Executive Function, Adherence, and Glycemic Control in Adolescents with Type 1 Diabetes: a Literature Review

Duke, Danny C.; Harris, Michael A.

doi:10.1007/s11892-014-0532-y

Cited by 79 publications

(83 citation statements)

References 72 publications

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“…A recent review of research in T1D and EF identified the following conclusions: a relation between stronger EF and greater adherence is supported and demonstrates small to medium effect sizes ( r =0.27–0.66). However, these findings are inconsistent across studies, as some studies used different subscales or composite scores of EF or found different results based on gender [5••]. Thus, more research is needed to better understand this association.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies indicate a bidirectional relation between stronger EF skills and greater adherence ([5••] see Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

“…1, link c). Poorer EF skills also have the potential to lead to difficulties with diabetes management ([5••, 10–13] Fig. 1, link a), which is known to worsen glycemic control ([14] see Fig.…”

Section: Introductionmentioning

confidence: 99%

“…1, link b). In light of these associations, researchers have recommended that diabetes care providers consider their patients' EF skill abilities in formulating care plans [5••, 6••]. However, few specific recommendations for interventions or environmental accommodations to support diabetes-related EF skills are available.…”

Section: Introductionmentioning

confidence: 99%

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Practical Strategies to Enhance Executive Functioning and Strengthen Diabetes Management Across the Lifespan

et al. 2015

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The complex type 1 diabetes (T1D) management regimen places extra demands on one's ability to plan, organize, and problem-solve, a set of skills described as executive functioning (EF). Research on the relation between EF and T1D management has been mounting and suggest that deficits in EF skills likely interfere with optimal management. However, given the substantial EF demands of T1D management, any person with T1D, including those without clinically significant deficits, could likely benefit from strategies to improve diabetes-related EF skills. The current review outlines typical EF development across the lifespan and suggests behavioral strategies (e.g., environmental modifications) from the EF literature and clinical experience to enhance EF skills at each period of development. When executive dysfunction is suspected, formal neuropsychological assessment is recommended as EF concerns can be a significant problem of their own, or they could be an indicator of another psychological disorder, such as depression or dementia.

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Section: Discussionmentioning

confidence: 99%

“…Recent studies indicate a bidirectional relation between stronger EF skills and greater adherence ([5••] see Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Practical Strategies to Enhance Executive Functioning and Strengthen Diabetes Management Across the Lifespan

et al. 2015

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“…Youth would likely benefit most from strategies that specifically bridge the gaps common during adolescence caused by normal neuro-cognitive and emotional development. [10] Challenges in executive functioning and cognitive abilities are common among infected youth, even prior to ART initiation. [11] Further, social support, impulsivity constraining prospective planning, lability, increased needs for autonomy, and identity development need careful attention in programs focused on support YLWH.…”

Section: Introductionmentioning

confidence: 99%

Triggered Escalating Real-Time Adherence Intervention to Promote Rapid HIV Viral Suppression Among Youth Living With HIV Failing Antiretroviral Therapy: Protocol for a Triggered Escalating Real-Time Adherence Intervention (Preprint)

Amico¹,

Dunlap²,

Dallas³

et al. 2018

Preprint

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Background: Youth living with HIV (YLWH) are confronted with a number of self-care challenges that can be experienced as overwhelming in the context of the normal developmental processes that characterize adolescence and young adulthood. Challenges to antiretroviral therapy (ART) adherence create a sizable minority of YLWH with unsuppressed viral load in the United States (US). Interventions to promote sustained viral suppression in YLWH are needed.

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Effect of Sleep Restriction on Adolescent Cognition by Adiposity

Stager,

Watson,

Cook

et al. 2024

JAMA Neurol

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ImportancePediatric obesity is associated with impaired cognitive function; however, the mechanisms underlying this association demand assessment. Sleep may be a relevant moderator, as poor sleep predicts both increased adiposity and impaired cognitive function.ObjectiveTo determine the effects of adiposity and sleep on adolescent cognitive function.Design, Setting, and ParticipantsThis single-blind randomized crossover trial was conducted from September 2020 to October 2022. Parents or caregivers provided demographic information for adolescent participants. Body mass index percentile and bioelectrical impedance analysis assessed adiposity. Adolescents completed 2 actigraphy-confirmed sleep conditions, adequate and restricted, followed by in-person cognitive assessment. No additional follow-up was provided. Data collection for this population-based study took place in a behavioral medicine clinic in Birmingham, Alabama. A total of 323 participants were assessed for eligibility (ages 14-19 years and healthy). Of the 244 eligible adolescents, 157 declined participation. Eighty-seven were randomized and 26 dropped out postenrollment. The final sample included 61 adolescents, 31 with healthy weight and 30 with overweight or obesity. Data were analyzed from April to October 2023.InterventionsFollowing a 2-day washout period of adequate sleep, adolescents completed 2 sleep conditions: adequate (mean [SD] duration, 8 hours, 54 minutes [58.0 minutes]) and restricted (mean [SD] duration, 4 hours, 12 minutes [50.7 minutes]).Main Outcomes and MeasuresThe National Institutes of Health Cognitive Toolbox assessed global and fluid cognition, cognitive flexibility, working and episodic memory, attention, and processing speed. The Stroop Task assessed inhibition.ResultsThe final sample included 61 adolescents (mean [SD] age, 16.3 [1.6] years; 35 [57.4%] female). Restricted sleep predicted poorer global cognition scores (restricted mean [SD], 98.0 [2.8]; adequate mean [SD], 103.2 [2.9]), fluid cognition scores (restricted mean [SD], 94.5 [3.2]; adequate mean [SD], 102.0 [3.6]), and cognitive flexibility scores (restricted mean [SD], 84.8 [3.0]; adequate mean [SD], 92.8 [3.0]) for adolescents with overweight or obesity. No differences emerged for adolescents with healthy weight. Adolescents with overweight or obesity also had poorer attention scores (mean [SD], 80.0 [2.3]) compared to adolescents with healthy weight (mean [SD], 88.4 [SD, 2.3]) following restricted sleep. No differences emerged following adequate sleep. Findings were similar for total body fat percentage (TBF%); however, for adolescents with TBF% above 42, restricted sleep also predicted poorer processing speed, and the association between sleep and attention did not vary based on TBF%.Conclusions and RelevanceAdolescents with overweight or obesity may be more vulnerable to negative cognitive effects following sleep restriction. Improved sleep hygiene and duration in this group may positively impact their cognitive health.Trial RegistrationClinicalTrials.gov Identifier: NCT04346433

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Executive Function, Adherence, and Glycemic Control in Adolescents with Type 1 Diabetes: a Literature Review

Cited by 79 publications

References 72 publications

Practical Strategies to Enhance Executive Functioning and Strengthen Diabetes Management Across the Lifespan

Practical Strategies to Enhance Executive Functioning and Strengthen Diabetes Management Across the Lifespan

Triggered Escalating Real-Time Adherence Intervention to Promote Rapid HIV Viral Suppression Among Youth Living With HIV Failing Antiretroviral Therapy: Protocol for a Triggered Escalating Real-Time Adherence Intervention (Preprint)

Effect of Sleep Restriction on Adolescent Cognition by Adiposity

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