Diabetes research and clinical practice最新文献_第3页

Knowledge, attitudes, and practices of elderly diabetes patients regarding home emergency management of acute complications 老年糖尿病患者关于急性并发症家庭急救管理的知识、态度和实践。

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112000

Li Wang, Runzhi Wen, Gaizhen Zhang, Naiqian Zhao

Aims

This study aims to assess the knowledge, attitudes, and practices (KAP) of elderly diabetic patients regarding the home emergency management of acute diabetic complications, which is critical for preventing severe outcomes and ensuring timely intervention in emergencies.

Methods

This cross-sectional study was conducted between September and October 2024 at the Second Hospital of Shanxi Medical University, among all elderly diabetic patients who voluntarily participated. Demographic information and KAP scores were evaluated.

Results

A total of 409 valid questionnaires were analyzed, yielding an effective rate of 98.32 %. Among the participants, 218 (53.3 %) were female, and 134 (32.76 %) had been diagnosed with diabetes for less than 1 year. The mean scores for KAP were 12.98 ± 6.65 (possible range: 0–28), 45.76 ± 6.30 (possible range: 11–55), and 51.74 ± 8.24 (possible range: 13–65), respectively. Structural equation modeling (SEM) revealed that education level, diabetes health education, and main treatment method significantly influenced knowledge. Additionally, knowledge and complicating diseases impacted attitude, while both knowledge and attitude strongly influenced practice. Education level, diabetes health education, and main treatment method also indirectly affected attitude and practice.

Conclusion

Elderly diabetic patients demonstrated inadequate knowledge but exhibited generally positive attitudes and practices regarding the home emergency management of acute diabetic complications.

目的：本研究旨在评估老年糖尿病患者对急性糖尿病并发症家庭急救管理的知识、态度和实践（KAP），这对于预防严重后果和确保紧急情况的及时干预至关重要。方法：本横断面研究于2024年9 - 10月在山西医科大学第二医院进行，研究对象为自愿参加的老年糖尿病患者。评估人口统计信息和KAP评分。结果：共分析有效问卷409份，有效率为98.32%。在参与者中，218名（53.3%）是女性，134名（32.76%）被诊断患有糖尿病少于1年。KAP平均评分分别为12.98±6.65（可能范围0 ~ 28）、45.76±6.30（可能范围11 ~ 55）、51.74±8.24（可能范围13 ~ 65）。结构方程模型（SEM）显示，教育程度、糖尿病健康教育和主要治疗方法对知识有显著影响。此外，知识和并发症影响态度，而知识和态度都强烈影响实践。教育程度、糖尿病健康教育、主要治疗方法也间接影响态度和行为。结论：老年糖尿病患者对急性糖尿病并发症的家庭急救认识不足，但总体上表现出积极的态度和做法。

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引用次数: 0

Evolution of myocardial steatosis in high cardiovascular risk T2DM patients treated by GLP1 receptor agonists: LICAS study

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112017

Lina Houbachi , Paul Michael Walker , Isabelle Fournel , Elea Ksiazek , Jean-Michel Petit , Alexandre Cochet , Thibault Leclercq , Antoine Roger , Isabelle Simoneau , Benjamin Bouillet , Charles Guenancia

Background

We hypothesized that the reduction of intramyocardial fat content may be involved in the cardioprotective effect of glucagon-like peptide-1 receptor agonists (GLP1-RA) in patients with type 2 diabetes (T2D). Therefore, we aimed to evaluate the change in intramyocardial triglyceride content in T2D patients treated with GLP1-RA.

Methods

This monocentric proof-of-concept cohort study included patients with unbalanced T2D prior to the introduction of GLP1-RA. Patients underwent cardiac magnetic resonance imaging (MRI) coupled with nuclear magnetic resonance (NMR) spectroscopy at baseline and six months after the introduction (M6) of a GLP1-RA to assess changes in intramyocardial triglyceride levels and morphological, functional, and cardiac tissue parameters. The relative delta (Δ_r) between baseline and M6 was calculated and analyzed by Student test or sign test.

Results

Twenty-six patients (mean age = 62.2 ± 6.7 years, median HbA1c = 9.1 %) fulfilled inclusion criteria and had both NMR measures. Compared with baseline, relative intramyocardial triglyceride levels significantly decreased after six months of treatment (mean Δ_r = -26 % [95 %CI:-39; −13]p = 0.003), as well as glycated hemoglobin (HbA1c) (median Δ_r = -26 % [IQR:25], p < 0.0001), body mass index (BMI) (mean Δ_r = -6% [-9; −4], p < 0.0001) and left ventricular mass (mean Δ_r = -6 [-12; −1] p = 0.02). The relative evolution of intramyocardial triglyceride content was not correlated with the relative evolution of HbA1c (r = 0.10) and BMI (r = -0.02).

