scholarly journals Idiosyncratic Personal Explanations for Blood Glucose Events Are Associated With Poorer Self-Management and Glycemic Control in Adult Patients With Long-Standing Type 1 Diabetes

Diabetes Care ◽  
2006 ◽  
Vol 29 (6) ◽  
pp. 1208-1213 ◽  
Author(s):  
A. J. Wearden ◽  
K. Hynd ◽  
H. Smith ◽  
R. Davies ◽  
N. Tarrier
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Adult Patients ◽  
Self Management

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 The Self-Management Experiences of Adolescents with Type 1 Diabetes: A Descriptive Phenomenology Study

2020 ◽  
Vol 17 (14) ◽  
pp. 5132
Author(s):  
Li-Chen Hung ◽  
Chu-Yu Huang ◽  
Fu-Sung Lo ◽  
Su-Fen Cheng
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Phenomenological Study ◽  
Medical Center ◽  
Self Management ◽  
Good Glycemic Control ◽  
Descriptive Phenomenology ◽  
Parental Assistance ◽  
Colaizzi's Method

Many adolescents with type 1 diabetes experience challenges in achieving good glycemic control and have insufficient understanding in executing interventions for glycemic control. This study aimed to understand self-management experiences of adolescents with type 1 diabetes in Taiwan. In this descriptive phenomenological study, we conducted in-depth interviews with 18 adolescents with type 1 diabetes from the pediatric outpatient clinic of a medical center. Data were analyzed using the Colaizzi’s method. Four themes were identified: (1) misconception regarding self-management of blood glucose; (2) conflict between depending on and breaking away from parental assistance for glycemic control; (3) encounter with disruptions in glycemic control regimen due to the presence of schedule changes; and (4) lack of motivation to achieve good glycemic control. The findings indicated that the misconceptions of adolescents with type 1 diabetes about managing glycemic levels resulted from an insufficient understanding of self-management of diabetes. In Taiwan, the heavy emphasis of academic achievement and changes of schedules during breaks tended to disrupt the regimen for glycemic control. Healthcare professionals are encouraged to provide individualized education focusing on the adolescents’ misconceptions regarding self-management of diabetes.

The Relationships Among School Nurse to Student Ratios, Self-Efficacy, and Glycemic Control in Adolescents With Type 1 Diabetes

2019 ◽  
pp. 105984051987031 ◽  
Author(s):  
Lori Wilt
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Self Efficacy ◽  
School Nurse ◽  
Older Age ◽  
Self Management ◽  
Demographic Questionnaire ◽  
Staffing Patterns ◽  
Student Ratios

Adolescents with Type 1 diabetes (T1D) experience unique self-management challenges, which can lead to poor glycemic control and sequelae. School nurses may impact student self-efficacy behaviors for T1D management in adolescents. The purpose of this study was to determine the relationships among school nurse staffing patterns, measured by school nurse to student ratios, self-efficacy, and glycemic control in adolescents with T1D. The sample consisted of 89 parent–adolescent dyads. Adolescents aged 10–16 years old with T1D completed the Self-Efficacy for Diabetes Self-Management (SEDM) Scale. Parents completed a demographic questionnaire. Higher school nurse to student ratios correlated with better glycemic control and older age. Higher SEDM scores correlated with older age, and females scored significantly higher. Findings contribute new knowledge to the paucity of literature on school nursing and adolescents with T1D, with implications for nursing practice, education, research, and policy.

scholarly journals Measures of Adherence and Challenges in Using Glucometer Data in Youth with Type 1 Diabetes: Rethinking the Value of Self-Report

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Karishma A. Datye ◽  
Niral J. Patel ◽  
Sarah S. Jaser
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Objective Measure ◽  
Relative Strength ◽  
Self Report ◽  
Strongly Correlated ◽  
Questionnaire Measure ◽  
Average Blood Glucose

Purpose. The current study compares the relative strength of associations of different adherence measures with glycemic control in adolescents with type 1 diabetes, while highlighting the challenges in using more objective measures (i.e., glucometer data). Methods. Adolescents with type 1 diabetes (n=149) and their caregivers completed a questionnaire measure assessing adolescents’ adherence (Self-Care Inventory (SCI)) to the diabetes regimen. Adolescents’ glucometers were downloaded to determine average blood glucose checks per day, as an objective measure of adherence. A measure of glycemic control (hemoglobin A1c (HbA1c)) was obtained as part of adolescents’ regular clinic visits. Results. Adolescents’ self-reported adherence to the treatment regimen was more strongly correlated with HbA1c than caregivers’ reports of adherence. In multivariate analyses, both adolescents’ self-report of adherence and average blood glucose checks per day (obtained via a glucometer) were significant predictors of HbA1c. Challenges to obtaining glucometer data were identified. Conclusions. The findings highlight adolescents’ self-report of adherence using the SCI as a brief and meaningful measure to understand and improve adolescents’ glycemic control, particularly when glucometer data is difficult to obtain.

