Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes: results from the International Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Study

2014 ◽  
Vol 32 (1) ◽  
pp. 133-140 ◽  
Author(s):  
J. L. Browne ◽  
G. Nefs ◽  
F. Pouwer ◽  
J. Speight
Keyword(s):  
Type 2 Diabetes ◽  
Young Adults ◽  
Diabetes Management ◽  
Self Care

scholarly journals Effects of a tailored text messaging intervention among diverse adults with type 2 diabetes: Evidence from the 15-month REACH RCT

2020 ◽  
Author(s):  
Lyndsay A. Nelson ◽  
Robert A. Greevy ◽  
Andrew Spieker ◽  
Kenneth A. Wallston ◽  
Tom A. Elasy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Self Efficacy ◽  
Text Messaging ◽  
Self Care ◽  
Baseline Hba1c ◽  
Median Response ◽  
Text Messaging Intervention

<b>Objective:</b> Text messaging interventions have high potential for scalability and to reduce health disparities; however, more rigorous, long-term trials are needed. We examined the long-term efficacy and mechanisms of a tailored text messaging intervention. <p><b>Research Design and Methods:</b> Adults with type 2 diabetes participated in a parallel-groups, 15-month randomized trial, assigned to receive REACH (Rapid Education/Encouragement and Communications for Health) for 12 months or control. REACH included interactive texts and tailored texts addressing medication adherence, and non-tailored texts supporting other self-care behaviors. Outcomes included HbA1c, diabetes medication adherence, self-care, and self-efficacy. </p> <p><b>Results:</b> Participants (N=506) were approximately half racial/ethnic minority and half were underinsured, had annual household incomes <$35,000 USD and ≤ high school education; 11% were homeless. <a>Average baseline HbA1c was 8.6%±1.8%; 70.0±19.7 mmol/mol) with n<i>=</i>219 having HbA1c≥8.5% (69 mmol/mol)</a> and half were prescribed insulin. Retention was over 90%. Median response rate to interactive texts was 91% (interquartile range 75%, 97%). The treatment effect on HbA1c at 6 months (-0.31%; 95% CI [-0.61%, -0.02%]) was greater among those with baseline HbA1c≥8.5% (-0.74%; 95% CI [-1.26%, -0.23%]), and there was not evidence of effect modification by race/ethnicity or socioeconomic disadvantage. REACH improved medication adherence and diet through 12 months, and self-efficacy through 6 months. Treatment effects were not significant for any outcome at 15 months. REACH reduced barriers to adherence, but barrier reduction did not mediate outcome improvements. </p> <p><b>Conclusions:</b> REACH engaged at-risk patients in diabetes self-management and improved short-term HbA1c. More than texts alone may be needed to sustain effects. </p>

scholarly journals Self-care adherence and affective disorders in Barbadian adults with type 2 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. 62-72
Author(s):  
Allison DaSantos ◽  
◽  
Carlisle Goddard ◽  
Dalip Ragoobirsingh ◽  
◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Behavioral Problem ◽  
Self Care ◽  
Self Report ◽  
Diabetes Distress ◽  
Glucose Testing ◽  
Blood Glucose Testing ◽  
Distress Scale

<abstract><sec> <title>Purpose</title> <p>Diabetes management requires adherence to complicated self-care behaviors. Therefore, the emotional state of the individual living with diabetes, is likely to affect their ability to comply with recommendations. This study explored the relationship of self-care adherence to diabetes distress and depression in Barbadian adults with type 2 diabetes.</p> </sec><sec> <title>Methods</title> <p>Adults aged 20 to 80 years, with type 2 diabetes, completed self-report questionnaires comprised of a profile section consisting of demographic and clinical characteristics; and standardized questionnaires comprising, The Diabetes Distress Scale (DDS), The Patient Health Questionnaire (PQH-9), and the Summary of Diabetes Self-care Activities Scale (SDSCA). Additionally biological measures (BP and HbA1c) were collected.</p> </sec><sec> <title>Results</title> <p>For the 509 participants there were no differences in adherence for males (30.8%) and females (69.2%), high diabetes distress and depression were associated with low adherence. General diet was negatively associated with BP and HbA1c; while HbA1c was positively correlated with blood glucose testing.</p> </sec><sec> <title>Conclusion</title> <p>Self-care non-adherence is more than a behavioral problem; it is a multidimensional phenomenon inclusive of demographic factors, condition or disease factors, psychological and social factors.</p> </sec></abstract>

scholarly journals Type 2 diabetes in women of reproductive age

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Donna M. Williams ◽  
Kathryn Evans Kreider
Keyword(s):  
Type 2 Diabetes ◽  
Nurse Practitioners ◽  
Diabetes Management ◽  
Reproductive Age ◽  
Current Evidence ◽  
Evidence Based ◽  
Women Of Reproductive Age