Conclusions

We demonstrate a significant reduction in intramyocardial triglyceride content in patients with T2D after six months of treatment with GLP1-RA. The lack of correlation with reductions in HbA1c and BMI suggests a specific effect of GLP1-RA on myocardial steatosis, which might contribute to their previously demonstrated cardiovascular benefits.

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引用次数: 0

Maternal vascular dysfunction in gestational diabetes is associated with birth of small neonates

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112032

Christos Chatzakis , Sarah Lausegger , Erika Sembrera , Sofia Vargas , Kypros H Nicolaides , Marietta Charakida

Aims

The study aimed to evaluate maternal hemodynamic and vascular changes in women with small-for-gestational age(SGA) and large-for-gestational age(LGA) fetuses in the presence and absence of gestational diabetes mellitus(GDM).

Materials

Women at 35⁺⁰ to 36⁺⁶ weeks’ gestation with and without GDM were included. Maternal demographics, ultrasound for fetal growth, Doppler studies of uterine and ophthalmic arteries, carotid–femoral pulse-wave velocity(PWV), augmentation index, cardiac output, and total peripheral resistance(TPR) were recorded. Multinomial logistic regression was used.

Results

Of 11,132 women, 1,228(11.0%) developed GDM. In GDM pregnancies, 158(12.8%) delivered SGA and 136(11.1%) delivered LGA neonates, while non-GDM pregnancies had 1,051(10.6%) SGA and 806(8.1%) LGA neonates. In GDM and non-GDM women, SGA groups had the highest uterine artery pulsatility index(PI) percentiles, PWV and ophthalmic artery peak systolic velocity ratio. PWV was higher in the GDM SGA group compared to non-GDM SGA group. Cardiac output was lower in SGA groups when compared to the AGA group. In women with GDM, TPR, ophthalmic artery PSV ratio and uterine artery PI percentile had a positive association with the development of SGA.

Conclusions

Women with GDM and vascular dysfunction have higher risk to deliver SGA neonates. Maternal hemodynamic and vascular maladaptation could potentially explain the development of SGA in women with GDM.

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引用次数: 0

Physical activity guidelines for adults with type 2 Diabetes: Systematic review 成人2型糖尿病患者的身体活动指南：系统综述

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2024.111982

Eda Tonga , Hannah Worboys , Rachael A. Evans , Sally J. Singh , Melanie J. Davies , G. Andre Ng , Thomas Yates

Aims

The aim of this study was to systematically review recommendations on physical activity for adults with type 2 diabetes (T2D).

Methods

Online databases were searched for clinical practice guidelines (CPGs), statements, and recommendations. Two authors screened the guidelines based on eligibility criteria. FITT (Frequency, Intensity, Time, Type) for physical activity and disease-specific precautions were extracted independently. The methodological quality of CPGs was assessed using the AGREE II instrument. Recommendations were categorized according to FITT, with disease-specific adaptations also recorded.

Results

Fifteen guidelines were included. Nine underwent AGREE II evaluation, with three rated high quality and the rest moderate to low. The predominant recommendation was to engage in at least 150 min of moderate aerobic exercise per week. Adaptations for T2D focused on glucose levels, diet, foot care, weather conditions, sedentary behaviour, neuropathy, and retinopathy.

Conclusion

While guidelines consistently recommended aerobic exercise, there was limited emphasis on strength and flexibility exercises. Significant limitations in methodological and reporting quality were noted, especially in stakeholder involvement and applicability. Future guidelines should use a standardized FITT framework and adhere to standard development methods to enhance usability for healthcare professionals and patients.

