini bertujuan untuk memverifikasi efektivitas dari penggunaan mobile health intervention terhadap manajemen diri dan kontrol glikemik pasien dengan diabetes melitus tipe 2. Metode: desain dalam penelitian ini adalah systematic review dengan menggunakan pendekatan PRISMA. Pencarian artikel dilakukan pada beberapa database yang meliputi: Scopus, Science Direct dan ProQuest dengan desain Randomized controlled trial dalam 10 tahun terakhir. Hasil: hasil temuan didapatkan sejumlah 407 artikel penelitian. Proses seleksi artikel dilakukan beberapa tahap meliputi: seleksi topik, fullteks, desain artikel penelitian dan didapatkan 10 artikel penelitian yang sesuai dengan kriteria inklusi. Berdasarkan hasil temuan dari 10 artikel penelitian yang digunakan, menunjukkan bahwa mobile health intervention efektif dalam memperbaiki kontrol glikemik pasien diabetes melalui penurunan kadar hbA1c, gula darah puasa, 2 jam post pandrial. Selanjutnya, mobile health intervention efektif dalam meningkatkan manajemen diri pasien diabetes dan meningkatkan kepatuhan pengobatan. Selain itu, mobile health intervention juga dapat memperbaiki level insulin dan profil lipid pasien diabetes melitus tipe 2. Kesimpulan: Mobile health intervention efektif dalam memperbaiki kontrol glikemik dan meningkatkan manajemen diri pasien diabetes melitus serta memudahkan komunikasi antara pasien dengan tenaga kesehatan Kata kunci: mobile health application; manajemen diri; kontrol glikemik; diabetes melitus

scholarly journals Suboptimal glycemic control among subjects with diabetes mellitus in India: a subset analysis of cross-sectional wave-7 (2016) data from the International Diabetes Management Practices Study (IDMPS)

2020 ◽  
Vol 11 ◽  
pp. 204201882093721
Author(s):  
Ambady Ramachandran ◽  
Sunil M. Jain ◽  
Sagarika Mukherjee ◽  
Sanjeev Phatak ◽  
Shailesh Pitale ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Management Practices ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Glycated Haemoglobin ◽  
Oral Glucose ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Glycemic Targets

Objective: To assess the real-world management practices of subjects with type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM) in India. Methods: This cross-sectional study was conducted between 7 March 2016 and 15 May 2016 in India as part of the seventh wave (2016) of the International Diabetes Management Practices Study (IDMPS). Adult subjects with T1DM or T2DM visiting physicians during a 2-week recruitment period were included. Results: A total of 55 physicians included 539 subjects who met eligibility criteria. Of 495 subjects with T2DM, 303 were treated with oral glucose lowering drugs (OGLDs) only, 158 were treated with OGLD + insulin, and 27 received insulin only. Among 44 subjects with T1DM receiving insulin, 13 (29.5%) were also treated with OGLD therapy. The most commonly used insulin regimens were basal alone (69/184; 37.5%) and premixed alone (63/184; 34.2%) in subjects with T2DM, and basal + prandial insulin (24/44; 54.5%) in subjects with T1DM. Proportions of subjects achieving glycemic targets were low [glycated haemoglobin (HbA1c) <7%: T1DM = 7.3% (3/44), T2DM = 25.2% (106/495); as targeted by the treating physician: T1DM = 31.8% (14/44), T2DM = 32.1% (59/185); global target: T1DM = 4.8% (2/42) and T2DM = 1.7% (8/482)]. In subjects with T2DM, HbA1c <7% was noted in 11/22 subjects receiving insulin only and 76/260 receiving only OGLDs. Lack of experience in self-managing insulin dosing, poor diabetes education and failure to titrate insulin dosages were the main reasons for non-achievement of glycemic targets. Conclusion: Timely insulinization, education and empowerment of people with diabetes may help improve glycemic control in India.