The prevalence of type 2 diabetes in women of reproductive age ranges from 3% to 7%. Due to the common nature of this condition, it is imperative for nurse practitioners who care for women to understand evidence-based methods of diabetes management. The aim of this article is to describe current screening and diagnostic criteria for type 2 diabetes, discuss current evidence-based management and patient education necessary to prevent long-term complications, and provide the tools for a healthy reproductive plan in women with type 2 diabetes from puberty until menopause. Diabetes management extends well beyond glucose control, and nurse practitioners should be attuned to all factors that can impact cardiovascular risk and quality of life.

A Diabetes Management Program for African American Women With Type 2 Diabetes

2000 ◽  
Vol 26 (5) ◽  
pp. 796-805 ◽  
Author(s):  
Thomas C. Keyserllng ◽  
Alice S. Ammerman ◽  
Carmen D. Samuel-Hodge ◽  
Allyson F. Ingram ◽  
Anne H. Skelly ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
African American ◽  
Randomized Trial ◽  
African American Women ◽  
Diabetes Management ◽  
Self Care ◽  
American Women ◽  
Phone Calls

PURPOSE this paper describes a clinic and community-based diabetes intervention program designed to improve dietary, physical activity, and self-care behaviors of older African American women with type 2 diabetes. It also describes the study to evaluate this program and baseline characteristics of participants. METHODS The New Leaf... Choices for Healthy Living With Diabetes program consists of 4 clinic-based health counselor visits, a community intervention with 12 monthly phone calls from peer counselors, and 3 group sessions. A randomized, controlled trial to evaluate the effectiveness of this intervention is described. RESULTS Seventeen focus groups of African American women were used to assessed the cultural relevance/acceptability of the intervention and measurement instruments. For the randomized trial, 200 African American women with type 2 diabetes were recruited from 7 practices in central North Carolina. Mean age was 59, mean diabetes duration was 10 years, and participants were markedly overweight and physically inactive. CONCLUSIONS Participants found this program to be culturally relevant and acceptable. Its effects on diet, physical activity, and self-care behaviors will be assessed in a randomized trial.

scholarly journals Low and reduced carbohydrate diets: challenges and opportunities for type 2 diabetes management and prevention

2020 ◽  
Vol 79 (4) ◽  
pp. 498-513 ◽  
Author(s):  
Chaitong Churuangsuk ◽  
Michael E. J. Lean ◽  
Emilie Combet
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Control ◽  
Diabetes Management ◽  
Food Selection ◽  
Food Sources ◽  
Micronutrient Deficiencies ◽  
Clinical Endpoints

Low-carbohydrate diets (LCD) have been promoted for weight control and type 2 diabetes (T2D) management, based on an emerging body of evidence, including meta-analyses with an indication of publication bias. Proposed definitions vary between 50 and 130 g/d, or <10 and <40 % of energy from carbohydrate, with no consensus on LCD compositional criteria. LCD are usually followed with limited consideration for other macronutrients in the overall diet composition, introducing variance in the constituent foods and in metabolic responses. For weight management, extensive evidence supports LCD as a valid weight loss treatment, up to 1–2 years. Solely lowering carbohydrate intake does not, in the medium/long term, reduce HbA1c for T2D prevention or treatment, as many mechanisms interplay. Under controlled feeding conditions, LCD are not physiologically or clinically superior to diets with higher carbohydrates for weight-loss, fat loss, energy expenditure or glycaemic outcomes; indeed, all metabolic improvements require weight loss. Long-term evidence also links the LCD pattern to increased CVD risks and mortality. LCD can lead to micronutrient deficiencies and increased LDL-cholesterol, depending on food selection to replace carbohydrates. Evidence is limited but promising regarding food choices/sources to replace high-carbohydrate foods that may alleviate the negative effects of LCD, demanding further insight into the dietary practice of medium to long term LCD followers. Long-term, high-quality studies of LCD with different food sources (animal and/or plant origins) are needed, aiming for clinical endpoints (T2D incidence and remission, cardiovascular events, mortality). Ensuring micronutrient adequacy by food selection or supplementation should be considered for people who wish to pursue long-term LCD.

