ABSTRACT
INTRODUCTION: To examine general and diabetes-related stressors in early adolescents with type 1 diabetes (T1D). METHOD: Data were from 205 participants (58% female; 33% minority; 11-14 years) enrolled in a clinical trial. Teens identified their top 3 stressors and responded to open-ended questions. A content analysis method was used to identify themes across stressor categories. RESULTS: Eight-two percent of teens reported that school was a top stressor, followed by social life (49%) and diabetes (48%). We identified 5 themes of general life stressors (fitting in, having friends, balancing competing demands, living with family, and feeling pressure to do well) and 3 themes of diabetes-specific stressors (just having diabetes, dealing with emotions, and managing diabetes). DISCUSSION: Though teens with T1D experienced stressors specific to T1D, they perceived stress related to normal adolescent growth and development more frequently. Teens with T1D may need psychosocial support that holistically addresses both typical developmental and diabetes-related stressors.
Subject(s)
Adaptation, Psychological , Adolescent Behavior/psychology , Adolescent Health Services , Diabetes Mellitus, Type 1/psychology , Social Support , Stress, Psychological/psychology , Adolescent , Attitude to Health , Cross-Sectional Studies , Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 1/physiopathology , Emotions , Female , Friends , Humans , Male , Medication Adherence/statistics & numerical data , Qualitative Research , Randomized Controlled Trials as Topic , Self Care/psychology , Stress, Psychological/diagnosis , Stress, Psychological/physiopathologyABSTRACT
Sagittal abdominal diameter (SAD) was obtained in 65 adolescents referred for assessment of cardiometabolic risk. We found that SAD was associated with cardiometabolic risk factors independent of BMI in males, but that SAD was not superior to BMI or other measures of abdominal adiposity for the detection of metabolic syndrome.
Subject(s)
Abdominal Fat/pathology , Adiposity , Anthropometry , Cardiovascular Diseases/diagnosis , Metabolic Syndrome/diagnosis , Obesity, Abdominal/diagnosis , Adolescent , Body Mass Index , Cardiovascular Diseases/etiology , Child , Female , Humans , Male , Metabolic Syndrome/etiology , Risk FactorsABSTRACT
Sixty-three parents with a child or an adolescent with type 1 diabetes participated in this study that focused on what helped them "live well with diabetes." Beyond medical expertise, parents described a partnering relationship with their provider as one of the factors that supported their efforts to live well with diabetes. Parents reported that a partnership was enhanced when the provider had the ability to understand the dynamic nature of the journey in living with diabetes, connect with their family and set the tone by inviting them to openly communicate about all aspects of family life impacting diabetes care, recognize when and how the provider may have to assume the role of Captain of the Ship in times of need, and empathize and respond therapeutically to intense emotions inherent in managing diabetes over time.
Subject(s)
Child Health/trends , Communication , Diabetes Mellitus, Type 1 , Parent-Child Relations , Parents/psychology , Physician-Patient Relations , Self Care/standards , Adolescent , Female , Focus Groups , Humans , Male , Qualitative Research , Surveys and QuestionnairesABSTRACT
Of 1112 children with type 1 diabetes, dilated eye exams were performed in 717 (64%). Children were less likely to be screened for diabetic retinopathy (DR) if they were black (OR=1.6; p=0.005) or had poorer diabetes control (p=0.002). Those at greatest risk for DR were least likely to be screened.
Subject(s)
Diabetes Mellitus, Type 1/complications , Diabetic Retinopathy/ethnology , Ethnicity/statistics & numerical data , Health Status Disparities , Mass Screening/statistics & numerical data , Adolescent , Child , Diabetes Mellitus, Type 1/physiopathology , Diabetic Retinopathy/etiology , Diabetic Retinopathy/prevention & control , Female , Follow-Up Studies , Humans , Male , Prognosis , Racial Groups , Retrospective StudiesABSTRACT
There is little research about what parents of children with diabetes want and need from their health-care providers as they negotiate life with diabetes. Sixty-three parents of children with type 1 diabetes were interviewed. Interviews were tape-recorded and transcribed verbatim, and a content analysis of text data was conducted. Three themes emerged describing what they wanted in their relationships with diabetes providers: laying the foundation, providing clinical care, and engaging families as partners. Collectively, these data provide vivid insights into the parent's perspective regarding their needs from diabetes providers as well as their perceptions of interactions that were unhelpful or worse, hurtful or undermining.
