Associations of Executive Function (EF) with Diabetes Management and Glycemic Control in Teens with Type 1 Diabetes (T1D)

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1375-P
Author(s):  
MEREL HANSMANN ◽  
ZIJING GUO ◽  
LISA VOLKENING ◽  
LORI M. LAFFEL
Keyword(s):  
Type 1 Diabetes ◽  
Executive Function ◽  
Glycemic Control ◽  
Diabetes Management

scholarly journals Executive Function in Adolescents With Type 1 Diabetes: Relationship to Adherence, Glycemic Control, and Psychosocial Outcomes

2016 ◽  
pp. jsw093 ◽  
Author(s):  
Katia M. Perez ◽  
Niral J. Patel ◽  
Jadienne H. Lord ◽  
Kimberly L. Savin ◽  
Alexandra D. Monzon ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Executive Function ◽  
Glycemic Control ◽  
Psychosocial Outcomes

scholarly journals A Time-Friendly, Feasible Measure of Nutrition Knowledge in Type 1 Diabetes: The Electronic Nutrition and Carbohydrate Counting Quiz (eNCQ)

2018 ◽  
Vol 13 (1) ◽  
pp. 68-74
Author(s):  
Arwen M. Marker ◽  
Amy E. Noser ◽  
Nicole Knecht ◽  
Mark A. Clements ◽  
Susana R. Patton
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Nutrition Education ◽  
Diabetes Management ◽  
Clinical Care ◽  
Nutrition Knowledge ◽  
Diabetes Diagnosis ◽  
Carbohydrate Counting ◽  
One Year

Background: Greater knowledge about nutrition and carbohydrate counting are associated with improved glycemic control and quality of life in youth with type 1 diabetes (T1D). However, limited assessments of nutrition and carbohydrate knowledge have been developed, and existing measures can be time-consuming, overly broad, or not conducive to routine clinical use. To fill this gap, we developed and examined the feasibility of administering the electronic Nutrition and Carbohydrate Counting Quiz (eNCQ). Method: Ninety-two caregivers and 70 youth with T1D (mean age 12.5 years; mean time since diagnosis 5 years; English speaking) completed the 19-item eNCQ via tablet during a routine clinical visit. Completion time and item completion rates were used to assess feasibility. Relationships between eNCQ scores and patient demographics, diabetes management, and health outcomes were examined. Results: Participants took 10 minutes, on average, to complete the eNCQ. Total and Carbohydrate subscale scores (youth report) were negatively correlated with youth hemoglobin A1c (total r = –.38, carbohydrate r = –.38, Ps < .05), indicating that greater nutrition knowledge related to better glycemic control. Nutrition knowledge scores were generally high, but knowledge was negatively related to time since diabetes diagnosis ( r = –.276, P < .05). Conclusions: Findings support feasibility of the eNCQ to assess nutrition knowledge in routine clinical care. Following additional acceptability and validity testing, the eNCQ may identify families in need of further nutrition education. Nutrition assessment is particularly indicated for youth over one year since T1D diagnosis, as these families displayed lower nutrition knowledge and may need continuing education to maintain diabetes-specific nutrition knowledge over time.

Impact of Real-Time CGM Data Sharing on Quality of Life in the Caregivers of Adults and Children with Type 1 Diabetes

2020 ◽  
pp. 193229682097842
Author(s):  
William H. Polonsky ◽  
Addie L. Fortmann
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Health Outcomes ◽  
Real Time ◽  
Data Sharing ◽  
Diabetes Management ◽  
Health Benefits

