Health-related quality of life of adolescents with type 1 diabetes in the context of resilience.

BACKGROUND: Adolescents with type 1 diabetes (T1D) can be faced with deterioration in glycemic control (GC), reduced health-related quality of life (HRQoL), and other psychosocial problems. It is important to understand how the disease and its clinical conditions influence HRQoL and how adolescents are able to overcome the life adjustment difficulties. OBJECTIVE: To assess HRQoL of adolescents with T1D from demographic, clinical, personal, and behavioral point of view. SUBJECTS: A total of 229 adolescents with T1D (51.2% males) with a mean age of 15.35 (2.29) years old were recruited from three diabetes centers. The mean diabetes duration was 7.48 (3.87), the mean hemoglobin A1C (HbA1c) level was 10.3 (1.76) mmol/L. METHODS: A multicenter quantitative correlational design study was applied to investigate the influence of sex, age, diabetes duration, GC expressed by HbA1c, intensive insulin regimen, physical activity (PA), resilience (RS), and socioeconomic background on HRQoL. RESULTS: Presence of the diabetes symptoms and worry about the disease has negative impact on the patients' HRQoL. Stepwise multiple regression analyses indicated that insulin pump therapy, male sex, and higher level of RS were significantly related to an increase in HRQoL, whereas the higher level of PA, male sex, and better HRQoL was significantly related to positive change in RS. Patients treated with insulin pump therapy had significantly better HRQoL. CONCLUSIONS: Significant association can be observed between HRQoL and RS. Supposedly, higher level of PA promotes higher level of RS that in turn helps increase HRQoL in adolescents with T1D. Treatment with insulin pump therapy also promotes better HRQoL.

Reduced physical fitness in children and adolescents with type 1 diabetes.

AIMS: To evaluate motor performance and cardiorespiratory function in youths with type 1 diabetes in comparison with age-matched control groups and to analyze the influence of physical activity level, anthropometric and physical fitness parameters on long-term metabolic control. METHODS: 106 youths with diabetes and 130 healthy youths aged 8-18 were assessed by the Eurofit test regarding motor performances, cardiorespiratory fitness (VO2max), skinfold thickness, and body mass index. Physical activity level was assessed through the use of questionnaires. Predictors of physical fitness and metabolic control were determined with regression analysis. RESULTS: There were no differences either in body composition or in physical activity level, but younger girls with diabetes had impaired results in speed of upper limb movement, abdominal muscle strength, upper body strength, running speed, and VO2max ; older girls with diabetes had poor results in speed of upper limb movement, abdominal muscle strength, upper body strength and VO2max . Younger boys with diabetes had impaired results in speed of upper limb movement, flexibility, static strength of hand, and abdominal muscle strength; and older boys with diabetes had poor results in speed of upper limb movement, flexibility, abdominal muscle strength, upper body strength, and VO2max compared with control groups. Older age, female gender, lower physical activity level, and higher HbA1c were significant independent predictors of poorer VO2max. Better VO2max proved to be the single predictor of favorable HbA1c . CONCLUSIONS: Youths with diabetes have reduced fitness parameters. Efforts should be carried out to improve physical fitness as part of treatment and care of children and adolescents with type 1 diabetes.

Motivation and mental well-being of long-distance hikers: A quantitative and qualitative approach.

Hikers performing long distances (1000-5500 kms a year) were analyzed using quantitative and qualitative methods to evaluate their mental well-being and to find their motivation as well as to analyze the excessive physical activity. 112 hikers completed a questionnaire (M(age) = 40.28, SD = 8.77, 57.1% male) and 25 individuals were interviewed. Distance had association only with perceived health status. There were no differences between males and females, as well as between age groups and educational attainments regarding distance. 33.3% of hikers indicated symptoms of loneliness and 4.5% were involved excessively in hiking that was significantly regressed by distress. Hikers had mainly intrinsic motivations to complete long distances including overcoming new challenges, finding the physical boundaries, experiencing a state outside the comfort zone, belonging to a special group with similar interest and attracted by the beauty of nature. Overcoming all these embodied in a flow experience that took them further to perform the new long-distance trails.

Exercise addiction and its related factors in amateur runners.

BACKGROUND AND AIMS: This study examines exercise addiction (EA) in amateur runners from a multidimensional approach, including demographics (age, sex, educational attainment, and financial situation), training factors (duration of running activity, weekly time spent running, mean workout distance per session, other sports activities, and childhood physical activity), psychological features (perceived health, life satisfaction, loneliness, stress, anxiety, depression, body shape, and eating disorders), and anthropometrics (body mass index) that might predict EA. METHODS: The well-validated Exercise Dependence Scale (EDS) was applied to evaluate the prevalence of EA in amateur runners. A multinomial logistic regression was performed to find explanatory variables of risk of EA using the SPSS 24.0 statistical software. RESULTS: A total of 257 runners (48.9% females, Mage = 40.49, SD = 8.99 years) with at least 2 years running activity participated in an anonymous questionnaire survey. About 53.6% of respondents were characterized as non-dependent symptomatic and 37.8% as non-dependent asymptomatic. About 8.6% had prevalence of being at risk of EA. The logistic regression model displayed five variables that significantly predicted the risk of EA: (a) anxiety, (b) loneliness, (c) weekly time spent running, (d) childhood physical activity, and (e) education level. DISCUSSION AND CONCLUSIONS: Findings indicate that loneliness and anxiety may lead to withdrawal and uncontrolled behavior that in turn leads to increased amount of exercise in amateur runners. Lower level of education attainment is also a likely risk of EA development, and childhood sports activity is a predictor.