scholarly journals Patterns of Self-Management in Pediatric Type 1 Diabetes Predict Level of Glycemic Control 2 Years Later

2013 ◽  
Vol 34 (3) ◽  
pp. 186-196 ◽  
Author(s):  
Jennifer M. Rohan ◽  
Jennifer Shroff Pendley ◽  
Alan Delamater ◽  
Lawrence Dolan ◽  
Grafton Reeves ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Self Management ◽  
Pediatric Type 1 Diabetes

scholarly journals Adherence to Insulin Pump Behaviors in Young Children With Type 1 Diabetes Mellitus

2016 ◽  
Vol 11 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Susana R. Patton ◽  
Kimberly A. Driscoll ◽  
Mark A. Clements
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Young Children ◽  
Type 1 Diabetes Mellitus ◽  
Insulin Pump ◽  
Insulin Use

Background: Parents of young children are responsible for daily type 1 diabetes (T1DM) cares including insulin bolusing. For optimal insulin pump management, parents should enter a blood glucose result (SMBG) and a carbohydrate estimate (if food will be consumed) into the bolus advisor in their child’s pump to assist in delivering the recommended insulin bolus. Previously, pump adherence behaviors were described in adolescents; we describe these behaviors in a sample of young children. Methods: Pump data covering between 14-30 consecutive days were obtained for 116 children. Assessed adherence to essential pump adherence behaviors (eg, SMBG, carbohydrate entry, and insulin use) and adherence to 3 Wizard/Bolus Advisor steps: SMBG–carbohydrate entry–insulin bolus delivered. Results: Parents completed SMBG ≥4 times on 99% of days, bolused insulin ≥3 times on 95% of days, and entered carbohydrates ≥3 times on 93% of days, but they corrected for hyperglycemia (≥250 mg/dl or 13.9 mmol/l) only 63% of the time. Parents completed Wizard/Bolus Advisor steps (SMBG, carbohydrate entry, insulin bolus) within 30 minutes for 43% of boluses. Inverse correlations were found between children’s mean daily glucose and the percentage of days with ≥4 SMBG and ≥3 carbohydrate entries as well as the percentage of boluses where all Wizard/Bolus Advisor steps were completed. Conclusions: Parents of young children adhered to individual pump behaviors, but showed some variability in their adherence to Wizard/Bolus Advisor steps. Parents showed low adherence to recommendations to correct for hyperglycemia. Like adolescents, targeting pump behaviors in young children may have the potential to optimize glycemic control.

scholarly journals Glycemic Control and Blood Glucose Monitoring Over Time in a Sample of Young Australians With Type 1 Diabetes: The role of personality

Diabetes Care ◽  
2013 ◽  
Vol 36 (10) ◽  
pp. 2968-2973 ◽  
Author(s):  
D. Waller ◽  
C. Johnston ◽  
L. Molyneaux ◽  
L. Brown-Singh ◽  
K. Hatherly ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Over Time

scholarly journals Different Effects of Structured Education on Glycemic Control and Psychological Outcomes in Adolescent and Adult Patients with Type 1 Diabetes: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Fang Liu ◽  
Yuzhu Guan ◽  
Xia Li ◽  
Yuting Xie ◽  
Jing He ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Well Being ◽  
Psychological Outcomes ◽  
Adult Patients ◽  
Cochrane Library ◽  
Structured Education

Aim. This systematic review aimed at investigating the effectiveness of structured education (SE) in improving glycemic control and psychological outcomes in adolescent and adult patients with type 1 diabetes. Methods. Electronic databases (EMBASE, Medline, PubMed, and the Cochrane Library) and the reference lists of included studies were searched from the beginning of the database through April 2019. Randomized controlled trials comparing SE with a control condition and reporting a change in glycosylated hemoglobin (HbA1c) level were included. The primary outcome was glycemic control measured by HbA1c. Secondary outcomes were diabetes-related distress, well-being, depression, and quality of life. Results. Eighteen studies representing 2759 patients were included. Twelve studies targeted adolescents and six targeted adults. Adolescent patients who were randomized to the intervention group did not show significant improvement of HbA1c in the short (SMD = −0.04; 95% CI: −0.14 to 0.06; P=0.41), medium (SMD = −0.03; 95% CI: −0.13 to 0.07; P=0.55), and long term (SMD = 0.04; 95% CI: −0.16 to 0.25; P=0.66) or of diabetes self-efficacy (SMD = −0.17; 95% CI: −0.33 to 0.00; overall effect P=0.05). However, SE was effective in reducing HbA1c levels in adult patients with inadequate baseline control (HbA1c higher than 7.5%) (SMD = −0.52; 95% CI: −0.86 to −0.17; P=0.003). SE significantly improved the well-being and psychological distress of adult patients but had no effect on the extent of depression. Conclusions. Development of more efficient SE programs according to the patients’ personal characteristics is needed.

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