Background: To examine caregivers’ experiences with real-time continuous glucose monitoring (RT-CGM) data sharing and its impact on quality of life (QoL) and health outcomes. Methods: Parents of children with type 1 diabetes (T1D) ( N = 303) and spouses/partners of T1D adults ( N = 212) using the Dexcom G5 Mobile or G6 RT-CGM system and who were actively following their T1Ds’ RT-CGM data completed a survey examining their perceived value of data sharing, the impact of sharing on their own QoL and their child/partner’s health, and how they used RT-CGM data to support their T1Ds’ diabetes management. Regression analyses examined whether their actions were linked to reported changes in QoL and health outcomes. Results: Respondents were predominantly non-Hispanic White (91.1% parents; 88.7% partners), female (78.2% parents; 54.7% partners), and college-educated (65.3% parents; 61.8% partners). The majority reported that data sharing had enhanced hypoglycemic confidence (97.7% parents; 98.1% partners), overall well-being (60.4% parents; 63.2% partners), and sleep quality (78.0% parents; 61.3% partners). Of note, three positive caregiver actions were broadly consistent and significant predictors of QoL and health benefits for both parents and partners: celebrating success related to glycemic control, providing encouragement when glycemic control is challenging, and teamwork discussions about how the caregiver should respond to out-of-range values. Conclusions: RT-CGM data sharing was associated with a range of QoL and health benefits for caregivers. Degree of benefits was influenced by the collaborative actions taken by caregivers to support their child’s or partner’s diabetes management. To determine the most effective strategies for collaborative data sharing, longitudinal trials are needed.

scholarly journals Parental Involvement and Executive Function in Emerging Adults with Type 1 Diabetes

2019 ◽  
Vol 44 (8) ◽  
pp. 970-979 ◽  
Author(s):  
Cynthia A Berg ◽  
Deborah J Wiebe ◽  
Eunjin Lee Tracy ◽  
Caitlin S Kelly ◽  
Daniel Mello ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Executive Function ◽  
Parental Involvement ◽  
Emerging Adulthood ◽  
Emerging Adults ◽  
Multilevel Models ◽  
Diabetes Management ◽  
Mothers And Fathers ◽  
Growth Curve Models

Abstract Objective To examine (a) changes in parental involvement across early emerging adulthood, (b) whether yearly fluctuations in parental involvement were associated with adherence and glycated hemoglobin (HbA1c) over time, and (c) whether higher involvement was more beneficial for those with poorer executive function (EF). Methods A total of 228 high school seniors (M age = 17.76) with type 1 diabetes reported on mothers’ and fathers’ acceptance, knowledge of diabetes activities, disclosure to mothers and fathers regarding diabetes, and adherence at four yearly time points. At baseline, participants completed performance-based measures of EF. HbA1c was collected from assay kits. Results Growth curve models revealed significant declines in disclosure to fathers and mothers’ and fathers’ knowledge of diabetes activities; no changes were found in mothers’ or fathers’ acceptance nor disclosure to mothers. Multilevel models indicated significant between-person effects for nearly all aspects of parental involvement with more acceptance, knowledge, and disclosure associated with better HbA1c and adherence. Within-person effects for disclosure to fathers, and mothers’ and fathers’ knowledge indicated that in years when emerging adults perceived higher amounts of these types of involvement (compared with their own average), HbA1c was lower. Within-person effects were found for acceptance to mothers, disclosure to mothers and fathers, and mothers’ diabetes knowledge for adherence. Disclosure to fathers and mothers’ knowledge of diabetes activities were especially beneficial for HbA1c for those with poorer EF performance. Conclusions Parental involvement in diabetes management remains important during the high-risk time of emerging adulthood, especially for those with poorer EF.

scholarly journals Covid Lockdown Impact on Type 1 Diabetes Health and Well-Being

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A338-A338
Author(s):  
Jamie Calma ◽  
Sabrina Sangha ◽  
Marina Basina
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Healthcare Delivery ◽  
Severe Depression ◽  
Well Being ◽  
Depression Symptoms ◽  
Published Data ◽  
The Impact

