scholarly journals The Effect of Training Based on James Brown Model on Self-efficacy in Adolescents with Type 1 Diabetes Mellitus

2021 ◽  
Vol 31 (2) ◽  
pp. 76-84
Author(s):  
Zahra Yosefi ◽  
◽  
Mohammad Afshar ◽  
Neda Mirbagher Ajorpaz ◽  
Zohre Sadat ◽  
...  

Introduction: Type 1 Diabetes Mellitus (T1DM) is one of the most frequent chronic diseases among children and adolescents. Educational strategies underscore patient’s roles in the management of diseases and enhance self-efficacy behaviors. Objective: The purpose of this study was to investigate the effects of an educational intervention based on James Brown’s model on self-efficacy in adolescents with T1DM. Materials and Methods: In this randomized clinical trial, 70 participants were selected and assigned to the control and intervention groups by random block. The two groups received routine care for T1DM. The intervention group was also provided with educational sessions, 60 minutes twice a week for 4 weeks, based on the educational model. The participants completed the diabetes management self-efficacy instrument at the beginning, at the end, and a month after the end of the study. Data analysis was performed using the Chi-square, Independent samples t-test, Covariance (ANCOVA), and repeated measures ANOVA. Results: The mean±SD age of the intervention and control groups was 14.81±2.05 and 15.18±2.11 years, respectively. Before the intervention, the two groups were not different statistically in terms of demographic variables (age, sex, duration of diabetes, insulin intake, etc.) and self-efficacy. The results showed that immediately after the intervention and also in the follow-up stage, the mean scores of self-efficacies and its subscales (nutrition, blood glucose monitoring, physical activity, and medical treatment) in the intervention group were significantly higher than the control group (P<0.05). The mean scores of self-efficacies at the beginning, at the end, and a month after the end of the study were 27.97±5.08, 41.46±4.41, and 44.55±4.38, respectively. In the control group, however, these differences were not significant. Conclusion: The education based on James Brown’s model can improve self-efficacy among adolescents with T1DM. It is recommended that nurses use this method to increase self-efficacy in adolescents with T1DM.

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Agnieszka Kowalska ◽  
Katarzyna Piechowiak ◽  
Anna Ramotowska ◽  
Agnieszka Szypowska

Background. The ELKa system is composed of computer software, with a database of nutrients, and a dedicated USB kitchen scale. It was designed to automatize the everyday calculations of food exchanges and prandial insulin doses. Aim. To investigate the influence of the ELKa on metabolic control in children with type 1 diabetes mellitus (T1DM). Methods. A randomized, parallel, open-label clinical trial involved 106 patients aged <18 years with T1DM, HbA1C≤10%, undergoing intensive insulin therapy, allocated to the intervention group, who used the ELKa (n=53), or the control group (n=53), who used conventional calculation methods. Results. After the 26-week follow-up, the intention-to-treat analysis showed no differences to all endpoints. In per protocol analysis, 22/53 (41.5%) patients reporting ELKa usage for >50% of meals achieved lower HbA1C levels (P=0.002), lower basal insulin amounts (P=0.049), and lower intrasubject standard deviation of blood glucose levels (P=0.023) in comparison with the control. Moreover, in the intervention group, significant reduction of HbA1C level, by 0.55% point (P=0.002), was noted. No intergroup differences were found in the hypoglycemic episodes, BMI-SDS, bolus insulin dosage, and total daily insulin dosage. Conclusions. The ELKa system improves metabolic control in children with T1DM under regular usage. The trial is registered at ClinicalTrials.gov, number NCT02194517.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ying Xiao ◽  
Tao Li ◽  
Yan Jia ◽  
Shanshan Wang ◽  
Chenhao Yang ◽  
...  

