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1.
JAMA ; 323(4): 339-351, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31990315

RESUMO

Importance: Public health screening for type 1 diabetes in its presymptomatic stages may reduce disease severity and burden on a population level. Objective: To determine the prevalence of presymptomatic type 1 diabetes in children participating in a public health screening program for islet autoantibodies and the risk for progression to clinical diabetes. Design, Setting, and Participants: Screening for islet autoantibodies was offered to children aged 1.75 to 5.99 years in Bavaria, Germany, between 2015 and 2019 by primary care pediatricians during well-baby visits. Families of children with multiple islet autoantibodies (presymptomatic type 1 diabetes) were invited to participate in a program of diabetes education, metabolic staging, assessment of psychological stress associated with diagnosis, and prospective follow-up for progression to clinical diabetes until July 31, 2019. Exposures: Measurement of islet autoantibodies. Main Outcomes and Measures: The primary outcome was presymptomatic type 1 diabetes, defined by 2 or more islet autoantibodies, with categorization into stages 1 (normoglycemia), 2 (dysglycemia), or 3 (clinical) type 1 diabetes. Secondary outcomes were the frequency of diabetic ketoacidosis and parental psychological stress, assessed by the Patient Health Questionnaire-9 (range, 0-27; higher scores indicate worse depression; ≤4 indicates no to minimal depression; >20 indicates severe depression). Results: Of 90 632 children screened (median [interquartile range {IQR}] age, 3.1 [2.1-4.2] years; 48.5% girls), 280 (0.31%; 95% CI, 0.27-0.35) had presymptomatic type 1 diabetes, including 196 (0.22%) with stage 1, 17 (0.02%) with stage 2, 26 (0.03%) with stage 3, and 41 who were not staged. After a median (IQR) follow-up of 2.4 (1.0-3.2) years, another 36 children developed stage 3 type 1 diabetes. The 3-year cumulative risk for stage 3 type 1 diabetes in the 280 children with presymptomatic type 1 diabetes was 24.9% ([95% CI, 18.5%-30.7%]; 54 cases; annualized rate, 9.0%). Two children had diabetic ketoacidosis. Median (IQR) psychological stress scores were significantly increased at the time of metabolic staging in mothers of children with presymptomatic type 1 diabetes (3 [1-7]) compared with mothers of children without islet autoantibodies (2 [1-4]) (P = .002), but declined after 12 months of follow-up (2 [0-4]) (P < .001). Conclusions and Relevance: Among children aged 2 to 5 years in Bavaria, Germany, a program of primary care-based screening showed an islet autoantibody prevalence of 0.31%. These findings may inform considerations of population-based screening of children for islet autoantibodies.


Assuntos
Autoanticorpos/sangue , Diabetes Mellitus Tipo 1/epidemiologia , Ilhotas Pancreáticas/imunologia , Programas de Rastreamento , Doenças Assintomáticas/epidemiologia , Doenças Assintomáticas/psicologia , Pré-Escolar , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/psicologia , Feminino , Seguimentos , Alemanha/epidemiologia , Humanos , Masculino , Pais , Inquéritos e Questionários
2.
Nurs Res ; 68(6): 445-452, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693550

RESUMO

BACKGROUND: The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health. OBJECTIVES: The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors. METHODS: This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores. RESULTS: Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c. DISCUSSION: This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.


Assuntos
Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/psicologia , Estresse Psicológico/epidemiologia , Adulto , Doenças Cardiovasculares/psicologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Autorrelato
3.
Ann Agric Environ Med ; 26(3): 429-438, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559799

