An Integrated Care Model to Support Adolescents With Diabetes-related Quality-of-life Concerns: An Intervention Study

Integrating psychosocial and behavioral interventions into type 1 diabetes care

“…A behavioral health stepped-care model for adolescents was evaluated in a quasi-experimental study [20 ▪ ]. One diabetes clinic implemented the care model ( n = 77, mean age 14.6 ± 1.3 years), while a second clinic provided usual care ( n = 39, mean age 14.6 ± 1.1 years).…”

“…First, communication about T1D (whether parent-child or patient-provider) remains challenging, with mixed findings among these studies (e.g., [19 ▪ ,27 ▪ ]); more basic research and intervention development is indicated in this area. Second, some studies reported a mix of positive and negative outcomes (e.g., improved QoL with deterioration in glycemia [20 ▪ ], improved physical activity with increased BMI [31 ▪ ]). Further refinement of such interventions is needed to preserve benefits while mitigating potential harms.…”

“…With respect to glycemia, nine studies reported favorable changes [12 ▪ ,13 ▪▪ ,14 ▪ ,15 ▪ ,22 ▪ ,23,26 ▪ ,28 ▪▪ ,30 ▪▪ ], seven found no change [9,10 ▪▪ ,16 ▪ ,18,19 ▪ ,21,31 ▪ ], and one reported an increase in HbA1c among intervention recipients [20 ▪ ]; five studies did not evaluate or report glucose metrics [8 ▪ ,24,25 ▪▪ ,27 ▪ ,29 ▪ ]. Psychosocial care is important independent of its relationship to glucose, and should be provided irrespective of the likelihood of improving glycemia.…”

“…A promising theme within these studies is the effective use of stepped care intervention approaches [20 ▪ ,28 ▪▪ ,32], which may more efficiently utilize scarce resources for psychosocial care within clinical settings. Group interventions [9,15 ▪ ,16 ▪ ,17,21,22 ▪ ,28 ▪▪ ,29 ▪ ], and automated intervention components [19 ▪ ,23,26 ▪ ,31 ▪ ], are additional strategies to increase access to psychosocial care in resource-poor settings.…”

Conhecimentos dos nutricionistas sobre o manejo do Diabetes mellitus tipo 1 quanto a contagem de macronutrientes e as unidades de insulina

“…Destaca-se que a contagem de carboidratos é um item fundamental para os indivíduos com diabetes mellitus tipo 1, sendo que tal fato contribui para diminuir os valores de hemoglobina glicada (HbA1C) nos pacientes com 18 a 60 anos (Azzolini et al, 2010), e naqueles de 70 (Trento et al, 2009). Os pacientes com diabetes mellitus tipo 1 são constantemente desafiados ao tentar equilibrar, monitorar, gerenciar e conciliar a saúde social, emocional e biológica normal (Versloot et al, 2021;Versloot et al, 2023), sendo que esse cenário imposto pela patologia pode resultar em desfechos negativos em relação à saúde mental, bem-estar, depressão e felicidade. Juntamente com outros profissionais de saúde, os nutricionistas têm um grande papel no manejo do DM1, fornecendo educação nutricional focada e assertiva desde o diagnóstico e ao longo dos acompanhamentos.…”