目的：本研究的目的是系统地回顾2型糖尿病（T2D）成人的身体活动建议。方法：检索在线数据库中的临床实践指南（CPG）、声明和建议。两位作者根据资格标准对指南进行了筛选。独立提取体力活动和疾病特异性预防措施的FITT（频率、强度、时间、类型）。CPGs的方法学质量使用AGREE II仪器进行评估。根据FITT对建议进行了分类，并记录了针对特定疾病的适应情况。结果：纳入了15条指南。9例进行了AGREE II评估，其中3例为高质量，其余为中低质量。最主要的建议是每周至少150 分钟的适度有氧运动。T2D的适应主要集中在血糖水平、饮食、足部护理、天气条件、久坐行为、神经病变和视网膜病变。结论：虽然指南一直推荐有氧运动，但对力量和柔韧性锻炼的重视程度有限。注意到在方法和报告质量方面的重大限制，特别是在利益相关者参与和适用性方面。未来的指南应使用标准化的FITT框架，并遵循标准的开发方法，以增强医疗保健专业人员和患者的可用性。

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引用次数: 0

Burden of vascular risk factors by age, sex, ethnicity and deprivation in young adults with and without newly diagnosed type 2 diabetes 在有和没有新诊断的2型糖尿病的年轻人中，按年龄、性别、种族和剥夺程度划分的血管危险因素负担

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112002

Jonathan Goldney , Mary M. Barker , Jack A. Sargeant , Enya Daynes , Dimitris Papamargaritis , Sharmin Shabnam , Louise M. Goff , Kamlesh Khunti , Joseph Henson , Melanie J. Davies , Francesco Zaccardi

Aims

Do associations between age at diagnosis of type 2 diabetes and vascular risk factors vary by ethnicity and deprivation?

Methods

Utilising the Clinical Practice Research Datalink, we matched 16–50-year-old individuals with newly diagnosed type 2 diabetes to ∼10 individuals without using sex, age and primary care practice. Differences in BMI, obesity, LDL-cholesterol, HbA1c, and hypertension between individuals with vs without type 2 diabetes across sex, age, ethnicity and deprivation quintiles were explored using generalised linear models.

Results

We included 108,061 individuals (45.6% women) with newly diagnosed type 2 diabetes and 829,946 controls. BMI, obesity, LDL-cholesterol, and hypertension were higher in individuals with vs without type 2 diabetes. Across both sexes, all ethnic groups and deprivation quintiles, these differences were larger with an earlier age, particularly for BMI and obesity. Association between age and HbA1c were variable across subgroups. Differences in BMI, obesity, and hypertension (individuals with vs without diabetes) were largest in White individuals and with less deprivation.

Conclusions

The increased vascular risk phenotype associated with an earlier age of diagnosis of type 2 diabetes was consistent across ethnic and deprivation groups. Population-based strategies are needed to address the risk associated with early-onset type 2 diabetes, especially weight-management-based strategies.

目的：2型糖尿病诊断年龄与血管危险因素之间的关系是否因种族和贫困而异？方法：利用临床实践研究数据链，我们将16-50岁的新诊断为2型糖尿病的个体与10个个体进行匹配，不使用性别、年龄和初级保健实践。使用广义线性模型探讨了2型糖尿病患者与非2型糖尿病患者在性别、年龄、种族和贫困五分位数之间的BMI、肥胖、ldl -胆固醇、HbA1c和高血压的差异。结果：我们纳入了108061例新诊断的2型糖尿病患者（45.6%为女性）和829946例对照。2型糖尿病患者的BMI、肥胖、低密度脂蛋白胆固醇和高血压均高于非2型糖尿病患者。在两性、所有种族和贫困五分之一人群中，年龄越早，这些差异就越大，尤其是在体重指数和肥胖方面。年龄与HbA1c之间的相关性在不同亚组中是不同的。白人在体重指数、肥胖和高血压（糖尿病患者与非糖尿病患者）方面的差异最大，且贫困程度较低。结论：血管风险表型的增加与2型糖尿病诊断年龄的早期相关，在种族和贫困群体中是一致的。需要以人群为基础的策略来解决与早发性2型糖尿病相关的风险，特别是以体重管理为基础的策略。

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引用次数: 0

Midline venous catheter: New insights for its use in hospitalized patients with diabetes 中线静脉导管在糖尿病住院患者中的应用

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-02-01 DOI: 10.1016/j.diabres.2025.112003

Marc Rivas , Mercè Abad , Eva Carnicero , Lidia Pereda , Raquel Corredor , Montserrat Martínez , Pablo Martínez , Francisco J. García de la Torre , Ana M. Olmo , Laura Millán , Olga Simó-Servat , Cristina Hernández , Andreea Ciudin , Rafael Simó

In a prospective study we found that in hospitalized patients with diabetes the use of mid line venous catheter (MVC) resulted in a significantly lower rate of vascular complications than short cannulas. However, a special attention should be paid to catheter obstruction when MCV is used.