RESUMO

INTRODUCTION: Quality of Life (QoL) of Polish women and men with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) was analyzed, taking into consideration acceptance of the illness, the occurrence of depression, complications of diabetes, concentration of glycated haemoglobin, and demographic factors. MATERIAL AND METHODS: The study was conducted among 115 patients with T1DM and 215 patients with T2DM aged 18-60. The patients were divided into women and men. The tool applied for studying QoL was the Polish language version of the Audit of diabetes-dependent QoL questionnaire(ADDQoL) comprising 2 questions related to the general QoL and 19 domains related to aspects of life. Each domain included 2 components: Impact and Importance, and their product determined the value of the weighted impact score. The Acceptance of Illness Scale, Beck Depression Inventory and studied demographic and clinical parameters were also applied. RESULTS: Patients with both types of diabetes demonstrated a negative influence of the disease in all domains of ADDQoL. Values of the average weighted impact of ADDQoL showed significant associations with diabetic complications in T1DM and gender and depressive symptoms in T2DM. Diabetes negatively affects the QoL of diabetic patients in Poland, especially regarding freedom to eat and to drink and sex life in both genders in T1DM, and freedom to eat and drink, and feelings about the future in both genders, and working life and sex life in T2DM men. CONCLUSIONS: Risk factors for worse QoL are: the occurrence of diabetes complications in T1DM patients and male gender and depression in T2DM patients.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/psicologia , Qualidade de Vida , Adolescente , Adulto , Depressão , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Humanos , Pessoa de Meia-Idade , Polônia , Inquéritos e Questionários , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-31546871

RESUMO

Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between children with T1D (n = 215) and healthy controls (n = 115) and to assess the physical activity of the study group in relation to the applied method of insulin therapy, i.e., the use of insulin pen vs. insulin pump. The level of physical activity was assessed with a hip-worn tri-axial accelerometer (ActiGraph GT3X+) used by the subjects for an uninterrupted period of seven days. Children with T1D had significantly lower median values of total time of moderate (213.3 vs. 272.1 min), vigorous (135.3 vs. 19.6 min) and moderate-to-vigorous (347.4 vs. 467.4 min) physical activity compared to healthy peers respectively, (p < 0.001) in all cases. In addition, the total median number of steps was significantly lower (53,631 vs. 67,542 steps), (p < 0.001). The method of insulin therapy was not associated with significant differences in physical activity level (p > 0.001). The level of physical activity in children and adolescents with T1D is lower than in their healthy peers and does not depend on the insulin therapy method.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Exercício , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Acelerometria , Adolescente , Estudos de Casos e Controles , Criança , Diabetes Mellitus Tipo 1/tratamento farmacológico , Feminino , Humanos , Sistemas de Infusão de Insulina , Masculino , Esforço Físico , Estudos Prospectivos
5.
Health Qual Life Outcomes ; 17(1): 141, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412881

RESUMO

BACKGROUND: Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting. METHODS: In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18-80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36-item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes. RESULTS: Correlation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA1c, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (< 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures. CONCLUSIONS: Among people with type 1 and type 2 diabetes, adults with high-risk HbA1c levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA1c levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/psicologia , Hemoglobina A Glicada/análise , Qualidade de Vida , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Inquéritos e Questionários , Suécia , Adulto Jovem
6.
J Clin Nurs ; 28(23-24): 4478-4487, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31410916

RESUMO

AIMS AND OBJECTIVES: To examine the effects of family functioning and resilience on self-management and glycaemic control among youth with type 1 diabetes and to determine whether resilience mediates the effects of family functioning on self-management and glycaemic control. BACKGROUND: Poor self-management and glycaemic control are common in youth with type 1 diabetes. Family functioning and resilience are known to be important psychosocial factors that contribute to individual health and development. However, no studies have explored the effects of family functioning and resilience on self-management and glycaemic control among youths with type 1 diabetes in mainland China. DESIGN: This study was conducted using a survey with a convenience sample following the STROBE guidelines. METHODS: A total of 204 Chinese youth who had been diagnosed with type 1 diabetes for at least 6 months were recruited. Family functioning, resilience, self-management and diabetes distress were measured using self-reports and standard measurement tools. Glycaemic control was assessed by glycated haemoglobin (HbA1C ) levels. A structural equation model was used to test the hypothesised model. RESULTS: The final model accounted for 52.1% and 19.5% of the total variance of self-management and HbA1C level, respectively. Resilience had a direct effect on self-management and an indirect effect on control of HbA1C . Family functioning had an indirect effect on both self-management and control of HbA1C through resilience. The model remained invariant across the mild-distress and severe-distress groups. CONCLUSION: In Chinese youth with type 1 diabetes, resilience positively affected self-management and ultimately optimised glycaemic control, even in the presence of diabetes distress. Family functioning positively affected self-management and glycaemic control by promoting resilience. RELEVANCE TO CLINICAL PRACTICE: This study found that family functioning and resilience had positive effects on self-management and glycaemic control in youth. This study confirms the importance of incorporating resilience assessments and family-based resilience interventions into clinical nursing practice with youth with type 1 diabetes.