scholarly journals A-039 Adherence and Executive Functioning in an Elderly Population with Type 2 Diabetes in México

2020 ◽  
Vol 35 (6) ◽  
pp. 829-829
Author(s):  
Ibarra C ◽  
Giudicessi A
Keyword(s):  
Type 2 Diabetes ◽  
Executive Functioning ◽  
Social Services ◽  
Diabetes Management ◽  
Self Care ◽  
Activity Level ◽  
Control Group ◽  
Neuropsychological Battery ◽  
The Relationship

Abstract Objective Diabetes is a prevalent chronic illness that can impact Executive Functioning (EF). Adherence to treatment is an important aspect in diabetes management however little published research addresses the relationship between adherence and EF in individuals with Type 2 Diabetes Mellitus (T2DM). The objectives of this study are: compare the levels of adherence and EF between T2DM and a control group. Analyze the relationship between adherence and EF in individuals with T2DM. Method The present study included 10 participants with T2DM and 10 control participants with Hypertension (HTN) all between the ages of 61–76. Participants were recruited through “Casa del Abue” a public center offering medical/social services to geriatric populations in Puebla, México. Neuropsychological Battery of Executive Functions and Frontal Lobes was administered to all participants, along with adherence measures specific to diagnosis: Summary of Diabetes Self-Care Activities or Hypertension Self-Care Activity Level Effects. Informed consent was obtained prior to participation. Results Results show significant differences in adherence between T2DM and HTN U = 1.0 p = &lt; 0.001 and also between groups in EF measures related to medial Orbitofrontal cortex (OFC) U = 21.0 p = &lt; 0.05. The relationship between adherence and EF in T2DM participants was moderately correlated r(10) = 0.32, p = 0.36. Descriptive statistics found in Table 1. Conclusion T2DM participants demonstrate significantly lower adherence levels and deficits in EF compared to the control group as expected. Given only a moderate correlation between adherence and EF was found, further research including a larger sample and more precise adherence measures such as HbA1c is suggested to further understand this relationship.

The overtreatment of type 2 diabetes in frail older people

2020 ◽  
Vol 2 (9) ◽  
pp. 496-502
Author(s):  
Hannah Syed
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Older People ◽  
Diabetes Management ◽  
Holistic Approach ◽  
Protective Effects ◽  
Frail Older People ◽  
Good Glycaemic Control

Intensive treatment with insulin and sulfonylureas in older people with low HbA1c (<53mmol/mol) can increase the risk of hypoglycaemia, morbidity and mortality. Older people, particularly those with frailty and/or comorbidities are less likely to benefit from the long-term protective effects of good glycaemic control and are often at risk of inappropriate polypharmacy. A person-centred holistic approach to diabetes management must be adapted for older people living with diabetes.

scholarly journals Exploration of Fatalism and Religiosity by Gender and Varying Levels of Engagement Among Mexican-American Adults of a Type 2 Diabetes Management Program

2021 ◽  
Vol 9 ◽  
Author(s):  
Cindy Lynn Salazar-Collier ◽  
Belinda M. Reininger ◽  
Anna V. Wilkinson ◽  
Steven H. Kelder
Keyword(s):  
Type 2 Diabetes ◽  
Mexican American ◽  
Diabetes Management ◽  
Healthcare Setting ◽  
Structured Interview ◽  
Management Program ◽  
Care Management Program ◽  
Diabetes Management Program

Objectives: Purpose of study is to explore the roles religiosity and fatalistic beliefs play in diabetes management among newly, currently, and long-term enrolled Mexican-American participants in a Type 2 diabetes mellitus (T2DM) chronic care management program.Methods: In 2017, study participants (n = 15) completed a semi-structured interview in their preferred language (English or Spanish). Sample was stratified by amount of time individual had been enrolled as a participant of the Salud y Vida program: newly, currently, or long-term. Interviews assessed religious beliefs, beliefs concerning the cause(s) of diabetes, perceived relationship between religiosity and fatalistic beliefs with T2DM management, and the appropriateness of discussing such topics with a health professional. Interview responses were analyzed using ATLAS.ti 8.Results: Themes identified included: perceived autonomy over diabetes prognosis, motivators for self-care, discussions of personal beliefs in the healthcare setting, and the church's role in diabetes management.Conclusions: Among this sample, religiosity and religious fatalism played a complex role in coping with and managing diabetes. Long-term enrolled and male participants expressed beliefs of divine control over health, and a connection between religiosity and health behavior. Long-term enrolled participants felt religious and fatalistic beliefs may be suitable and beneficial to discuss in the healthcare setting.