Purpose. To compare ocular biometry between children with type 1 diabetes mellitus (T1DM) and healthy children in China and to determine the correlation of ocular biometry with the glycosylated hemoglobin (HbA1c) level and diabetes duration. Methods. A case-control study was conducted at Children’s Hospital of Fudan University between T1DM children and healthy children. The participants were evaluated for central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), K1 and K2 keratometry, and axial length (AL); also cycloplegic refraction was performed, and spherical equivalent (SE) was acquired. HbA1c levels of the T1DM cases were obtained. Results. Fifty-four eyes of 54 children with T1DM and 53 eyes of 53 healthy children were included. The mean age of T1DM group and control group was 10.59 ± 3.40 years and 9.55 ± 1.89 years, respectively, and the differences between age and gender were not significant (p=0.052, p=0.700). The mean LT in T1DM group (3.49 ± 0.18 mm) was thicker than that in the control group (3.40 ± 0.16 mm) (p=0.018), the mean ACD in T1DM group (3.52 ± 0.26 mm) was shallower than that in the control group (3.72 ± 0.26 mm) (p<0.001), and there were no significant differences of CCT, K1, K2, AL, and SE (p=0.088, p=0.672, p=0.821, p=0.094, and p=0.306, respectively). There was no significant correlation between HbA1c or diabetes duration and ocular biometry. Conclusions. Thicker LT and shallower ACD occurred in T1DM children rather than age-matched and sex-matched healthy children, but the overall refraction was not affected. HbA1c or diabetes duration was not correlated with ocular biometry in T1DM children.


2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Nasser S. Abou Khalil ◽  
Alaa S. Abou-Elhamd ◽  
Salwa I. A. Wasfy ◽  
Ibtisam M. H. El Mileegy ◽  
Mohamed Y. Hamed ◽  
...  

Medicinal plants are effective in controlling plasma glucose level with minimal side effects and are commonly used in developing countries as an alternative therapy for the treatment of type 1 diabetes mellitus. The aim of this study is to evaluate the potential antidiabetic and antioxidant impacts ofBalanites aegyptiacaandPetroselinum sativumextracts on streptozotocin-induced diabetic and normal rats. The influences of these extracts on body weight, plasma glucose, insulin, total antioxidant capacity (TAC), malondialdehyde (MDA) levels, and liver-pyruvate kinase (L-PK) levels were assessed. Furthermore, the weight and histomorphological changes of the pancreas were studied in the different experimental groups. The herbal preparations significantly reduced the mean plasma glucose and MDA levels and significantly increased the mean plasma insulin, L-PK, and TAC levels in the treated diabetic groups compared to the diabetic control group. An obvious increase in the weight of the pancreas and the size of the islets of Langerhans and improvement in the histoarchitecture were evident in the treated groups compared to untreated ones. In conclusion, the present study provides a scientific evidence for the traditional use of these extracts as antidiabetic and antioxidant agents in 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 ◽  
...  

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.


2018 ◽  
Vol 7 (12) ◽  
pp. 1275-1279 ◽  
Author(s):  
Changwei Liu ◽  
Jingwen Wang ◽  
Yuanyuan Wan ◽  
Xiaona Xia ◽  
Jian Pan ◽  
...  

Background To investigate the relationship 25-hydroxy vitamin D (25OHD) level among children and in children with type 1 diabetes mellitus (T1DM). Methods A case–control study was conducted to compare the serum 25OHD levels between cases and controls. This study recruited 296 T1DM children (106 newly diagnosed T1DM patients and 190 established T1DM patients), and 295 age- and gender-matched healthy subjects as controls. Results The mean serum 25OHD in T1DM children was 48.69 ± 15.26 nmol/L and in the controls was 57.93 ± 19.03 nmol/L. The mean serum 25OHD in T1DM children was lower than that of controls (P < 0.01). The mean serum 25OHD level (50.42 ± 14.74 nmol/L) in the newly diagnosed T1DM children was higher than that (47.70 ± 15.50 nmol/L) in the established T1DM children but the difference was not statistically significant (P = 0.16). HbA1c values were associated with 25OHD levels in established T1DM children (r = 0.264, P < 0.01), and there was no association between 25OHD and HbA1c in newly diagnosed T1DM children (r = 0.164; P > 0.05). Conclusion Vitamin D deficiency is common in T1DM children, and it should be worthy of attention on the lack of vitamin D in established T1DM children.