Assuntos
Automonitorização da Glicemia/psicologia , Diabetes Mellitus Tipo 1/psicologia , Família/psicologia , Resiliência Psicológica , Autogestão/psicologia , Adolescente , Diabetes Mellitus Tipo 1/terapia , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Autorrelato , Inquéritos e Questionários , Adulto Jovem
7.
Can J Diabetes ; 43(6): 372-376, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375177

RESUMO

OBJECTIVE: Pursuant to the legalization of recreational cannabis in Canada, a rapid review was undertaken to develop a position statement concerning the effects of cannabis consumption on Canadians living with diabetes. METHODS: An expert committee of 1 adult endocrinologist and 1 pediatric endocrinologist, with the help of coauthors, collaborated to develop the position statement using the same evidence-based principles as the Diabetes Canada Clinical Practice Guidelines (with the exception of an independent methods review). A rapid review was conducted by researchers with the Strategic Patient-Oriented Research Evidence Alliance. The scope of the review was limited to evaluating the effects of recreational cannabis use on: 1) metabolic factors and diabetes complications, and 2) diabetes self-management behaviors in people ≥13 years of age. An informed person with diabetes, Canadian health-care providers and scientific advisors performed independent external reviews. RESULTS: The review found a limited amount of published or presented literature for the review questions, with gaps in direct evidence linking cessation of cannabis use to improved outcomes in diabetes. However, there were sufficient data to begin developing recommendations for type 1 and type 2 diabetes about education, counseling and management related to recreational cannabis usage. CONCLUSIONS: This is the first attempt in the world to generate an evidence-based guidance document on the topic of recreational cannabis use and diabetes. It provides guidance for health-care providers, so that they can assist and counsel Canadians living with diabetes on recreational cannabis. Further, higher quality research is required to provide more robust and evidence-informed guidance.


Assuntos
Cannabis/efeitos adversos , Complicações do Diabetes/prevenção & controle , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/psicologia , Educação de Pacientes como Assunto , Padrões de Prática Médica/normas , Autocuidado , Adolescente , Adulto , Canadá/epidemiologia , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/etiologia , Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Prática Clínica Baseada em Evidências , Pessoal de Saúde/educação , Humanos , Prognóstico , Comportamento de Redução do Risco , Adulto Jovem
9.
J Clin Nurs ; 28(21-22): 4062-4076, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31327174

RESUMO

AIM AND OBJECTIVES: To examine the needs and perspectives regarding healthcare transition for adolescents and young adults (AYAs) with the following long-term conditions: diabetes, cystic fibrosis and congenital heart disease. BACKGROUND: Transition of AYAs within healthcare services has become increasingly important as more children are surviving into adulthood with long-term conditions. Yet, limited empirical evidence exists regarding transition experiences. DESIGN: Qualitative study fulfilling the completed consolidated criteria for reporting qualitative studies criteria (see Appendix S1). METHODS: Semi-structured interviews with AYAs aged 14-25 years (n = 47), parents (n = 37) and health professionals (n = 32), which was part of a larger mixed-methods study. Sample was recruited from two children's hospitals and four general hospitals in Ireland. RESULTS: Transfer occurred between the ages of 16-early 20s years depending on the service. None of the hospitals had a transition policy, and transition practices varied considerably. Adolescents worried about facing the unknown, communicating and trusting new staff and self-management. The transition process was smooth for some young adults, while others experienced a very abrupt transfer. Parents desired greater involvement in the transition process with some perceiving a lack of recognition of the importance of their role. In paediatric services, nurses reported following-up adolescents who struggled with treatment adherence and clinic attendance, whereas after transfer, little effort was made to engage young adults if there were lapses in care, as this was generally considered the young adults' prerogative. CONCLUSIONS: The amount of preparation and the degree to which the shift in responsibility had occurred prior to transition appeared to influence successful transition for AYAs and their parents. RELEVANCE TO CLINICAL PRACTICE: Nurses in collaboration with the multidisciplinary team can help AYAs develop their self-management skills and guide parents on how to relinquish responsibility gradually prior to transition.


