The Choice Should Be Yours: Diabetes-Related Distress by Insulin Delivery Method for People with Type 1 Diabetes.

Background: American Diabetes Association (ADA) recommends psychosocial assessment for people with diabetes, including diabetes-related distress. Elevated diabetes-related distress is associated with poor self-management, lower medication adherence, and poorer quality of life. Insulin delivery methods are multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). Because people with type 1 diabetes mellitus (T1DM) require comprehensive insulin therapy to manage blood glucose, we explored the association of insulin delivery methods and diabetes distress in this group. Methods: The U.S. Air Force Diabetes Center of Excellence (DCOE), a specialty clinic for adults who are Military Health System beneficiaries, administers the validated 17-item Diabetes-related Distress Scale (DDS-17) as part of standard care. Patient data were analyzed from June 2015 to August 2016 using SPSS version 22. Patients were free to choose the method of insulin delivery with minimal or no additional cost. Results: There were 203 patients with T1DM who completed the DDS-17 as part of standard care during the time period. Patients were categorized as CSII (57.6%) or MDI (42.4%). Women were significantly more likely to choose MDI over CSII than men (P = 0.003). DDS-17 scores were low in both groups, and there were no significant differences in DDS-17 by insulin delivery method. Furthermore, no significant differences were found in hemoglobin A1c (HbA1c) between CSII (7.9% or 63 mmol/mol) and MDI (8.1% or 65 mmol/mol) users (P = 0.22) and no significant differences in body mass index (BMI) between patients using CSII (M = 28.33 kg/m2) and MDI (28.49 kg/m2) users (P = 0.15). Conclusions: Our study demonstrated that if patients are relatively free to choose the insulin delivery method (minimal or no financial constraints), there were no differences in diabetes distress scores, HbA1c, or BMI between CSII and MDI. Therefore, people with T1DM may benefit from choosing the method of insulin delivery that will enable them to achieve individual goals and manage diabetes-related distress.

Tracking Changes of Chinese Pre-Service Teachers' Aerobic Fitness, Body Mass Index, and Grade Point Average Over 4-years of College.

Although increasing attention has been given to student academic achievement, usually measured by grade point average (GPA), and fitness in children and adolescents, much fewer studies have been conducted in higher education settings, especially in China. This study investigated the longitudinal associations of aerobic fitness (AF), body mass index (BMI), and GPA in Chinese pre-service teachers at a university. A longitudinal research design was employed to track changes in AF, BMI, and GPA, for a total of 1980 students for four years. Multi-level growth models were used to examine the interactive changes of the above three variables. It was found that GPA and BMI increased each year, while AF declined dramatically at the fourth year. The three-way interaction among GPA, gender, and BMI was significant, suggesting females who were overweight/obese had lower GPA. The data from the current study suggested that AF did not impact students' GPA. Class standing (i.e., the fourth year) and gender (i.e., females) need to be taken into consideration when designing interventions to improve student overall fitness and academic performance in Chinese pre-service teacher populations.