scholarly journals Pengaruh Diabetes Self Management Education and Support (DSME/S) terhadap Diabetes Distress pada Pasien Diabetes Melitus Tipe 2 di RSD dr. Soebandi Jember (The Effect of Diabetes Self Management Education and Support [DSME/S] on Diabetes Distress in Patie

2018 ◽  
Vol 6 (1) ◽  
pp. 133
Author(s):  
Novita Nurkamilah ◽  
Rondhianto Rondhianto ◽  
Nur Widayati
Keyword(s):  
Diabetes Mellitus ◽  
Management Education ◽  
Intervention Group ◽  
Self Care ◽  
T Test ◽  
Self Management ◽  
Diabetes Distress ◽  
Control Group ◽  
Significant Difference

Diabetes Mellitus (DM) is a chronic disease that requires a continous self-care. A low level ofknowledge about self-care can worsen health condition and cause diabetes distress. The continuingstress can cause hyperglycemia that lead to complications of DM. DSME/S is a structured healtheducation that facilitates DM patients in implementing and maintaining their behavior for sustainableself-care. This research aimed to analyze the effect of DSME/S on diabetes distress in patients withtype 2 DM. This research was quasi experimental with non randomized control group pretestposttest design. Thirty respondents in this study were divided into 15 respondents as theintervention group and 15 respondents as the control group by consequtive sampling technique.DSME/S was conducted in 6 sessions: 4 sessions in the hospital and 2 sessions at respondent'shouse. The data were analyzed by using dependent t test and independent t test with significancelevel of 0.05. The result of dependent t test revealed a significant difference of diabetes distressbetween pretest and posttest both in the intervention group (p=0.001) and in the control group(p=0.046). Furthermore, independent t test showed a significant difference between interventiongroup and control group (p=0.001). The decrease of diabetes distress was higher in the interventiongroup than control group. This result indicates that there was a significant effect of DSME/S ondiabetes distress in patients with type 2 DM. Nurses are expected to apply DSME/S as a dischargeplanning to reduce diabetes distress in patients with type 2 DM.Keywords: diabetes distress, DSME/S, Diabetes Mellitus

scholarly journals Diabetes Distress, Depressive Symptoms and Type 2 Diabetes Management and Glycemic Control: the Mediating Role of Self-efficacy

2020 ◽  
Author(s):  
Yuexia Gao ◽  
Yarong Han ◽  
Xin Zou ◽  
Judy Xu ◽  
Dean Getrude Mawen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Diabetes Distress ◽  
Hierarchical Regression ◽  
Psychological Variables ◽  
Diabetes Outcomes

Abstract Background: Diabetes distress has been distinguished from depressive symptoms in the linkages to type 2 diabetes management and glycemic control. There are few evidences in rural China untangled the underlying pathways among them. The aim of our study was to examine whether self-efficacy reduced the detrimental effects of psychological variables on diabetes outcomes such as self-care behaviors, glycemic control and health-related quality of life (HRQoL).Methods: 1574 adults diagnosed with type 2 diabetes from 31 rural clinics in China were assessed for psychological variables, self-management and HRQoL. Hemoglobin A1c (HbA1c) data at 6 months after the survey were extracted from electronic medical records. Hierarchical regression model examined independent effects of psychological variables, self-efficacy on diabetes outcomes. KHB method and bootstrapping confidence intervals were employed to test the mediating effect of self-efficacy.Results: Hierarchical regression analysis showed both diabetes distress and depressive symptoms were significantly related to diet and HRQoL, but not related to glycemic control and medication adherence. Depressive symptoms, but not diabetes distress, was directly associated with physical activity. Mediation analysis demonstrated self-efficacy mediated the relationships of both diabetes distress and depressive symptoms on self-care behaviors, glycemic control and HRQoL.Conclusions: Self-efficacy may contribute to better diabetes outcome by ameliorating the effects of diabetes distress and depressive symptoms. Patients with psychological conditions may need tailored intervention that enhance self-efficacy to improve diabetes management.

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