Assuntos
Doença Crônica/psicologia , Pessoal de Saúde/psicologia , Pais/psicologia , Transição para Assistência do Adulto/organização & administração , Adolescente , Adulto , Criança , Doença Crônica/terapia , Fibrose Cística/psicologia , Fibrose Cística/terapia , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Feminino , Cardiopatias Congênitas/psicologia , Cardiopatias Congênitas/terapia , Humanos , Irlanda , Masculino , Relações Profissional-Paciente , Pesquisa Qualitativa , Adulto Jovem
10.
Am J Med Sci ; 358(2): 121-126, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31331449

RESUMO

BACKGROUND: Multiple studies have addressed ethnic diabetes mellitus (diabetes) care inequalities. But few have assessed whether ethnicity influences patient perceptions of diabetic quality-of-life (QOL). The authors therefore designed a cross-sectional study to quantify the overall QOL associated with diabetes in consecutive white (Caucasian) and black (African-American) participants. MATERIAL AND METHODS: A validated, time tradeoff utility instrument was consecutively administered by interview to 518 white and 92 African-American, adult, diabetic participants in an ambulatory setting. The instrument calculates QOL by quantifying a utility associated with their condition, with utility anchors of 1.00 (perfect health for that condition permanently) and 0.00 (death). Utility acquisition as used herein, first requires asking participants to estimate their theoretical remaining time of life, then subtracting from 1.00 the maximum proportion of their estimated remaining time of life they would be willing to hypothetically trade-if any-to permanently cure their condition (diabetes). Thus, a diabetic participant estimating 20 remaining years of life who will theoretically trade 3 of those years to cure their diabetes, has a diabetes-associated utility of [1.00 - (3/20) =)] 0.85. The closer the utility is to 1.00, the better the QOL associated with a condition, while the closer it is to 0.00, the poorer the associated QOL. RESULTS: The mean diabetes utility (QOL) for the white, diabetic participant cohort was 0.87, while that for the black cohort was 0.86 (P = 0.95). The ethnic cohorts were matched for age (P = 0.70), sex (P = 0.64), level of education (P = 0.29), known years of having diabetes (P = 0.10), insulin use (P = 0.23), type of diabetes (P = 0.27) and the number of associated comorbidities (P = 0.23). There was no difference between the cohorts for the presence and severity of the individual, diabetes-related comorbidities of retinopathy (P = 0.15), nephropathy (P = 0.24), neuropathy (P = 0.52), depression (P = 0.23) and heart disease (P = 0.32). Multiple linear regression integrating both cohorts revealed no effect of ethnicity upon diabetes utility (P = 0.60). CONCLUSIONS: Diabetes-related QOL was similar in matched cohorts of adult white and black participants with diabetes mellitus. This study suggests utilities for diabetes mellitus can be used in economic analyses without adjustment for white and black ethnicity.