在一项前瞻性研究中，我们发现在住院的糖尿病患者中，使用中线静脉导管（MVC）导致血管并发症的发生率明显低于短导管。然而，当使用MCV时，应特别注意导管阻塞。

引用次数: 0

The role of depression and diabetes distress in glycemic control: A meta-analysis

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-01-30 DOI: 10.1016/j.diabres.2025.112014

Kenni Wojujutari Ajele, Erhabor Sunday Idemudia

Aims

This study evaluated the associations between depression, diabetes distress, glycemic control (HbA1c), and self-care behaviours in individuals with diabetes. Findings on these relationships have been inconsistent, highlighting the need for systematic evaluation.

Methods

Data from 61 studies involving 19,537 participants conducted between 2001 and 2024 were analysed using random-effects models. Subgroup analyses examined variations by diabetes type, geographic location, and measurement tools. Heterogeneity was assessed using I² statistics.

Results

Depression and diabetes distress were significantly associated with poorer glycemic control (r = 0.23, 95 % CI [0.15 to 0.31], p < 0.001) and reduced self-care behaviours (r = –0.19, 95 % CI [–0.28 to –0.10], p < 0.001). Stronger correlations were observed in mixed diabetes populations (r = 0.35, 95 % CI [0.30 to 0.40], I² = 0 %) and in studies conducted in Europe (r = 0.28) and North America (r = 0.34). High heterogeneity (I² = 97.24 %) was identified.

Conclusions

Depression and diabetes distress are associated with poorer glycemic control and reduced self-care behaviours. Findings highlight the need for standardized measures and longitudinal studies to explore mechanisms underlying these associations.

{"title":"The role of depression and diabetes distress in glycemic control: A meta-analysis","authors":"Kenni Wojujutari Ajele, Erhabor Sunday Idemudia","doi":"10.1016/j.diabres.2025.112014","DOIUrl":"10.1016/j.diabres.2025.112014","url":null,"abstract":"<div><h3>Aims</h3><div>This study evaluated the associations between depression, diabetes distress, glycemic control (HbA1c), and self-care behaviours in individuals with diabetes. Findings on these relationships have been inconsistent, highlighting the need for systematic evaluation.</div></div><div><h3>Methods</h3><div>Data from 61 studies involving 19,537 participants conducted between 2001 and 2024 were analysed using random-effects models. Subgroup analyses examined variations by diabetes type, geographic location, and measurement tools. Heterogeneity was assessed using I<sup>2</sup> statistics.</div></div><div><h3>Results</h3><div>Depression and diabetes distress were significantly associated with poorer glycemic control (r = 0.23, 95 % CI [0.15 to 0.31], p < 0.001) and reduced self-care behaviours (r = –0.19, 95 % CI [–0.28 to –0.10], p < 0.001). Stronger correlations were observed in mixed diabetes populations (r = 0.35, 95 % CI [0.30 to 0.40], I<sup>2</sup> = 0 %) and in studies conducted in Europe (r = 0.28) and North America (r = 0.34). High heterogeneity (I<sup>2</sup> = 97.24 %) was identified.</div></div><div><h3>Conclusions</h3><div>Depression and diabetes distress are associated with poorer glycemic control and reduced self-care behaviours. Findings highlight the need for standardized measures and longitudinal studies to explore mechanisms underlying these associations.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"221 ","pages":"Article 112014"},"PeriodicalIF":6.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-effectiveness of AI-based diabetic retinopathy screening in nationwide health checkups and diabetes management in Japan: A modeling study

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-01-30 DOI: 10.1016/j.diabres.2025.112015

Yoko Akune , Ryo Kawasaki , Rei Goto , Hiroshi Tamura , Yoshimune Hiratsuka , Masakazu Yamada

Aims

We evaluated the cost-effectiveness of artificial intelligence (AI)-based diabetic retinopathy (DR) screening in Japan. This evaluation compared the simultaneous introduction of AI in nationwide health checkups, namely “specific health check-ups in Japan” (SHC), and diabetes complication management (AI-case) with the current situation where AI is not being introduced (conventional-case) from the healthcare payer’s perspective.

Methods

A cost-effectiveness analysis was conducted using a new individual-based state transition model. Model parameters, including the incidence and progression of DR, health utility values, and costs of screening and treatment, were based on literature data and expert opinion. The analysis estimated quality-adjusted life years (QALYs), cumulative costs, and incremental cost-effectiveness ratios (ICER).