Abstract Introduction: Data on the impact of the COVID-19 lockdown on glycemic control and psychological well-being in individuals with Type 1 Diabetes Mellitus (T1DM) showed mixed results. Some studies showed improvement in glycemic control attributed to more time for self-care and a more regular lifestyle schedule during the lockdown. However, most published data reflects a short duration of 3–5 months. The impact of long-term social isolation and transition to telemedicine on the health of T1DM patients remains unknown. Our study analyzes patient perception surrounding the impact of an 11-month lockdown on glycemic control, well-being, and self-reported depression symptoms. Methods: PHQ-9 was integrated into a 55-question survey created using RedCap, a secure portal for managing surveys. The survey was sent to 160 T1DM patients over the age of 18 to gauge their current diabetes management and overall well-being prior to, and during the pandemic. The survey also inquired about patients’ perceived effectiveness of telemedicine visits. PHQ9 scores were collected and analyzed along with survey responses. Results: Data collection is still ongoing. From the 47 responders, the PHQ9 screening showed 51% were in the minimal depression score, 34% in the range of mild depression, 11% in moderate depression, and 4% scored in moderate to severe depression. No patients scored within severe depression. In a regular week during the pandemic, 40% of patients experienced difficulty with their motivation and diabetes management and 60% reported no concern, as compared to 36% and 64% respectively before the pandemic. Among the 47 of patient respondents, 30 reported both A1c levels prior and during the pandemic of which 46% showed an improved A1c amid the pandemic, 10% had no change, and 44% reported a worsened A1c level. For the telehealth part of the survey, 90% of patients reported feeling “comfortable with the level of care” they receive via telemedicine, whereas the other 10% were not. Whilst 54% of patients preferred in-person visits and 46% indicated a preference for telehealth visits. Conclusion: T1DM management is challenging. The pandemic adds to the complexity and burden to both self-management and healthcare delivery. Staying locked down for a prolonged period of time imposes economical, psychological, and medical constraints to diabetes care, as nearly half of the patients reported worsening of glycemic control. Our comprehensive survey reports the longest duration reported up to date of how the COVID-19 lockdown impacts patient’s perceived changes in their mental health and diabetes management. It helps clinicians understand the connection between mental and physical health during the pandemic and improve time-restricted telehealth visits by understanding patient concerns. Additional larger scale studies are imperative to expand the knowledge in this field.

scholarly journals Stigma and Its Association With Glycemic Control and Hypoglycemia in Adolescents and Young Adults With Type 1 Diabetes: Cross-Sectional Study (Preprint)

2017 ◽  
Author(s):  
Anne-Sophie Brazeau ◽  
Meranda Nakhla ◽  
Michael Wright ◽  
Mélanie Henderson ◽  
Constadina Panagiotopoulos ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Severe Hypoglycemia ◽  
Poor Glycemic Control ◽  
Self Report ◽  
Diabetes Diagnosis ◽  
Hypoglycemic Episode ◽  
Cross Sectional

BACKGROUND Qualitative studies in type 1 diabetes indicate that visibility of diabetes supplies, self-care, and hypoglycemia symptoms are associated with stigma and suboptimal management. This may be particularly salient in youth who face concurrent challenges such as establishing autonomy and making vocational choices. OBJECTIVE The aim of the study was to estimate stigma prevalence in youth (aged 14-24 years) with type 1 diabetes and its associations with glycemic control. METHODS Participants, recruited largely through social media, were asked to complete a Web-based survey and to send via mail capillary blood samples for glycated hemoglobin (HbA1c) measurement. The primary definition of stigma required endorsement of one or more of 3 stigma-specific items of the Barriers to Diabetes Adherence questionnaire. These addressed avoidance of diabetes management with friends present, difficulty telling others about diabetes diagnosis, and embarrassment in performing diabetes care with others present. Poor glycemic control was defined as HbA1c>9% (ie, >75 mmol/mol; measured value when available, else self-report) and/or ≥1 severe hypoglycemic episode in the previous year (reported requiring assistance from someone else during the episode). Stigma prevalence was computed (95% CI), and associations with glycemic control were evaluated (multivariate logistic regression models). RESULTS Among the 380 respondents, stigma prevalence was 65.5% (95% CI 60.7-70.3). Stigma was associated with a 2-fold higher odds of poor glycemic control overall (odds ratio [OR] 2.25, 95% CI 1.33-3.80; adjusted for age, sex, and type of treatment). There were specific associations with both HbA1c>9% (75 mmol/mol; OR 3.05, 95% CI 1.36-6.86) and severe hypoglycemia in the previous year (OR 1.86, 95% CI 1.05-3.31). CONCLUSIONS There is a high prevalence of stigma in youth with type 1 diabetes that is associated with both elevated HbA1c levels and severe hypoglycemia. Targeted strategies to address stigma are needed. CLINICALTRIAL ClinicalTrials.gov NCT02796248; http://clinicaltrials.gov/ct2/show/NCT02796248 (Archived by WebCite at http://www.webcitation.org/6yisxeV0B)

scholarly journals Generic and disease-specific quality of life in adolescents with type 1 diabetes: comparison to age-matched healthy peers

