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Lee D, Lee H, Shin Y, Park G. Effectiveness of Non-pharmacological Interventions for Adolescents With Type 1 Diabetes in the Last Five Years: A Systematic Review and Meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:51-59. [PMID: 38307162 DOI: 10.1016/j.anr.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/14/2024] [Accepted: 01/29/2024] [Indexed: 02/04/2024] Open
Abstract
PURPOSE Evidence on non-pharmacological interventions for adolescents with type 1 diabetes is unclear. This review aimed to evaluate the effectiveness of non-pharmacological intervention in adolescents with type 1 diabetes. METHODS We conducted a search on databases from November 11 to 19, 2022, for randomized controlled trials for the effects of non-pharmacological intervention in adolescents with type 1 diabetes. To identify recent research trends, we included studies published from 2017 to November 2022. The risk of bias was assessed using the Cochrane risk-of-bias tool 2.0. To estimate the effect size, a meta-analysis was performed using RevMan 5.4 program and R Studio. RESULTS A total of 45 studies were included in the systematic review. Among those, 30 studies were included in the meta-analysis. Non-pharmacological interventions were significantly effective in improving Glycated hemoglobin (HbA1c) (standardized mean difference [SMD] = -0.26, 95% confidence interval [CI]: -0.42, -0.09), quality of life (SMD = 0.44, 95% CI: 0.13 to 0.76), and anxiety (SMD = -0.91, 95% CI: -1.26, -0.56). Subgroup analysis showed that duration of intervention was not a covariate related to HbA1c levels. CONCLUSIONS Non-pharmacological interventions have shown effectiveness in improving the HbA1c, quality of life, and anxiety in adolescents with type 1 diabetes. Future studies with more rigorous methodology are needed to confirm and strengthen the validity of these findings. Additionally, attention to changes in the lipid profile and self-care motivation among adolescents with type 1 diabetes is warranted. TRIAL REGISTRATION NUMBER Prospective Register of Systematic Reviews (CRD42022382190).
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Affiliation(s)
- DaeEun Lee
- College of Nursing, Pusan National University, South Korea
| | - Haejung Lee
- College of Nursing/Research Institute of Nursing Science, Pusan National University, South Korea.
| | - YoonYoung Shin
- College of Nursing, Pusan National University, South Korea
| | - Gaeun Park
- College of Nursing/Research Institute of Nursing Science, Pusan National University, South Korea
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Lee DE, Lee H, Cheon CK, Yoon JY. Healthcare coaching program for youth with type 1 diabetes in South Korea: a pilot study. CHILD HEALTH NURSING RESEARCH 2024; 30:17-30. [PMID: 38302269 PMCID: PMC10834303 DOI: 10.4094/chnr.2023.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/30/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024] Open
Abstract
PURPOSE This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes. METHODS A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed. RESULTS The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified. CONCLUSION The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.
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Affiliation(s)
- Dae Eun Lee
- Doctoral Candidate, College of Nursing, Pusan National University, Yangsan, Korea
| | - Haejung Lee
- Professor, College of Nursing · Research Institute of Nursing Science, Pusan National University, Yangsan, Korea
| | - Chong Kun Cheon
- Professor, Department of Pediatrics, College of Medicine, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Ju Young Yoon
- Professor, Department of Pediatrics, College of Medicine, Pusan National University Children’s Hospital, Yangsan, Korea
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Patience M, Janssen X, Kirk A, McCrory S, Russell E, Hodgson W, Crawford M. 24-Hour Movement Behaviours (Physical Activity, Sedentary Behaviour and Sleep) Association with Glycaemic Control and Psychosocial Outcomes in Adolescents with Type 1 Diabetes: A Systematic Review of Quantitative and Qualitative Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4363. [PMID: 36901373 PMCID: PMC10001999 DOI: 10.3390/ijerph20054363] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Type 1 Diabetes (T1D) is a condition requiring 24-hour management. The way in which an individual combines their 24-hour movement behaviours (24-h MBs), which is comprised of physical activity (PA), sedentary behaviour (SB), and sleep, throughout the day can have a significant impact on physical and mental health. This mixed methods systematic review aimed to investigate 24-h MBs' relationship with glycaemic control and psychosocial outcomes in adolescents (11-18 years) with T1D. Ten databases were searched for quantitative and qualitative English language articles reporting at least one of the behaviours and their relationship with outcomes. There were no restrictions on article publication dates or study design. Articles were subjected to title and abstract screening, full text screening, data extraction and quality assessment. Data were summarised narratively, and a meta-analysis was conducted where possible. From 9922 studies, 84 were included for data extraction (quantitative (n = 76), qualitative (n = 8)). Meta-analyses revealed a significant favourable association between PA and HbA1c (-0.22 [95% CI: -0.35, -0.08; I2 = 92.7%; p = 0.001). SB had an insignificant unfavourable association with HbA1c (0.12 [95% CI: -0.06, 0.28; I2 = 86.1%; p = 0.07]) and sleep had an insignificant favourable association (-0.03 [95% CI: -0.21, 0.15; I2 = 65.9%; p = 0.34]). Importantly, no study investigated how combinations of behaviours collectively interacted and impacted on outcomes.