Subject(s)
Diabetes Mellitus, Type 1/therapy , Parents , Patient Satisfaction , Physician-Patient Relations , Adolescent , Child , Disease Management , Humans , Power, PsychologicalABSTRACT
Adolescents with type 1 diabetes reported more clinically significant depressive symptoms in the spring/summer months (22% in April-September) than in the fall/winter months (11% in October-March) (χ(2)=5.67, p=.018). This seasonal pattern was stronger in low-income adolescents than in adolescents from higher-income families.
Subject(s)
Depression/pathology , Diabetes Mellitus, Type 1/psychology , Seasons , Adolescent , Child , Female , Humans , Male , Socioeconomic Factors , Young AdultABSTRACT
PURPOSE: The purpose of this article is to review risk behaviors and their health consequences in adolescents with type 1 diabetes. The existing literature on common risk behaviors in adolescents is examined, with a focus on illicit drug use, alcohol use, smoking, unprotected sexual activity, and disordered eating behaviors. CONCLUSIONS: A review of the literature highlights the lack of studies of risk behaviors in this population. Much of what is known comes from studies with adolescents in the general population or from studies of adults with type 1 diabetes. Known risk and protective factors for risk behaviors and health outcomes are noted. Based on these findings, suggestions are provided for diabetes educators and health care providers to assess for and prevent risk behaviors in adolescents with type 1 diabetes. Directions for future research in this population are indicated, including the need to develop and test standardized prevention programs.
Subject(s)
Diabetes Mellitus, Type 1/rehabilitation , Health Education , Risk-Taking , Adolescent , Alcohol Drinking/prevention & control , Diabetes Mellitus, Type 1/psychology , Feeding and Eating Disorders/prevention & control , Female , Humans , Male , Risk Assessment , Sexual Behavior , Smoking Prevention , Substance-Related Disorders/prevention & controlABSTRACT
BACKGROUND: The development of instruments to measure self-management in youth with type 1 diabetes has not kept up with current understanding of the concept. OBJECTIVE: This study aimed to report the development and the testing of a new self-report measure to assess the Self-Management of Type 1 Diabetes in Adolescents (SMOD-A). METHODS: Following a qualitative study, items were identified and reviewed by experts for content validity. A total of 515 adolescents, 13 to 21 years old, participated in a field study by completing the SMOD-A (either once or twice) and additional measures of diabetes-related self-efficacy (Self-Efficacy for Diabetes Scale), quality of life (Diabetes Quality of Life for Youth Questionnaire), self-management (Diabetes Self-Management Profile), and adherence (Self-Care Inventory). Data were collected also on metabolic control (glycosylated hemoglobin [HbA1c]). RESULTS: The content validity index was .93. Exploratory alpha factor analyses revealed five subscales: Collaboration With Parents, Diabetes Care Activities, Diabetes Problem Solving, Diabetes Communication, and Goals (alpha = .71 to .85). The stability of the SMOD-A ranged from .60 to .88 at 2 weeks (test-retest) to .59 to .85 at 3 months. Correlations of SMOD-A subscales with Self-Efficacy for Diabetes Scale-Diabetes; Diabetes Quality of Life for Youth Questionnaire satisfaction, impact, and worry; Diabetes Self-Management Profile; and Self-Care Inventory were generally significant and in the expected direction. Collaboration with parents and HbA1c values were related significantly and positively (r = .11); all other SMOD-A subscales were related significantly and negatively to HbA1c (r = -.10 to -.26), demonstrating that better self-management is associated somewhat with better metabolic control and supporting construct validity of the new measure. DISCUSSION: The SMOD-A has been found to be a reliable, stable, and valid measure of SMOD-A.