Results

The ICER comparing the AI-case with conventional-case was estimated to be JPY 1,598,244/QALY (USD 11,375/QALY), which is below the willingness-to-pay threshold of JPY 5 million/QALY (USD 35,584/QALY). Scenario analyses revealed that ICERs for the AI-based DR screening in SHC-only condition was JPY 1,895,226/QALY (USD 13,488/QALY) and JPY 3,960,839/QALY (USD 28,189/QALY) in diabetes management-only condition.

Conclusions

The introduction of AI-based DR screening for SHC and diabetes management was cost-effective compared to the current situation in Japan.

{"title":"Cost-effectiveness of AI-based diabetic retinopathy screening in nationwide health checkups and diabetes management in Japan: A modeling study","authors":"Yoko Akune , Ryo Kawasaki , Rei Goto , Hiroshi Tamura , Yoshimune Hiratsuka , Masakazu Yamada","doi":"10.1016/j.diabres.2025.112015","DOIUrl":"10.1016/j.diabres.2025.112015","url":null,"abstract":"<div><h3>Aims</h3><div>We evaluated the cost-effectiveness of artificial intelligence (AI)-based diabetic retinopathy (DR) screening in Japan. This evaluation compared the simultaneous introduction of AI in nationwide health checkups, namely “specific health check-ups in Japan” (SHC), and diabetes complication management (AI-case) with the current situation where AI is not being introduced (conventional-case) from the healthcare payer’s perspective.</div></div><div><h3>Methods</h3><div>A cost-effectiveness analysis was conducted using a new individual-based state transition model. Model parameters, including the incidence and progression of DR, health utility values, and costs of screening and treatment, were based on literature data and expert opinion. The analysis estimated quality-adjusted life years (QALYs), cumulative costs, and incremental cost-effectiveness ratios (ICER).</div></div><div><h3>Results</h3><div>The ICER comparing the AI-case with conventional-case was estimated to be JPY 1,598,244/QALY (USD 11,375/QALY), which is below the willingness-to-pay threshold of JPY 5 million/QALY (USD 35,584/QALY). Scenario analyses revealed that ICERs for the AI-based DR screening in SHC-only condition was JPY 1,895,226/QALY (USD 13,488/QALY) and JPY 3,960,839/QALY (USD 28,189/QALY) in diabetes management-only condition.</div></div><div><h3>Conclusions</h3><div>The introduction of AI-based DR screening for SHC and diabetes management was cost-effective compared to the current situation in Japan.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"221 ","pages":"Article 112015"},"PeriodicalIF":6.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Telehealth occupational therapy improves psychosocial well-being but not glycemia among young adults with type 1 diabetes: The Resilient, Empowered, Active Living-Telehealth (REAL-T) randomized controlled trial

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-01-28 DOI: 10.1016/j.diabres.2025.112005

Elizabeth A. Pyatak , Pey-Jiuan Lee , Ngozi D. Nnoli , Yujia Mo , Anya Khurana , Aina Ali , D.Steven Fox , John Sideris , Jesus Diaz , Gabrielle Granados , Jeanine Blanchard , Elissa S. Lee , Jennifer K. Raymond

Background

Young adults with type 1 diabetes mellitus often face challenges managing their condition, leading to elevated glucose and heightened psychosocial distress. Diabetes care traditionally focuses on biomedical outcomes, with less emphasis on well-being. Occupational therapy offers a holistic approach to managing diabetes by integrating changes to daily habits and routines and psychosocial support.

Methods

This randomized controlled trial involved participants aged 18–30 with HbA1c ≥ 7.5 % (≥58 mmol/mol). Participants received either telehealth occupational therapy or usual care. The intervention addressed diabetes management, daily habits and routines, and emotional well-being. Data collected at baseline, 3 months, and 6 months included HbA1c, continuous glucose monitoring metrics, and psychosocial outcomes. Analyses employed intent-to-treat principles, using ANCOVA to evaluate between-group differences.

Results

Participants (n = 209) were 24.3 (±3.7) years old, 59.8 % female, 44.5 % non-Hispanic White, and 47.4 % publicly insured. No significant differences were found in glycemic outcomes. Intervention participants had improved diabetes-related quality of life (DQoL; least-squares [LS] mean 0.67, 95 % CI 0.02 to 1.32, p = 0.045) and reduced diabetes distress (LS-mean −0.36, CI −0.65 to −0.07, p = 0.01).

Conclusion

Generalizability may be impacted by external factors related to COVID-19. The findings suggest occupational therapy may be beneficial for young adults experiencing diabetes-related distress and poor DQoL.