Assuntos
Afro-Americanos , Diabetes Mellitus Tipo 1/etnologia , Diabetes Mellitus Tipo 2/etnologia , Grupo com Ancestrais do Continente Europeu , Qualidade de Vida/psicologia , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Complicações do Diabetes/tratamento farmacológico , Complicações do Diabetes/etnologia , Complicações do Diabetes/psicologia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Insulina/administração & dosagem , Insulina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
11.
Diabetes Metab Syndr ; 13(2): 1059-1063, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336444

RESUMO

AIMS: The aim of the study is comparing the psychiatric symptom in Type1 DM, Type 2 DM and controls. METHODS: The study was designed as case control study and conducted between September 2011 and April 2012 to the Diabetes Clinic. Age, gender and education level matched 70 type 1 diabetics, 68 type 2 diabetics and 70 controls included to the study. SCL-90-R [Symptom Check List-90 (Revised)] test is used for determining the psychiatric symptom rates. RESULTS: It was found that the rate of somatization, interpersonal sensitivity, anger-hostility and additional scales were significantly different in type 1, type 2 diabetics and controls ((p = 0.023, p = 0.008, p = 0.018 and p = 0.039, respectively). Compared to control group, being a patient with type 1 or type 2 Diabetes found as a risk factor for somatization, depression, anger-hostility and additional scales. Moreover being a patient with type 1 DM was found as a risk factor for having OBS symptoms (p = 0.039) and type 1 DM was protective against having interpersonal sensitivity symptoms (p = 0.006). CONCLUSION: In diabetic patient groups, an increase in the rate of psychiatric symptoms was observed. Therefore a careful psychiatric examination is required in DM.


Assuntos
Ira , Transtornos de Ansiedade/diagnóstico , Transtorno Depressivo/diagnóstico , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/psicologia , Adulto , Transtornos de Ansiedade/etiologia , Estudos de Casos e Controles , Transtorno Depressivo/etiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Escalas de Graduação Psiquiátrica , Fatores de Risco , Adulto Jovem
12.
Diabetes Metab Syndr ; 13(2): 1159-1164, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336459

RESUMO

AIM: To examine management of diabetes mellitus (DM) and patients' attitude towards DM in a random sample of the adult Greek population. METHODS: s: We selected a random sample of adults with self-reported DM (n = 1002) from a population-based nationwide study using the effective random sampling technique. Collection of data was performed through phone interviews. RESULTS: Prevalence of type 1 DM was 3.5% and of type 2 DM 96.5%. Prevalence of type 1 DM declined while of type 2 DM increased with age. No gender or residency differences were found between type 1 and type 2 DM. A total of 72.0% of subjects with type 2 DM were treated with oral antidiabetic drugs (OAD), 11.5% were treated with insulin and 7.1% were treated with both OAD and insulin. Internists specialized in DM were mainly doctors who started insulin treatment. Almost half of insulin naive subjects were skeptical towards insulin initiation and their main concern was the needle punch. CONCLUSIONS: In a random nationwide sample of the adult population in Greece the majority of subjects with self-reported DM had type 2 DM. Most patients with type 2 were treated with OAD. Almost half of insulin naive subjects were skeptical towards insulin initiation.


Assuntos
Atitude Frente a Saúde , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/psicologia , Dieta para Diabéticos , Exercício , Hipoglicemiantes/uso terapêutico , Autocuidado/psicologia , Adulto , Biomarcadores/análise , Glicemia/análise , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Gerenciamento Clínico , Feminino , Seguimentos , Grécia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Inquéritos e Questionários , Adulto Jovem
13.
Orv Hetil ; 160(29): 1136-1142, 2019 Jul.
Artigo em Húngaro | MEDLINE | ID: mdl-31303013