scholarly journals Effects of a tailored text messaging intervention among diverse adults with type 2 diabetes: Evidence from the 15-month REACH RCT

2020 ◽  
Author(s):  
Lyndsay A. Nelson ◽  
Robert A. Greevy ◽  
Andrew Spieker ◽  
Kenneth A. Wallston ◽  
Tom A. Elasy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Self Efficacy ◽  
Text Messaging ◽  
Self Care ◽  
Baseline Hba1c ◽  
Median Response ◽  
Text Messaging Intervention

<b>Objective:</b> Text messaging interventions have high potential for scalability and to reduce health disparities; however, more rigorous, long-term trials are needed. We examined the long-term efficacy and mechanisms of a tailored text messaging intervention. <p><b>Research Design and Methods:</b> Adults with type 2 diabetes participated in a parallel-groups, 15-month randomized trial, assigned to receive REACH (Rapid Education/Encouragement and Communications for Health) for 12 months or control. REACH included interactive texts and tailored texts addressing medication adherence, and non-tailored texts supporting other self-care behaviors. Outcomes included HbA1c, diabetes medication adherence, self-care, and self-efficacy. </p> <p><b>Results:</b> Participants (N=506) were approximately half racial/ethnic minority and half were underinsured, had annual household incomes <$35,000 USD and ≤ high school education; 11% were homeless. <a>Average baseline HbA1c was 8.6%±1.8%; 70.0±19.7 mmol/mol) with n<i>=</i>219 having HbA1c≥8.5% (69 mmol/mol)</a> and half were prescribed insulin. Retention was over 90%. Median response rate to interactive texts was 91% (interquartile range 75%, 97%). The treatment effect on HbA1c at 6 months (-0.31%; 95% CI [-0.61%, -0.02%]) was greater among those with baseline HbA1c≥8.5% (-0.74%; 95% CI [-1.26%, -0.23%]), and there was not evidence of effect modification by race/ethnicity or socioeconomic disadvantage. REACH improved medication adherence and diet through 12 months, and self-efficacy through 6 months. Treatment effects were not significant for any outcome at 15 months. REACH reduced barriers to adherence, but barrier reduction did not mediate outcome improvements. </p> <p><b>Conclusions:</b> REACH engaged at-risk patients in diabetes self-management and improved short-term HbA1c. More than texts alone may be needed to sustain effects. </p>

scholarly journals Quantifying Remission Probability in Type 2 Diabetes Mellitus

2021 ◽  
Vol 11 (4) ◽  
pp. 850-859
Author(s):  
Sanjay Kalra ◽  
Ganapathi Bantwal ◽  
Nitin Kapoor ◽  
Rakesh Sahay ◽  
Saptarshi Bhattacharya ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Treatment Options ◽  
Nutrition Therapy ◽  
Progressive Disorder ◽  
Medical Nutrition

Type 2 diabetes mellitus (T2DM) is a chronic progressive disorder and is associated with significant morbidity and mortality. The concept of T2DM remission and the reversal of diabetic parameters to normal levels has been gaining momentum over the past years. T2DM remission is increasingly being recognized by various global guidelines. Multiple models have been developed and validated for quantifying the extent of remission achieved. Based on favorable clinical evidence, T2DM remission can be considered as the therapeutic goal in diabetes management and, in select cases, as an alternative to expensive treatment options, which can be burdensome as T2DM progresses. This narrative review discusses the available strategies, such as lifestyle interventions, physical activity, bariatric surgery, medical nutrition therapy, and non-insulin glucose-lowering medications, for achieving T2DM remission. Although the concept of T2DM remission has emerged as a real-world option, effective implementation in routine clinical practice may not be feasible until long-term studies prove the efficacy of different approaches in this regard.

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