scholarly journals Executive Function Predicting Longitudinal Change in Type 1 Diabetes Management During the Transition to Emerging Adulthood

Diabetes Care ◽  
2018 ◽  
Vol 41 (11) ◽  
pp. 2281-2288 ◽  
Author(s):  
Cynthia A. Berg ◽  
Deborah J. Wiebe ◽  
Yana Suchy ◽  
Sara L. Turner ◽  
Jonathan Butner ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Executive Function ◽  
Emerging Adulthood ◽  
Diabetes Management ◽  
Longitudinal Change

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 Experiences and perspectives of the parents of emerging adults living with type 1 diabetes

2020 ◽  
Vol 8 (1) ◽  
pp. e001125
Author(s):  
Cheryl Pritlove ◽  
Benjamin Markowitz ◽  
Geetha Mukerji ◽  
Andrew Advani ◽  
Janet A Parsons
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adulthood ◽  
Emerging Adults ◽  
Diabetes Management ◽  
Self Management ◽  
Comparative Approach ◽  
Transition To Adult Care ◽  
Adult Care ◽  
Difficult Time

IntroductionWhereas it is widely recognized that emerging adulthood can be a difficult time in the life of an individual living with type 1 diabetes, relatively little is known about the experiences of their parents or guardians. These individuals once shouldered much of the burden for their child’s diabetes ‘self’-management, yet their contribution is often overlooked by the adult healthcare system. Here, we set out to gain an understanding of the perspectives of parents of emerging adults living with type 1 diabetes.Research design and methodsSemi-structured interviews were performed with a purposeful sample of parents of emerging adults with type 1 diabetes recruited from two urban young adult diabetes clinics and through a national diabetes charity. Thematic coding was derived using a constant comparative approach.ResultsAnalysis of interviews with 16 parents of emerging adults with type 1 diabetes identified three themes: parental experiences of the transition to adult care; negotiating parent–child roles, responsibilities and relationships; and new and evolving fears. Parents spoke in detail about the time surrounding their child’s diagnosis of type 1 diabetes to emphasize the complexity of diabetes care and the need to establish a ‘new normal’ for the family. In turn, adolescence and emerging adulthood required a renegotiation of roles and responsibilities, with many parents continuing to play a role in high-level diabetes management. Several parents of emerging adults with type 1 diabetes (particularly those of young men) vocalized worries about their child’s readiness to assume responsibility for their self-care, and some expressed frustration with the apparent dichotomy in the role expectations of parents between the pediatric and adult care settings.ConclusionsAdult healthcare providers should recognize both the ongoing involvement of parents in the ‘self’-management of emerging adults with type 1 diabetes and the unique aspects of the caregiver burden that they experience.

Developmental model of parent-child coordination for self-regulation across childhood and into emerging adulthood: Type 1 diabetes management as an example

2017 ◽  
Vol 46 ◽  
pp. 1-26 ◽  
Author(s):  
Cynthia A. Berg ◽  
Jonathan Butner ◽  
Deborah J. Wiebe ◽  
Amy Hughes Lansing ◽  
Peter Osborn ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adulthood ◽  
Diabetes Management ◽  
Self Regulation ◽  
Developmental Model ◽  
Parent Child

scholarly journals Continuous glucose monitoring reduces pubertal hyperglycemia of type 1 diabetes

2020 ◽  
Vol 33 (7) ◽  
pp. 865-872
Author(s):  
Benjamin Udoka Nwosu ◽  
Shamima Yeasmin ◽  
Sanaa Ayyoub ◽  
Shwetha Rupendu ◽  
Tony R. Villalobos-Ortiz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Longitudinal Change ◽  
Controlled Study ◽  
Pubertal Status ◽  
Male Age

AbstractBackgroundPhysiologic hyperglycemia of puberty is a major contributor to poor glycemic control in youth with type 1 diabetes (T1D). This study’s aim was to determine the effectiveness of continuous glucose monitoring (CGM) to improve glycemic control in pubertal youth with T1D compared to a non-CGM cohort after controlling for age, sex, BMI, duration, and insulin delivery methodology. The hypothesis is that consistent CGM use in puberty improves compliance with diabetes management, leading to increased percentage (%) time in range (TIR70–180 mg/dL) of glycemia, and lowering of HbA1c.MethodsA longitudinal, retrospective, case-controlled study of 105 subjects consisting of 51 T1D controls (60.8% male) age 11.5 ± 3.8 y; and 54 T1D subjects (48.1% male) age 11.1 ± 5.0 y with confirmed CGM use for 12 months. Pubertal status was determined by Tanner staging. Results were adjusted for baseline HbA1c and diabetes duration.ResultsHbA1c was similar between the controls and the CGM group at baseline: 8.2 ± 1.1% vs 8.3 ± 1.2%, p=0.48 respectively; but was significantly lower in the CGM group 12 months later, 8.2 ± 1.1% vs. 8.7 ± 1.4%, p=0.035. Longitudinal change in HbA1c was similar in the prepubertal cohort between the control- and CGM groups: −0.17 ± 0.98% vs. 0.38 ± 1.5%, p=0.17. In contrast, HbA1c increased with advancing age and pubertal status in the pubertal controls but not in the pubertal CGM group: 0.55 ± 1.4 vs −0.22 ± 1.1%, p=0.020. Percent TIR was inversely related to HbA1c in the CGM group, r=-0.6, p=0.0004, for both prepubertal and pubertal subjects.ConclusionsCGM use significantly improved glycemic control in pubertal youth with T1D compared to non-CGM users.

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

Can Innovative Technologies Overcome HbA1c Disparity for African-American Youth with Type 1 Diabetes?

2021 ◽  
pp. 193229682110213
Author(s):  
Stuart Chalew ◽  
Alan M. Delamater ◽  
Sonja Washington ◽  
Jayalakshmi Bhat ◽  
Diane Franz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Racial Disparity ◽  
Diabetes Management ◽  
New Technology ◽  
African American Youth ◽  
Glucose Monitoring ◽  
Supportive Role

Achieving normal or near-normal glycemic control as reflected by HbA1c levels in patients with type 1 diabetes (T1D) is important for preventing the development and progression of chronic complications. Despite delineation and dissemination of HbA1c management targets and advances in insulin pharmacology, insulin delivery systems, and glucose monitoring, the majority of children with T1D do not achieve HbA1c goals. In particular, African Americans are more likely not to reach HbA1c goals and have persistently higher HbA1c than Non-Hispanic Whites. Availability of pumps and other technology has not eliminated the disparity in HbA1c. Multiple factors play a role in the persisting racial disparity in HbA1c outcome. The carefully designed application and deployment of new technology to help the patient/family and facilitate the supportive role of the diabetes management team may be able to overcome racial disparity in glycemic outcome and improve patient quality of life.

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