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Affiliation(s)
- Mhairi Patience
- Psychology Group, Faculty of Humanities & Social Sciences, School of Psychological Sciences & Health, University of Strathclyde, Glasgow G1 1XP, UK
| | - Xanne Janssen
- Physical Activity for Health Group, Faculty of Humanities & Social Sciences, School of Psychological Sciences & Health, University of Strathclyde, Glasgow G1 1XP, UK
| | - Alison Kirk
- Physical Activity for Health Group, Faculty of Humanities & Social Sciences, School of Psychological Sciences & Health, University of Strathclyde, Glasgow G1 1XP, UK
| | - Stephanie McCrory
- Psychology Group, Faculty of Humanities & Social Sciences, School of Psychological Sciences & Health, University of Strathclyde, Glasgow G1 1XP, UK
| | - Eilidh Russell
- Physical Activity for Health Group, Faculty of Humanities & Social Sciences, School of Psychological Sciences & Health, University of Strathclyde, Glasgow G1 1XP, UK
| | - William Hodgson
- Physical Activity for Health Group, Faculty of Humanities & Social Sciences, School of Psychological Sciences & Health, University of Strathclyde, Glasgow G1 1XP, UK
| | - Megan Crawford
- Psychology Group, Faculty of Humanities & Social Sciences, School of Psychological Sciences & Health, University of Strathclyde, Glasgow G1 1XP, UK
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Ata A, Er E, Evin F, Işıklar H, Abdullayev N, Demir G, Özen S, Altınok YA, Darcan Ş, Gökşen D. Treatment and long-term follow-up of patients diagnosed with type 1 diabetes mellitus before age 5. J Pediatr Endocrinol Metab 2021; 34:201-207. [PMID: 33544547 DOI: 10.1515/jpem-2020-0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 11/19/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study aimed to determine the effects of continuous subcutaneous insulin infusion (CSII) treatment on anthropometric measurements, mean HbA1c, and insulin dosage in patients diagnosed under 5 years of age and compare with multiple-dose injection therapy (MDI). METHODS Children with type 1 diabetes mellitus, diagnosed <5 years since 2000 and their 19-year follow-up were evaluated retrospectively. Weight, height, body mass index (BMI), blood pressure, and HbA1c values were recorded for each visit. RESULTS Hundred and five patients (58.1% female, 41.9% male) were included in the study. Sixty-three (60 %) patients were treated by CSII and 42 (40%) by MDI. Mean age at diagnosis was 2.68 ± 1.42 and 3.29 ± 1.30 years respectively. Mean follow-up was 7.42 ± 4.76 and 6.01 ± 4.41 years respectively. For each group, weight standard deviation score (SDS) increased significantly in the first year after the diagnosis (p<0.001), and with the onset of puberty weight SDS decreased significantly (p<0.001). The trend of weight and BMI SDS changes over the years showed similar characteristics in both groups. During follow-up height SDS was similar in both groups except in Tanner stage 5. When puberty was completed, mean height SDS was 0.51 ± 1.03 in CSII and -0.31 ± 0.75 in the MDI group (p: 0.029). Mean HbA1c was significantly lower in the CSII group (7.62 ± 0.82 and 8.17 ± 1.22 respectively). Systolic and diastolic blood pressure change trends during the follow-up were also similar in both groups. CONCLUSIONS CSII treatment had positive effects on metabolic control and height SDS in patients with early-onset diabetes without increasing BMI.
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Affiliation(s)
- Aysun Ata
- Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Eren Er
- Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Evin
- Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Hafize Işıklar
- Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Nushaba Abdullayev
- Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Günay Demir
- Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Samim Özen
- Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Yasemin Atik Altınok
- Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Şükran Darcan
- Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Damla Gökşen
- Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
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Taş D, Mengen E, Kocaay P, Uçaktürk SA. The Effects of Risk Behaviors and Orthorexic Behavior on Glycemic Control in Adolescents with Type 1 Diabetes. J Clin Res Pediatr Endocrinol 2020; 12:233-240. [PMID: 31722516 PMCID: PMC7499139 DOI: 10.4274/jcrpe.galenos.2019.2019.0128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/14/2019] [Indexed: 12/15/2022] Open
Abstract
Objective Adolescents with chronic disease are as likely to exhibit risk-taking behavior as their peers. The aim was to investigate the risk behaviors of adolescents with type 1 diabetes (T1D) and the effect of orthorexic eating behaviors (OEB) on glycemic control (GC). Methods This cross-sectional study was conducted with 107 adolescents with T1D, aged between 13-18 years and attending high school. The Risk Behavior Scale (RBS) and Orthorexic Behavior Scale (ORTO-11) were administered. A high RBS score indicates risky behavior; a low ORTO-11 score suggests a tendency to OEB. Participants hemoglobin A1c (HbA1c) status was used to assess GC: optimal GC (HbA1c ≤7%); or poor GC (HbA1c >7%). Results Among females, those with poor GC had significantly lower (p=0.031) ORTO-11 scores than those with optimal GC, which was not the case in males. A significant correlation (r=0.358, p<0.001) was found between HbA1c and total RBS, eating habits subscale, and suicidal tendency subscale scores. Participants with poor GC had significantly higher eating habits subscale, alcohol use, and tobacco use subscale scores (p<0.05). Among females, total RBS and suicidal tendency subscale score was found to be significantly higher in those with poor GC; among males, alcohol subscale score was found to be significantly higher in those with poor GC. Conclusion This study is the first to show the effect of the tendency for OEB on GC among female adolescents with T1D. The study showed that, along with inappropriate eating behaviors, adolescents with T1D should also be assessed for other risk behaviors to help achieve optimal GC.
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Affiliation(s)
- Demet Taş
- Ankara City Hospital, Children’s Hospital, Clinic of Pediatrics, Ankara, Turkey
| | - Eda Mengen
- Ankara City Hospital, Children’s Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Pınar Kocaay
- Ankara City Hospital, Children’s Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Seyit Ahmet Uçaktürk
- Ankara City Hospital, Children’s Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
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