Metabolic and Clinical Outcomes in Type 1 Diabetes in the COVID-19 Pre- and Post-Vaccination Periods in Spain: The COVID-SED1 Study.

Aims: To evaluate the metabolic and clinical outcomes in the Spanish type 1 diabetes mellitus (T1D) population before and after COVID-19 vaccination. Methods: A retrospective observational study was carried out in Spanish public hospitals previously enrolled in the SED1 study. Adults and children with T1D were included and their clinical electronic records were reviewed. Clinical, laboratory, and glucometric parameters from continuous glucose monitoring (CGM) data corresponding to the periods before and after administering the first COVID-19 vaccination were analyzed. Results: A total of 26 centers and 228 patients participated in this new phase of the SED1 study and 187 were finally evaluable (mean age 37.5 ± 15.6 years, 56.7% women). Overall, 94.6% of the sample was vaccinated, and this percentage increased with higher levels of education (p-value = 0.027). In the pre- and post-vaccination periods, respectively, the number of patients with acute hyperglycemic decompensation was 6/161 (3.7%) and 7/161 (4.3%) (p = 1) and with acute hypoglycemic decompensation was 6/161 (3.7%) and 6/161 (3.7%) (p = 1). The HbA1c level was lower in the post-vaccination period(mean ± SD, mg/dL): pre-vaccination 7.4 ± 0.9; post-vaccination 7.2 ± 1.0, (-0.19; p-value = 0.0006). A total of 31.9% of patients (95% CI: 24.7-39.7) in the pre-vaccination period and 45.0% (IC95%: 37.1-53.1) in the post-vaccine period had HbA1c < 7% (p-value < 0.001). Glucometrics from CGM data also showed numerical improvements post-vaccination. Conclusions: The COVID-19 vaccination was highly accepted in the Spanish T1D population, with hesitancy about the COVID-19 vaccine being higher in those with lower educational levels. A mildly better glycemic control was observed in the post-vaccination period.

Estrés en madres y padres de niños/as con diabetes: validación de la versión española de la escala Problem Areas in Diabetes (PAID-PR) / Stress among mothers and fathers of children with diabetes: Validation of the Spanish version of the Problem Areas in Diabetes scale (PAID-PR)

La experiencia continuada de estrés asociada al cuidado de un hijo/a con diabetes puede afectar el bienestar emocional de sus progenitores. El objetivo de este estudio fue analizar la estructura factorial, fiabilidad y validez de la versión española de la escala Problem Areas in Diabetes-Parent Revised (PAID-PR). Un total de 237 progenitores (146 madres y 91 padres) de niños/as y adolescentes con diabetes tipo 1 (2-17 años) completaron la escala PAID-PR. El análisis factorial exploratorio identificó 2 factores. Las puntuaciones en la escala total y por factores de la PAID-PR correlacionaron con las medidas de ansiedad-rasgo. Además, las madres presentaron niveles más altos de estrés. Los resultados indican que la versión española de la escala PAID-PR es una medida breve, fiable y válida que puede usarse en contextos clínicos y de investigación

The constant experience of stress associated with caring for a child with diabetes can affect the emotional well-being of their parents. The main purpose of the present study was to analyse the factor structure, reliability and validity of the Spanish version of the Problem Areas in Diabetes-Parent Revised (PAID-PR) scale. Two hundred and thirty seven parents (146 mothers and 91 fathers) of children and adolescents with type 1 diabetes completed the PAID-PR. Exploratory factor analysis yielded 2 factors. As expected, PAID-PR scores correlated with measures of trait-anxiety. Mothers reported higher stress levels. Results indicate that the Spanish version of the PAID-PR is a reliable and valid brief measure, useful in research and clinical settings

Validation of the Spanish version of the Problem Areas in Diabetes (PAID-SP) Scale.

This study aimed to assess the psychometric properties of the Spanish version of the Problem Areas in Diabetes (PAID-SP) Scale. Data were collected from patients with type 1 and type 2 diabetes. The findings suggested that the PAID-SP is a reliable and valid measure of diabetes-specific emotional problems.

