ABSTRACT
INTRODUCTION: While a few studies have assessed the association between personality and metabolic outcomes in children and adolescents with type 1 diabetes (T1DM), there have been none in adults or in subjects treated with insulin pumps, and hypoglycaemic episodes have not been considered in these studies. The aim of this observational single-visit study was to assess the association between personality traits and metabolic control, hypoglycaemic episodes and insulin pump use in adult T1DM patients. METHODS: Data were obtained from 52 adults with T1DM treated in a tertiary care centre (no complications or comorbidities; aged 27 ± 8 years; diabetes duration of 12.8 ± 6.8 years; treated with insulin pumps for 6.3 ± 0.4 years). "Big Five" personality traits (neuroticism, extraversion, openness, agreeableness and conscientiousness) were assessed using the NEO-Five Factor Inventory questionnaire. Data on HbA1c, blood glucose levels, frequency of glucose testing, the number of hypoglycaemic episodes (< 3.9 mmol/l), basal and prandial insulin doses, and the number and types of boluses in the last 14 days were obtained from the insulin pumps and glucometers. RESULTS: The mean levels of the assessed parameters were: HbA1c 7.2 ± 1.2% (55.0 ± 13.1 mmol/mol), episodes of hypoglycaemia 7.0 (3.00-9.75) and glucose tests per day 7.3 ± 3.9. All personality traits showed average intensity. None of the traits were associated with HbA1c, glycaemia, number of glucose tests, or number or kind of insulin boluses. Conscientiousness was the only factor associated with the incidence of hypoglycaemia in both univariate (r = + 0.46, p < 0.001) and multivariate (ß = + 0.41, p < 0.001) analyses. CONCLUSIONS: Despite results reported for children and adolescents, personality traits of adult patients with T1DM were not essential for metabolic control assessed by HbA1c or for the use of insulin pump functions; however, higher conscientiousness may be related to more frequent hypoglycaemic episodes. Extrinsic factors should be searched as more relevant for metabolic control and proper use of very expensive insulin pump therapy.
ABSTRACT
Recently, the Paleolithic diet became popular due to its possible health benefits. Several, albeit not all, studies suggested that the consumption of the Paleolithic diet might improve glucose tolerance, decrease insulin secretion, and increase insulin sensitivity. Therefore, the aim of this meta-analysis was to compare the effect of the Paleolithic diet with other types of diets on glucose and insulin homeostasis in subjects with altered glucose metabolism. Four databases (PubMed, Web of Sciences, Scopus, and the Cochrane Library) were searched to select studies in which the effects of the Paleolithic diet on fasting glucose and insulin levels, glycated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), and area under the curve (AUC 0-120) for glucose and insulin during the oral glucose tolerance test were assessed. In total, four studies with 98 subjects which compared the effect of the Paleolithic diet with other types of diets (the Mediterranean diet, diabetes diet, and a diet recommended by the Dutch Health Council) were included in this meta-analysis. The Paleolithic diet did not differ from other types of diets with regard to its effect on fasting glucose (standardized mean difference (SMD): -0.343, 95% confidence interval (CI): -0.867, 0.181, p = 0.200) and insulin (SMD: -0.141; 95% CI: -0.599, 0.318; p = 0.548) levels. In addition, there were no differences between the Paleolithic diet and other types of diets in HOMA-IR (SMD: -0.151; 95% CI: -0.610, 0.309; p = 0.521), HbA1c (SMD: -0.380; 95% CI: -0.870, 0.110; p = 0.129), AUC 0-120 glucose (SMD: -0.558; 95% CI: -1.380, 0.264; p = 0.183), and AUC 0-120 insulin (SMD: -0.068; 95% CI: -0.526, 0.390; p = 0.772). In conclusion, the Paleolithic diet did not differ from other types of diets commonly perceived as healthy with regard to effects on glucose and insulin homeostasis in subjects with altered glucose metabolism.