RESUMO

Introduction: Most of the adolescents suffering from type 1 diabetes mellitus (T1DM) can be described with HbA1c values below the target level. Several research investigated the impact of diabetes on the quality of life, however, no complex questionnaire has been developed to examine each area of the disease. Aim: The aim of the present study is to create a Hungarian, reliable and valid questionnaire which can cover each aspect of the adherence related to type 1 diabetes mellitus. Method: In the present study, the attention was drawn to the introduction of a new questionnaire related to diabetes adherence which can be applied among children and adolescents as well. To test the questionnaire and to reduce the number of the items and to determine the scales, reliability analysis (Cronbach's α) and factor analysis was applied. Results: The new measurement, which was created through the translation of English language international questionnaires, their pre-test, and its reduction by factor and reliability analysis, containing 9 subscales with 58 items, is stated as reliable regarding the results of the Cronbach's α index. Conclusion: It can be stated that the created Diabetes Adherence Questionnaire can be reliably applied on child and adolescent population and it can be adapted for people suffering from other types of chronic diseases. Orv Hetil. 2019; 160(29): 1136-1142.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Adesão à Medicação , Qualidade de Vida , Inquéritos e Questionários/normas , Adolescente , Criança , Diabetes Mellitus Tipo 1/psicologia , Humanos , Hungria , Linguagem , Psicometria , Reprodutibilidade dos Testes , Traduções
14.
Acta Diabetol ; 56(11): 1209-1216, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31313005

RESUMO

AIMS: Diabetic retinopathy remains asymptomatic until its late stages but remains a leading cause of vision impairment and blindness. We studied quality of life and the ability to deal with the discomfort deriving from the presence of a chronic disease in patients with type 1 diabetes and different stages of retinopathy. METHODS: Multicenter collaborative observational study involving nine centers screening for retinopathy in different areas of Italy. The National Eye Institute 25-item visual functioning questionnaire and the locus of control tool were administered to 449 people with type 1 diabetes between February 2016 and March 2018. Socio-demographic and clinical data were collected. RESULTS: On multivariable analysis, severe retinopathy is associated with worse scores for general vision, ocular pain, near vision activities, distance vision activities, driving, color vision, peripheral vision and lower values of internal control, independently of visual acuity. Women had a perception of worse general health, distance vision activities and driving, and lower internal control and trust in others. Worse scores for visual-specific social functioning, visual-specific mental health, visual-specific role difficulties, visual-specific dependency and peripheral vision were associated with higher HbA1c levels. Fatalism increased with rising HbA1c levels. CONCLUSIONS: These results confirm that a gap exists between patients' knowledge and expectations on retinopathy and providers' expertise and assumptions. To bridge this gap, patient-centered education and engaging approaches may be more effective than simple information given during consultations.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Retinopatia Diabética/psicologia , Qualidade de Vida , Acuidade Visual , Adaptação Psicológica , Idoso , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/patologia , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
JMIR Mhealth Uhealth ; 7(7): e11527, 2019 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-31290400

RESUMO

BACKGROUND: Despite the fact there are many wearable and mobile medical devices that enable patients to better self-manage their diabetes, not many patients are aware of all the options they have. In addition, there are those who are not fully satisfied with the devices they use, and those who often do not use them effectively. OBJECTIVE: The study aimed to propose possible changes to the combination of devices used by 6 specific patients for diabetes self-management. We assessed the suitability of selected technical devices for diabetes control. METHODS: Data of 6 patients (3 men and 3 women) with type 1 diabetes mellitus, who had been using the Diani telemedicine system for at least 3 months, were analyzed. The suitability of selected technical devices for diabetes control was ascertained using the data obtained via the Diani telemedicine system, as well as the patients' subjective feelings and statements, their everyday life habits, and self-management of diabetes. Informed consent was signed and obtained from each of the patients included. RESULTS: Each of the presented case studies describes how a given patient handled the system and its specific components based on his or her lifestyle, level of education, habits related to diabetes management, personality type, and other factors. At the conclusion of each case study, the best composition of devices for patients with similar personal descriptions was suggested. CONCLUSIONS: We believe this study can provide relevant guidance on how to help particular patients choose the technology that is best suited for their needs, based on the specific patient information we are able to obtain from them. Furthermore, clinicians or educators should be aware of available technologies a given patient can choose from. In addition, there is a substantial need for proper patient education in order for them to effectively use devices for diabetes self-management.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Gerenciamento Clínico , Telemedicina/normas , Adulto , Idoso de 80 Anos ou mais , Diabetes Mellitus Tipo 1/terapia , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Autogestão/métodos , Telemedicina/métodos , Telemedicina/estatística & dados numéricos
16.
J Fam Psychol ; 33(7): 809-818, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31355650