Estrategias de afrontamiento y bienestar emocional en padres y madres de niños y adolescentes con diabetes: diferencias de género / Coping strategies and well-being in parents of children with diabetes: Gender differences

El impacto del cuidado de la diabetes de un hijo parece ser distinto entre padres y madres. Este estudio examina las diferencias en las estrategias de afrontamiento y en los niveles de bienestar emocional de madres y padres de niños con diabetes, así como la asociación de ciertas estrategias de afrontamiento con su bienestar emocional. Un total de 103 madres y 63 padres de niños y adolescentes con diabetes tipo 1 completaron un cuestionario de afrontamiento de la diabetes y el índice de bienestar de la OMS. Se encontró un efecto significativo del género en el uso de estrategias de afrontamiento. Las madres buscaban más apoyo social, usaban más las estrategias de planificación y expresaban más sus emociones negativas. Entre los padres, la expresión emocional y el uso del pensamiento desiderativo se asociaban con su bienestar. Para las madres, sólo la expresión de emociones negativas se asociaba con el bienestar. Los resultados revelan la importancia de evaluar las estrategias de afrontamiento para detectar estrategias no adaptativas (AU)

The impact of caring for a child with diabetes seems to be different for fathers and mothers. This study examined the differences in coping strategies and emotional well-being between mothers and fathers of children with diabetes as well as the association between certain coping strategies and parents’ well-being. One hundred and three mothers and 63 fathers of children and adolescents with type 1 diabetes completed questionnaires on their coping strategies and emotional well-being. There was a significant gender effect in the use of coping strategies. Mothers were more likely than fathers to seek social support, to use planful problem-solving and express negative emotions. For fathers, emotional expression and wishful thinking were associated with well-being. Among women, the expression of negative emotions was negatively associated with well-being. Results reveal the importance of assessing parents’ emotional well-being and exploring their coping styles in order to detect maladaptive strategies (AU)

Assessment of parent-adolescent partnership in diabetes care: a review of measures.

PURPOSE: To identify and evaluate psychometric properties of available measures to assess dimensions of parent-adolescent partnership in diabetes care, including parent-adolescent responsibility in diabetes management, parental monitoring, diabetes family conflict, and parental involvement. METHODS: A literature review that included searches of electronic databases from 1990 to April 2009 was conducted. Instruments were reviewed extracting information about aim, target population, and psychometric properties. RESULTS: Eight instruments were identified. Study samples appear to be large enough for psychometric validation but with a small proportion of fathers. The instruments have been designed and evaluated with adolescents and parents in the United States. Most of the instruments have adequate reliability, both for adolescents' and parents' forms. Regarding construct validity, factor structure of most of the instruments was evaluated either with exploratory factor analysis or confirmatory factor analysis. In addition, some measures have significant relationships with age in the direction expected or with other outcomes such as adherence or quality of life. Finally, all the reviewed studies are cross-sectional and have not yet addressed predictive validity or instrument responsiveness. CONCLUSIONS: Valid measures tapping into aspects of diabetes-related adolescent-parent partnership are available, but longitudinal studies are needed to determine if the instruments are able to detect clinically significant change (eg, impact on metabolic control, adherence, quality of life). Rather than develop new measures, refinement and further validation of existing instruments is suggested.

Beliefs about insulin as a predictor of fear of hypoglycaemia.

The present study extends previous research by exploring the predictive value of beliefs about insulin therapy in fear of hypoglycaemia (FoH). Data were collected on 81 Spanish adults (aged 18-58 years) with type 1 diabetes. Participants completed a survey questionnaire containing the following measures: state-trait anxiety inventory, beliefs about medicines questionnaire (specific scale), a modified version of the FoH Survey (worry scale) and different questions about demographic and clinical information (duration of diabetes, daily shots of insulin, severe hypoglycaemic episodes, metabolic control). Regression analyses showed that history of severe hypoglycaemic episodes and concerns about insulin therapy had the most predictive influence on FoH. Treatment perceptions, particularly concerns about insulin, were related to reported FoH. However, FoH is a complex phenomenon and more research is needed in order to gain a better understanding of its predictors and correlates.