Stabilization of glycemic control and improved quality of life using a shared medical appointment model in adolescents with type 1 diabetes in suboptimal control

Floyd, Baraka; Block, Jennifer M.; Buckingham, Bruce A.; Ly, Trang T.; Foster, Nicole C.; Wright, Robert C.; Mueller, Claudia L; Hood, Korey K.; Shah, Avni

doi:10.1111/pedi.12373

Cited by 29 publications

(28 citation statements)

References 32 publications

(72 reference statements)

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“…A review of new approaches to diabetes care identifies a range of patient-centered strategies, including shared decision-making, motivational interviewing, shared medical appointments (SMAs), and multidisciplinary team collaboration as potential positive diabetic management interventions [9]. SMAs, a patient-centered approach in diabetes care [10], have been shown to yield improvement in various outcomes for patients with diabetes (e.g., HgbA1c, patient satisfaction, and depression) when compared with the more traditional physician-patient office visits [10][11][12][13][14], even though the statistical significance varies across different studies. Another patient-centered strategy is motivational interviewing [15], a psychotherapeutic concept that focuses on enhancing patient's intrinsic motivation to initiate behavior change and accomplish a desired goal.…”

Section: Introductionmentioning

confidence: 99%

“JUMPing into Diabetes Control”: A Group-Setting Self-Empowerment Lifestyle Intervention among Diabetes Patients

et al. 2020

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We examined the impact of a group-based self-empowerment intervention among diabetes patients, which uses multidisciplinary education, collaborative learning, peer support, and development of diabetes-specific social capital to improve glycemic control and weight management. Thirty-five patients who had primary care established at the Prisma Health Upstate, Internal Medicine Resident clinic and held the diagnosis of diabetes for longer than one year were recruited for our single-arm pilot intervention. Each group intervention session involved one to two internal medicine resident physician facilitators, a clinical diabetic educator, and 5-10 patients. Each session had a framework facilitated by the resident, with most of the discussion being patient-led, aiming to provide a collaborative learning environment and create a support group atmosphere to encourage self-empowerment. Patients' hemoglobin A1c level and body mass index (BMI) before the intervention and 3 to 6 months after completion were collected from the laboratory results obtained in the participants' routine clinic visits. All graduates from this three-week intervention were invited to attend monthly maintenance sessions, and we tracked the HgbA1c measures of 29 JUMP graduates one year after the intervention, even though 13 of the 29 chose not to participate in the monthly maintenance sessions. The pre-intervention HgbA1c level averaged 8.84%, whereas the post-intervention HgbA1c level averaged 7.81%. A paired t test showed that this pre-post difference of 1.03 percentage points was statistically significant (p = 0.0007). For BMI, there was an average decline of 0.78 from the pre-intervention mean value of 40.56 to the post-intervention mean value of 39.78 (p = 0.03). Among the 29 participants who agreed to participate in our follow-up measure of their HgbA1c status one year after the intervention, a paired t test showed that there was no significant difference between the post-JUMP measure and the follow-up measure (p = 0.808). There was no statistically significant difference between the HgbA1c level of those participating in the maintenance program and that of those not participating (post-intervention t test of between-group difference: p = 0.271; follow-up t test of between-group difference: p = 0.457). Our single-arm, pilot study of the three-week group intervention of self-empowerment shows promising results in glycemic control and weight loss. The short duration and small number of sessions expected could make it more feasible for implementation and dissemination as compared with popular intervention protocols that require much longer periods of attendance, if the effectiveness of this patient group-based self-empowerment approach can be further established by randomized controlled studies in the future.