RESUMO

Emerging adults with Type 1 diabetes benefit when parents remain knowledgeable of their self-management. Yet how early emerging adults remain connected with parents while they experience normative declines in involvement and move out of the parental home is unclear. The present study examined how disclosure to, and solicitation from, parents may (a) be a way that emerging adults and parents remain connected, (b) occur with different methods of contact (i.e., face-to-face; non-face-to-face), and (c) associate with diabetes management differently for those living in versus outside of the parental home. Early emerging adults with Type 1 diabetes (N = 202; Mage = 18.81 years; 66% female) completed measures of their methods of contact with parents; diabetes-related disclosure to, and solicitation from, parents; and diabetes management as part of a 14-day daily diary. General linear models found that face-to-face contact was associated with greater disclosure to parents, for both those living in and out of the parental home. Individuals who lived outside the parental home used more non-face-to-face contact (e.g., texting) than those in the parental home. Multilevel models revealed that higher disclosure to mothers on a daily basis (within-persons) and to mothers and fathers overall (between-persons) was associated with better diabetes management similarly for those living in versus out of the parental home. Results suggest that face-to-face contact may be most effective for keeping parents "in the know" about diabetes management. Moreover, disclosure and solicitation continue to support diabetes management even as individuals move out of the parental home. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Comportamento do Adolescente/psicologia , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Revelação , Relações Pais-Filho , Autocuidado/psicologia , Adolescente , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pais/psicologia
17.
Clín. salud ; 30(2): 55-62, jul. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-183918

RESUMO

A positive cognitive illness representation (CIR) of diabetes is associated with better metabolic control and health. The aims of this research were to assess CIR with a newly developed Spanish scale - the ERCE - and to predict metabolic control, health outcomes, and psychological distress. One hundred and fifty-two Type 1 diabetic patients were all administered the ERCE, the MOS SF-36, the PANAS, and the HADS scales. Data on glycated hemoglobin (HbA1c) were also collected. Scores on the ERCE led to the creation of two profiles (+/- CIR) by clustering the scores. After patients were grouped, multiple hierarchical regressions were performed. A negative view of diabetes (negative CIR) was associated with poor health outcomes. The ERCE scale demonstrated acceptable psychometric guarantees and validity evidences for being used in clinical contexts. This new instrument allows educators to adjust treatment to each individual, which leads to a more efficient and better support for people with diabetes in Spain


Una representación cognitiva de la enfermedad (RCE) positiva se asocia con mejor control metabólico y mayor salud en diabetes. Los objetivos fueron evaluar la RCE con una nueva escala -la ERCE- y predecir el control metabólico, los indicadores de salud y el malestar psicológico en 152 pacientes diabéticos tipo 1. Se administraron la escala ERCE, la MOS SF-36, la PANAS y la HADS. Se recogió también la hemoglobina glicosilada (HbA1c). Mediante un análisis de clusters con las puntuaciones de la ERCE, se crearon dos perfiles (+/-RCE). El análisis de regresión jerárquico mostró que una visión negativa de la diabetes (RCE negativa) se asoció con peor estado de salud. La ERCE demostró garantías psicométricas y evidencias de validez aceptables, que justifican su uso en contextos clínicos. Este instrumento permite a los educadores evaluar la RCE y ajustar el tratamiento, lo que conduce a una asistencia más eficiente para las personas con diabetes en España


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Diabetes Mellitus Tipo 1/psicologia , Estresse Psicológico/psicologia , Estudos Transversais , Escolaridade
18.
Compr Child Adolesc Nurs ; 42(sup1): 189-196, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192710