{"title":"Telehealth occupational therapy improves psychosocial well-being but not glycemia among young adults with type 1 diabetes: The Resilient, Empowered, Active Living-Telehealth (REAL-T) randomized controlled trial","authors":"Elizabeth A. Pyatak , Pey-Jiuan Lee , Ngozi D. Nnoli , Yujia Mo , Anya Khurana , Aina Ali , D.Steven Fox , John Sideris , Jesus Diaz , Gabrielle Granados , Jeanine Blanchard , Elissa S. Lee , Jennifer K. Raymond","doi":"10.1016/j.diabres.2025.112005","DOIUrl":"10.1016/j.diabres.2025.112005","url":null,"abstract":"<div><h3>Background</h3><div>Young adults with type 1 diabetes mellitus often face challenges managing their condition, leading to elevated glucose and heightened psychosocial distress. Diabetes care traditionally focuses on biomedical outcomes, with less emphasis on well-being. Occupational therapy offers a holistic approach to managing diabetes by integrating changes to daily habits and routines and psychosocial support.</div></div><div><h3>Methods</h3><div>This randomized controlled trial involved participants aged 18–30 with HbA1c ≥ 7.5 % (≥58 mmol/mol). Participants received either telehealth occupational therapy or usual care. The intervention addressed diabetes management, daily habits and routines, and emotional well-being. Data collected at baseline, 3 months, and 6 months included HbA1c, continuous glucose monitoring metrics, and psychosocial outcomes. Analyses employed intent-to-treat principles, using ANCOVA to evaluate between-group differences.</div></div><div><h3>Results</h3><div>Participants (<em>n</em> = 209) were 24.3 (±3.7) years old, 59.8 % female, 44.5 % non-Hispanic White, and 47.4 % publicly insured. No significant differences were found in glycemic outcomes. Intervention participants had improved diabetes-related quality of life (DQoL; least-squares [LS] mean 0.67, 95 % CI 0.02 to 1.32, <em>p</em> = 0.045) and reduced diabetes distress (LS-mean −0.36, CI −0.65 to −0.07, p = 0.01).</div></div><div><h3>Conclusion</h3><div>Generalizability may be impacted by external factors related to COVID-19. The findings suggest occupational therapy may be beneficial for young adults experiencing diabetes-related distress and poor DQoL.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"221 ","pages":"Article 112005"},"PeriodicalIF":6.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Experiences of women of childbearing age with diabetes skin pruritus: An interpretative phenomenological analysis

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice

Pub Date : 2025-01-27 DOI: 10.1016/j.diabres.2025.112007

Han Fu , Wanting Xie , Dong Zhu , Bihui Chen , Qiannan Han , Haili Zhu

Aim

This study aims to explore the experiences and feelings of women of childbearing age with diabetes skin pruritus after being diagnosed.

Methods

Using the Interpretative Phenomenological Analysis method, semi-structured interviews were conducted with women of childbearing age who suffer from diabetes skin pruritus, followed by data analysis.

Results

Three superordinate themes and eight subthemes were identified, including psychological distress (self-identity, lack of understanding from others, emotional damage and self-disgust), physical impairment (loss of bodily control, treatment challenges, impact on female sexual characteristics), and coping post-trauma (social withdrawal, active coping).

Conclusion

The physical and mental health of women of childbearing age with diabetes skin pruritus has been severely compromised, particularly their sense of self-worth as women of childbearing age. Despite this, they demonstrate a solid willingness to seek treatment. Therefore, it is recommended to strengthen research in this field, improve health education, establish online support platforms for sharing experiences, and enhance government oversight of social security measures. These initiatives will promote active treatment and recovery among patients, ultimately improving their quality of life.

目的：本研究旨在探讨育龄女性糖尿病皮肤瘙痒症患者在确诊后的经历和感受：方法：采用解释性现象学分析方法，对患有糖尿病皮肤瘙痒症的育龄妇女进行半结构化访谈，然后进行数据分析：结果：确定了三个上位主题和八个次主题，包括心理困扰（自我认同、缺乏他人理解、情感伤害和自我厌恶）、身体损伤（身体失控、治疗挑战、对女性性征的影响）和创伤后应对（社会退缩、积极应对）：结论：患有糖尿病皮肤瘙痒症的育龄妇女的身心健康受到严重损害，尤其是她们作为育龄妇女的自我价值感。尽管如此，她们仍然表现出强烈的求医意愿。因此，建议加强对公众的宣传和教育，建立分享经验的在线支持平台，加强政府对社会保障措施的监督，促进这些人积极治疗和康复，最终提高她们的生活质量。

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引用次数: 0