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Section: Introductionmentioning

confidence: 99%

“JUMPing into Diabetes Control”: A Group-Setting Self-Empowerment Lifestyle Intervention among Diabetes Patients

et al. 2020

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“…This may include an openness about their diabetes diagnosis, symptoms and management with their classmates in the school setting . Finally, perceived treatment adherence barriers may be targeted directly for self‐management strategies designed to improve overall HRQOL in AYA with type 1 diabetes who are experiencing diabetes symptoms …”

Section: Discussionmentioning

confidence: 99%

“…41 Finally, perceived treatment adherence barriers may be targeted directly for self-management strategies designed to improve overall HRQOL in AYA with type 1 diabetes who are experiencing diabetes symptoms. 42 The present study has several strengths, including the relatively large overall sample size, and the nationwide representation of the participants. Limitations include the lack of information on families who chose not to participate.…”

Section: Exploratory Factor Analysismentioning

confidence: 99%

Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes

et al. 2018

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“…Lo anterior es aún más significativo dado el bajo número de adolescentes con síntomas depresivos que reciben tratamiento psicológico 12 . La educación no ha sido de gran impacto sobre el control glicémico, es por esto que se requieren intervenciones interdisciplinarias incluyendo los aspectos médicos y psicosociales de las personas y sus familias, potenciando habilidades de afrontamiento y resolución de problemas 5,44 . Es importante que el equipo interdisciplinario que trabaje con pacientes con DMT1 y sus familias debe mantener un contacto regular, enfatizando la participación familiar en el manejo de la diabetes 45 .…”

Section: Discussionunclassified

Impacto psicosocial de la diabetes mellitus tipo 1 en niños, adolescentes y sus familias. Revisión de la literatura

Henríquez-Tejo¹,

Cartes‐Velásquez

2018

Rev. chil. pediatr.

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ResumenLa diabetes mellitus tipo 1 es la patología endocrina crónica más común en niños. El tratamiento incluye dieta, actividad física, medicación con insulina y un autocontrol adecuado. Este autocontrol puede ser dificultoso, provocando que niños, adolescentes y sus familias sufran diversas complicaciones psicosociales. Existe una relación inversa entre autocontrol y presencia de complicaciones psicosociales, siendo los principales problemas ansiedad y depresión, donde los adolescentes llegan a ser 2,3 veces más propensos a presentar problemas de salud mental. Las familias se ven afectadas inicialmente en el período de debut por un estado de shock, con sentimientos de angustia e ira. Los necesarios cambios de hábitos y estilos de vida pueden generar problemas psicosociales entre los que destacan trastornos ansiosos, depresivos y alimenticios. Posteriormente, el niño o adolescente y su grupo familiar pueden transitar a un nuevo equilibrio caracterizado por un buen autocontrol y adherencia al tratamiento o profundizar los trastornos individuales y grupales, trastornos que pueden reaparecer, especialmente en la adolescencia. El tratamiento integral de la diabetes mellitus tipo 1 requiere atender estos aspectos mediante equipos multidisciplinarios que incluyen profesionales médicos y del ámbito psicosocial. En esta revisión se analizan los principales aspectos relacionados al impacto psicosocial en niños y adolescentes con diabetes mellitus tipo 1 y sus familias. Keywords:Diabetes mellitus type 1; psychosocial impact; family AbstractType 1 diabetes mellitus is the most common chronic endocrine pathology among children. Treatment includes diet, physical activity, insulin medication, and proper self-control. This self-control may be difficult, resulting in children, adolescents and their families suffering diverse psychosocial complications. There is an inverse relationship between self-control and psychosocial complications, the main problems being anxiety and depression, where adolescents are 2.3 times more likely to have mental

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Stabilization of glycemic control and improved quality of life using a shared medical appointment model in adolescents with type 1 diabetes in suboptimal control

Abstract: SMAs are feasible replacements to individual appointments in adolescent T1D, stabilizing glycemic control and improving QOL. Randomized controlled trials with optimizations are needed to further explore and refine this intervention.

Cited by 29 publications

References 32 publications

“JUMPing into Diabetes Control”: A Group-Setting Self-Empowerment Lifestyle Intervention among Diabetes Patients

“JUMPing into Diabetes Control”: A Group-Setting Self-Empowerment Lifestyle Intervention among Diabetes Patients

Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes

Impacto psicosocial de la diabetes mellitus tipo 1 en niños, adolescentes y sus familias. Revisión de la literatura

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