2016 ◽  
Vol 29 (7) ◽  
Author(s):  
Andrea Lukács ◽  
Péter Sasvári ◽  
András Török ◽  
László Barkai
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Regular Exercise ◽  
Pump Therapy

AbstractThis study aimed to evaluate the health-related quality of life (HRQoL) of adolescents with type 1 diabetes (T1DM) on the basis of the pediatric quality of life inventory™ (PedsQL™) generic and diabetes-specific modules, and to compare it to that of healthy peers.This retrospective case-control study involved 650 participants between ages of 13 and 19 years including 296 adolescents with T1DM from four diabetes centers and 354 healthy peers matched for age and gender from three different cities of the country. Participants completed the validated PedsQL™ for assessing the HRQoL. The analysis included an independent t-test to compare the means of the total and subscales of the PedsQL™ between boys and girls as well as between a healthy group and a group with T1DM. Gender differences in exercise, insulin therapy modalities were evaluated with the Pearson χAdolescents with T1DM have similar HRQoL in all domains when compared to their healthy counterparts. Females report worse HRQoL regardless of the presence of the disease. Insulin pump therapy facilitates better glycemic control and HRQoL. Regular exercise positively correlates with the generic HRQoL in both groups; however, it has no relationship with glycemic control.Optimal metabolic control and improved HRQoL are the eventual goals of diabetes management. Despite the difficulties, adolescents with diabetes can manage their disease well and live normal lives, similar to their healthy peers. Although diabetes-related problems exist, it seems that regular exercise and staying physically active, as well as promoting insulin pump therapy where it is applicable are related to favorable HRQoL.

Cognitive functions and glycemic control in children and adolescents with type 1 diabetes

2009 ◽  
Vol 40 (1) ◽  
pp. 95-103 ◽  
Author(s):  
S. Ohmann ◽  
C. Popow ◽  
B. Rami ◽  
M. König ◽  
S. Blaas ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Metabolic Control ◽  
Child Behavior Checklist ◽  
Diabetes Management ◽  
Social Activity ◽  
Self Report ◽  
Patients With Diabetes

BackgroundThe relationship between metabolic control and cognitive function in adolescents with type 1 diabetes (DM type 1) is not clear. We compared the quality of glycemic control (GC) and cognitive measures in adolescents with DM type 1 to find out if the quality of diabetes management is related to cognitive impairment.MethodWe assessed executive functions (EFs) and other neuropsychological and psychosocial variables in 70 adolescent patients with DM type 1 and 20 age-matched controls. Patients were divided into two groups according to their last hemoglobin A1c (HbA1c): acceptable (HbA1c 5.9–8.0%, mean 6.9%, 36 patients, mean age 14 years) and non-optimal (HbA1c 8.2–11.6%, mean 9.3%, 34 patients, mean age 15.6 years).ResultsWe found impaired EFs, mainly problems of concept formation (p=0.038), cognitive flexibility (p=0.011) and anticipation (p=0.000), in the patients with DM type 1. Both groups did not differ in intelligence, most assessed EFs and adjustment to chronic illness (Youth Self-Report; YSR). Younger patients (<15 years) were cognitively less flexible. GC was worse in older patients and in patients with longer duration of the disease. We also found significant differences between patients with diabetes and controls concerning somatic complaints, internalizing problems (Child Behavior Checklist; CBCL) and social activity (CBCL and YSR).ConclusionsDM type 1 is associated with cognitive deficits in adolescents independent of the quality of metabolic control and the duration of the disease. These deficits are probably related to the disease, especially in patients with early-onset diabetes.

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