scholarly journals Challenges and Considerations for Reducing Diabetes Distress and Fear of Hypoglycemia in Parents of Youth With Type 1 Diabetes During the COVID-19 Pandemic (Preprint)

2020 ◽  
Author(s):  
Alexandra Monzon ◽  
Nicole Kahhan ◽  
Arwen Marker ◽  
Susana Patton
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Diabetes Distress ◽  
Treatment Needs ◽  
Treatment Groups ◽  
Manualized Treatment ◽  
Fear Of Hypoglycemia ◽  
Psychosocial Concerns ◽  
P Type

UNSTRUCTURED Type 1 diabetes management can be challenging for children and their families. To address psychosocial concerns for parents of youth with type 1 diabetes, we developed two parent-focused interventions to reduce their diabetes distress and fear of hypoglycemia. Our team conducted several of these interventions during the early stages of the COVID-19 pandemic and recognized a need to make timely adjustments to our interventions. In this viewpoint article, we describe our experience conducting these manualized treatment groups during the pandemic, the range of challenges and concerns specific to COVID-19 that parents expressed, and how we adjusted our approach to better address parents’ treatment needs.

scholarly journals Challenges and Considerations for Reducing Diabetes Distress and Fear of Hypoglycemia in Parents of Youth With Type 1 Diabetes During the COVID-19 Pandemic

10.2196/25106 ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. e25106
Author(s):  
Alexandra Monzon ◽  
Nicole Kahhan ◽  
Arwen Marker ◽  
Susana Patton
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Diabetes Distress ◽  
Treatment Needs ◽  
Treatment Groups ◽  
Manualized Treatment ◽  
Early Stages ◽  
Fear Of Hypoglycemia ◽  
Psychosocial Concerns

Type 1 diabetes management can be challenging for children and their families. To address psychosocial concerns for parents of youth with type 1 diabetes, we developed two parent-focused interventions to reduce their diabetes distress and fear of hypoglycemia. Our team conducted several of these interventions during the early stages of the COVID-19 pandemic and recognized a need to make timely adjustments to our interventions. In this viewpoint article, we describe our experience conducting these manualized treatment groups during the pandemic, the range of challenges and concerns specific to COVID-19 that parents expressed, and how we adjusted our approach to better address parents’ treatment needs.

Group engagement in parent-focused telehealth interventions for families of children with type 1 diabetes

2021 ◽  
pp. 1357633X2110670
Author(s):  
Alexandra D Monzon ◽  
Mark A Clements ◽  
Susana R Patton
Keyword(s):  
Type 1 Diabetes ◽  
Treatment Outcomes ◽  
Hemoglobin A1c ◽  
Well Being ◽  
Post Treatment ◽  
Diabetes Distress ◽  
Treatment Groups ◽  
Fear Of Hypoglycemia ◽  
Group Engagement

Introduction Group engagement is an important component of video-based telehealth interventions, yet this construct remains understudied. In the present study, we applied a multidimensional conceptualization of group engagement in two video-based telehealth interventions that either aimed to reduce fear of hypoglycemia or diabetes distress in parents of children with type 1 diabetes. We examined variability in group engagement across parents and assessed the relationship between parents’ level of group engagement and their treatment outcomes. Methods Twenty-nine parents participated in one of two manualized, closed-group, telehealth interventions and completed outcome measures pre- and post-treatment. We behaviorally coded telehealth sessions based on six dimensions of group engagement using the Group Engagement Measure (inter-rater reliability = 0.94). We examined correlations between group engagement dimensions, parent psychosocial well-being, and child hemoglobin A1c. Further, we examined independent sample t-tests to assess differences between treatment groups. Results Mean parent age was 37.69  ±  6.83 years, mean child age was 7.69  ±  3.76 years, and mean child hemoglobin A1c was 8.06  ±  1.27% (41.4% had a hemoglobin A1c <7.5%). Parents who spent more time attending to other group member's issues, reported lower hypoglycemia fear at post-treatment, and parents who showed more active support of the group leader's purpose/goals during the session also reported fewer depressive symptoms at post-treatment. Discussion We identify several dimensions of group engagement that are associate with improved parent psychosocial and child hemoglobin A1c outcomes. Intervention designs that use group engagement to guide treatment planning or inform treatment-related decisions in video-based telehealth interventions could help families achieve more optimal treatment outcomes.

Challenges Imposed By Hypoglycemia in Adults With Type 1 Diabetes

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.

scholarly journals An open trial of app-assisted acceptance and commitment therapy (iACT) for eating disorders in type 1 diabetes

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rhonda M. Merwin ◽  
Ashley A. Moskovich ◽  
Michael Babyak ◽  
Mark Feinglos ◽  
Lisa K. Honeycutt ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Acceptance And Commitment Therapy ◽  
Diabetes Management ◽  
Personal Values ◽  
Psychological Flexibility ◽  
Open Trial ◽  
Diabetes Distress ◽  
Acceptance And Commitment

Abstract Background Eating disorders (EDs) among individuals with type 1 diabetes (T1D) increase the risk of early and severe diabetes-related medical complications and premature death. Conventional eating disorder (ED) treatments have been largely ineffective for T1D patients, indicating the need to tailor treatments to this patient population and the unique conditions under which ED symptoms emerge (in the context of a chronic illness with unrelenting demands to control blood glucose, diet and exercise). The current study was a pilot open trial of iACT, a novel intervention for EDs in T1D grounded in Acceptance and Commitment Therapy (ACT). iACT was based on the premise that ED symptoms emerge as individuals attempt to cope with T1D and related emotional distress. iACT taught acceptance and mindfulness as an alternative to maladaptive avoidance and control, and leveraged personal values to increase willingness to engage in T1D management, even when it was upsetting (e.g., after overeating). A tailored mobile application (“app”) was used in between sessions to facilitate the application of ACT skills in the moment that individuals are making decisions about their diabetes management. Methods Adults with T1D who met criteria for an ED completed 12 sessions of iACT (with three optional tapering sessions). In addition to examining whether treatment was acceptable and feasible (the primary aim of the study), the study also examined whether iACT was associated with increased psychological flexibility (i.e., the ability to have distressing thoughts/feelings about diabetes while pursuing personally meaningful values), and improvements in ED symptoms, diabetes management and diabetes distress. Results Treatment was acceptable to T1D patients with EDs and feasible to implement. Participants reported increased psychological flexibility with diabetes-related thoughts/feelings, and less obstruction and greater progress in pursuing personal values. There were large effects for change in ED symptoms, diabetes self-management and diabetes distress from baseline to end-of-treatment (Cohen’s d = .90–1.79). Hemoglobin A1c also improved, but the p-value did not reach statistical significance, p = .08. Conclusions Findings provide preliminary evidence for iACT to improve outcomes for T1D patients with EDs and support further evaluation of this approach in a controlled trial. Trial registration NCT02980627. Registered 8 July 2016.

scholarly journals Diabetes distress is linked with worsening diabetes management over time in adults with Type 1 diabetes

2017 ◽  
Vol 34 (9) ◽  
pp. 1228-1234 ◽  
Author(s):  
D. M. Hessler ◽  
L. Fisher ◽  
W. H. Polonsky ◽  
U. Masharani ◽  
L. A. Strycker ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Diabetes Distress ◽  
Over Time
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