2021 ◽  
pp. 1-5
Author(s):  
Mehmet Türe ◽  
Alper Akın ◽  
Edip Unal ◽  
Ahmet Kan ◽  
Suat Savaş

Abstract Background: Adult patients diagnosed with type 1 diabetes mellitus are at risk for ventricular arrhythmias and sudden cardiac death. Aim: The objective of our study is to evaluate the electrocardiographic data of children diagnosed with type 1 diabetes mellitus and to determine the possibility of arrhythmia in order to prevent sudden death. Methods: Electrocardiographic data of 60 patients diagnosed with type 1 diabetes mellitus and 86 controls, who were compatible with the patient group in terms of age and gender, were compared. Results: The duration of diabetes in our patients with type 1 diabetes mellitus was 5.23 ± 1.76 years, and the haemoglobin A1c levels were 9.63% ± 1.75%. The heart rate, QRS, QT maximum, QT dispersion, QTc minimum, QTc maximum, QTc dispersion, Tp-e maximum, Tp-e maximum/QTc maximum and the JTc were significantly higher compared to the control group. There was no significant correlation between the duration of type 1 diabetes mellitus and HbA1c levels and the electrocardiographic data. Conclusion: We attributed the lack of a significant correlation between the duration of type 1 diabetes mellitus and the haemoglobin A1c levels and the electrocardiographic data to the fact that the duration of diabetes was short, since our patients were children. We believe that patients with type 1 diabetes mellitus should be followed up closely in terms of sudden death, as they have electrocardiographic changes that may cause arrhythmias compared to the control group. However, more studies with longer follow-up periods are necessary to support our data.


2019 ◽  
pp. 089719001985092 ◽  
Author(s):  
Kyle A. Farina ◽  
Michael P. Kane

Two Food and Drug Administration-approved programmed cell death-1 (PD-1) inhibitors, nivolumab (Opdivo®), and pembrolizumab (Keytruda®), are indicated for treatment-resistant malignancies. Inhibition of PD-1 also inhibits T-cell peripheral tolerance, enhancing autoimmunity. Various autoimmune conditions have been reported with the use of these agents, including type 1 diabetes mellitus (T1DM). This article reviews literature regarding the development of T1DM in patients treated with PD-1 inhibitors and identifies strategies for the appropriate identification, monitoring, and follow-up of these patients. Published cases of T1DM related to PD-1 inhibitor therapy were identified using PubMed. Eighty-three identified publications were reviewed, of which 37 publications involving 42 cases of anti-PD-1 therapy-induced T1DM were identified. The average age of patients at presentation was 62 years and 59.5% were male. The mean number of PD-1 inhibitor doses received was 5, with a mean time to presentation of 11 weeks. Initial presentation of diabetic ketoacidosis was reported in 69% of cases, with an average blood glucose of 660 mg/dL and an average HbA1cof 8.7%. The exact mechanism PD-1 inhibitor therapy-induced T1DM is unknown. Blood glucose monitoring is recommended for all patients receiving anti-PD-1 therapy. Further research is needed to delineate the frequency of this adverse effect, as well as to evaluate potential risk factors and ideal management strategies.


Author(s):  
Shih-Yi Lin ◽  
Cheng-Li Lin ◽  
Cheng-Chieh Lin ◽  
Wu-Huei Hsu ◽  
Chung-Y. Hsu ◽  
...  

Type 1 diabetes mellitus (T1DM) has been linked to many autoimmune problems. The association between T1DM and urticaria warrants investigation. Data were extracted from the National Health Insurance Research Database (NHIRD) of Taiwan. Participants with T1DM were recruited as the case group, and that group was matched by sex and age at a ratio of 1:4 to the control group comprising those without T1DM. The study period was 1998–2011. All participants were followed up to the diagnosis of urticaria, withdrawal from the insurance program, death, or the end of the study. A multivariable Cox proportional hazard model was used to calculate the adjusted and crude hazard ratios for urticaria. A total of 5895 participants (1179 in the case group and 4716 in the control group) were followed up in the study. The total incidence rate of urticaria in patients with type 1 DM was 26.6 per 1000 person-years, and that in controls was 6.85 per 1000 person-years. Compared with the control group, the hazard ratio of urticaria in the case group was 2.84 (95% CI = 2.27–3.56). Compared with age-matched participants without T1DM, patients with type 1 DM aged <18 years had a 3.62-fold higher risk of urticaria (95% CI = 2.85–4.59). The hazard ratio in patients with an adjusted Diabetes Complications Severity Index (aDCSI) score of 1.01–2.00 per year was 2.57 (95% CI = 1.18–5.57), and that in patients with an aDCSI score of >2.00 per year was 4.47 (95% CI = 2.68–7.47). T1DM patients aged <18 years had an increased risk of urticaria, but a similar phenomenon was not observed among T1DM patients older than 18 years.


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