Different Effects of Structured Education on Glycemic Control and Psychological Outcomes in Adolescent and Adult Patients with Type 1 Diabetes: A Systematic Review and Meta-Analysis

Liu, Fang; Guan, Yuzhu; Li, Xia; Xie, Yuting; He, Jing; Zhang, Zhou; Li, Lezhi

doi:10.1155/2020/9796019

Cited by 7 publications

(4 citation statements)

References 49 publications

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“…Even so, as this same study confesses, meta-analyses in the USA found that psychoeducational interventions can improve HbA1c levels by up to half a percentage point, in addition to other psychological and educational benefits (Armour et al, 2005;Winkley et al, 2006). Another study argues that although no evidence of significant improvements in HbA1c levels was found in their meta-analysis for the adolescent population after structured education, there was evidence for the adult population (Liu et al, 2020), though a reduction in vascular complications was found in the adult population with T1D (Menezes et al, 2016).…”

Section: Contrasting Positions On the Effectiveness Of Educational Or Psychoeducational Interventionsmentioning

confidence: 91%

Psychoeducational Interventions in Children and Adolescents with Type-1 Diabetes: A Systematic Review

Luque¹,

Villaécija²,

Castillo‐Mayén³

et al. 2022

Clínica Y Salud

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The effectiveness of psychoeducational interventions in children and adolescents with type 1 diabetes is unclear. A systematic review was developed in accordance with PRISMA. Relevant databases (Pubmed, Cochrane, PsycINFO, and PsyARTICLES) were analyzed. Articles of the last decade with type 1 diabetes population between 6 and 18 years participating in psychoeducational interventions were the inclusion criteria. Twenty studies were reviewed, and improvements were found in glycosylated hemoglobin, diabetes knowledge, and psychosocial variables. The results support the positive effect of these interventions. The characteristics that seem to be behind the success of these interventions are the design appropriate to the characteristics of the population, the participation of psychologist and educators, the continuity of the program over time, and the use of digital tools and interaction strategies. Further studies need to be carried out and replicated in different groups of children and adolescents.

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Section: Contrasting Positions On the Effectiveness Of Educational Or Psychoeducational Interventionsmentioning

confidence: 91%

Psychoeducational Interventions in Children and Adolescents with Type-1 Diabetes: A Systematic Review

Luque¹,

Villaécija²,

Castillo‐Mayén³

et al. 2022

Clínica Y Salud

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“…46,47 However, a meta-analysis concluded that SE had no significant effect on glycaemic control, diabetes self-efficacy, or QoL in adolescents with T1D. 48 They attributed it to lack of maturity and lack of knowledge and understanding of the disease and its complications as well as the therapeutic regimens of T1D. Also, most of these SE programmes focused primarily on carbohydrate counting and insulin adjustment which may be difficult for adolescents to comprehend.…”

Section: Solutionmentioning

confidence: 99%

Glycaemic Control in Youth and Young Adults: Challenges and Solutions

Khadilkar¹,

Oza²

2022

DMSO

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Diabetes is the third most prevalent severe chronic disease of youth. Management of any chronic condition like type-1 diabetes (T1D) during adolescence, a time of rapid growth and physiological changes accompanied by important individuation and socialization processes, constitutes a major challenge for the youth, their family and the health-care team. The increasing prevalence of T1D in the adolescent age group and deteriorating glycaemic control from childhood to adolescence and youth, as well as the secular trend of worsening glycaemic control in youth and young adults with T1D, are a matter of real concern. Lack of monitoring, insufficient self-control, psychosocial factors, lack of family support and parental supervision, inadequate adherence to treatment, pubertal increase in insulin resistance and incompetent transition from paediatric to adult care are likely causes of deteriorating glycaemic control in youth. Efforts to improve insulin sensitivity by using pharmacological agents such as metformin are insufficient in resolving this problem. Interventions such as structured intervention, motivational interviews, development of youth friendly services and organization of diabetes camps for peer support can improve adherence in these individuals. Innovative technologies such as continuous subcutaneous insulin infusion and continuous glucose monitoring, comprehensive multidisciplinary teams with effective communication, parental support and supervision with planned transition from paediatric to adult care will not only reduce the risk of micro-and macrovascular complications in young adults with T1D but will also cause significant improvement in their quality of life.

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“…In particular, the highest quality educational approach is structured education, a program with a clear purpose and flexible content, designed to meet the clinical and psychological needs of the patient while adapting to their socio-cultural context [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Impact on Glycemia Risk Index and other metrics in type 1 adult patients switching to Advanced Hybrid Closed-Loop systems: a one-year real-life experience

Resmini,

Zarra,

Dotti

et al. 2024

Eur J Med Res

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Background Advanced Hybrid Closed-Loop system (AHCL) has profoundly changed type 1 diabetes therapy. This study primarily aimed to assess the impact on Glycemia Risk Index (GRI) and other continuous glucose monitoring (CGM) metrics when switching from one of four insulin strategies to AHCL in type 1 adult patients. Methods A single-center, retrospective pre/post observational study; 198 patients (age 44.4 ± 12.7 years, 115 females/83 males, diabetes duration 24.7 ± 11.6 years, HbA1c 7.4 ± 1%), treated with different insulin therapies (MDI, CSII, SAP with PLGS, HCL) were assessed before and after switching to an AHCL (MiniMed 780G, Diabeloop Roche, Tandem Control-IQ) at 1, 3, 6, and 12 months. Mixed-effects multivariable regression models were used to estimate the mean pre/post variations at different time points, adjusted for potential confounders. Results A month after the switch, there was an improvement in CGM metrics and HbA1c for all patients: GRI −10.7, GMI −0.27%, CV −2.1%, TAR>250 −3.7%, TAR180-250 −5.6%, TIR + 9.7%, HbA1c −0.54% (all p < 0.001). This improvement was maintained throughout the observational period (at 3, 6, and 12 months, with all p-values < 0.001). When improvements across the 780, Diabeloop, and Tandem CIQ devices were compared: Diabeloop demonstrated significantly better performance in terms of GRI, GMI, CV, TAR>250 at T1 (for all p < 0.01); 780 recorded highest average decrease in TAR180-250 (p = 0.020), while Tandem achieved the most significant reduction in TBR54-69 (p = 0.004). Conclusions Adopting an AHCL leads to a rapid and sustained improvement in GRI and other parameters of metabolic control for up to a year, regardless of prior insulin therapies, baseline conditions or brands.

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Different Effects of Structured Education on Glycemic Control and Psychological Outcomes in Adolescent and Adult Patients with Type 1 Diabetes: A Systematic Review and Meta-Analysis

Cited by 7 publications

References 49 publications

Psychoeducational Interventions in Children and Adolescents with Type-1 Diabetes: A Systematic Review

Psychoeducational Interventions in Children and Adolescents with Type-1 Diabetes: A Systematic Review

Glycaemic Control in Youth and Young Adults: Challenges and Solutions

Impact on Glycemia Risk Index and other metrics in type 1 adult patients switching to Advanced Hybrid Closed-Loop systems: a one-year real-life experience

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