RESUMO

To identify the effect of sleep hygiene education on sleep quality in children with Type 1 Diabetes Mellitus (T1DM), a quasi-experiment with control group and pretest-posttest design was conducted. Samples of 46 children with T1DM in IKADAR were assigned into intervention (n = 23) and control (n = 23). The intervention group received sleep hygiene education for 10 minutes via video, then applied for 3 days. Respondents completed the Pittsburgh Sleep Quality Index (PSQI) Indonesian version (pretest) and were evaluated on the third day (posttest). There was a significant difference in sleep quality score rate (p < 0.001) pre and post-intervention in the intervention group and no significant difference (p = 0.833) in the control group. There was a significant difference in sleep quality score rate between intervention and control group after intervention (p = 0.001). Sleep hygiene can improve sleep quality in children with T1DM; therefore, it can be implemented as a nursing intervention to overcome sleep disorder in children with T1DM.


Assuntos
Diabetes Mellitus Tipo 1/terapia , Educação em Saúde/normas , Higiene do Sono , Adolescente , Criança , Diabetes Mellitus Tipo 1/psicologia , Feminino , Educação em Saúde/métodos , Humanos , Indonésia , Masculino , Psicometria/instrumentação , Psicometria/métodos
19.
Compr Child Adolesc Nurs ; 42(sup1): 217-225, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192712

RESUMO

This study was conducted to identify the correlations between the coping strategies and the quality of life of children with type 1 diabetes mellitus (T1DM). This cross-sectional study involved 39 children from 13 to 18 years old with T1DM who were selected using the consecutive sampling technique. The Pediatric Quality of Life Inventory 3.2 and Coping with a Disease questionnaire were used for this research, and the statistical analysis was conducted using the Pearson and Spearman correlation tests. The average age of the participants was 15.23 years old (± 1.81), they had been diagnosed with T1DM for an average of 5.54 years (± 3.06), and 59% were females. The most commonly used coping method was wishful thinking, and the quality of life mean was 63.82. The emotional reaction (p = 0.009, r = -0.413) and acceptance (p = 0.049. r = 0.317) coping strategies were significantly correlated with the quality of life. However, the other four coping strategies had no significant correlations with the quality of life. These study findings suggest that nurses should help to prevent children with T1DM from adopting emotional reactions as long-term coping mechanisms. Moreover, they should promote the use of the acceptance coping mechanism when providing nursing care for children with T1DM.


Assuntos
Adaptação Psicológica , Diabetes Mellitus Tipo 1/complicações , Qualidade de Vida/psicologia , Adolescente , Estudos Transversais , Diabetes Mellitus Tipo 1/psicologia , Crianças com Deficiência/psicologia , Feminino , Humanos , Masculino , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e Questionários
20.
Compr Child Adolesc Nurs ; 42(sup1): 115-121, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192721

RESUMO

Children with Type-1 Diabetes Mellitus (TIDM) need long-term care that requires supervision. Without good management, there will be an increase in blood glucose, which can cause complications in organs and tissues. One way to improve self-management and level of compliance in blood glucose control is by providing education. This study aimed to determine the effect of PRISMA education on self-management and level of compliance in children with T1DM. This study used a quasi-experimental design with no control group. PRISMA education using animated videos was given to the respondents who filled out the questionnaire about self-management and level of compliance (pre-test) and were evaluated on the eighth day (post-test). The sample of this study consisted of 31 children in Jakarta, Bogor, Depok, and Tangerang. The results of this study indicate that PRISMA education had significant effects on self-management (p < 0.05) and level of compliance (p < 0.05). The delivery of self-management education in the form of animated videos could improve self-management and children's compliance in the management of diet, physical act, treatment, stress management and blood glucose control. Thus, this educational tool could be useful if it is integrated into nursing interventions, especially in the field of pediatric nursing.


Assuntos
Diabetes Mellitus Tipo 1/terapia , Educação em Saúde/normas , Cooperação do Paciente/psicologia , Autogestão/educação , Adolescente , Criança , Diabetes Mellitus Tipo 1/psicologia , Feminino , Educação em Saúde/métodos , Educação em Saúde/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Indonésia , Masculino , Cooperação do Paciente/estatística & dados numéricos , Autogestão/métodos , Inquéritos e Questionários
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