General and diabetes-specific stress in adolescents with type 1 diabetes

Rechenberg, Kaitlyn; Whittemore, Robin; Holland, Margaret L.; Grey, Margaret

doi:10.1016/j.diabres.2017.05.003

Cited by 59 publications

(65 citation statements)

References 33 publications

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“…Another study by Thomas et al, who surveyed 9310 45-year-old participants from the 1958 British birth cohort, also showed that household dysfunction and lack of paternal care during childhood was associated with HbA1c ≥6% [19]. Rechenberg et al conducted a questionnaire based study involving 320 children with T1DM of ages 11-14 years, which showed those participants who underwent general stress and diabetes specific stress had significantly elevated HbA1c [20].…”

Section: Discussionmentioning

confidence: 99%

Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes

Iqbal¹,

Kumar²,

Hansen³

et al. 2020

Children

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Adverse childhood experiences (ACE) have been associated with a greater prevalence of risky behaviors and chronic health conditions, such as diabetes in adulthood. While adolescents with risk taking behaviors experience worsening of diabetic metabolic control, it is yet to be determined whether glycemic management in children and adolescents is negatively and independently influenced by ACEs. This study examines the relationship between ACEs in children and adolescents with type 1 diabetes (T1DM) and glycemic control, BMI and lipids. For such children, we hypothesized that hemoglobin A1c (HbA1c) is positively correlated with ACE scores. Parents of children (age 2–18 years) with T1DM completed a validated ACE questionnaire. The associations between parent and child ACE score and HbA1c, lipids and BMI z-scores were assessed using linear regression. The prevalence of any ACE was 27.9% among children and 49.0% among parents. HbA1c was significantly higher in children who had exposure to three or more ACEs (β:0.63 (4.5 mmol/mol); p = 0.02), in those who had a parent exposed to four or more ACEs (β:0.87 (7.2 mmol/mol); p = 0.03), in children who had exposure to household incarceration (β:0.62 (4.4 mmol/mol); p = 0.05) and children who witnessed or had been victim of violence in the neighborhood (β:0.71 (5.4 mmol/mol); p = 0.02). ACEs were highly prevalent among children with T1DM and had a positive association with glycemic control.

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Section: Discussionmentioning

confidence: 99%

Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes

Iqbal¹,

Kumar²,

Hansen³

et al. 2020

Children

View full text Add to dashboard Cite

show abstract

“…For persons with T1D, stress has the potential to affect metabolic control directly through its impact on cortisol and other catecholamine hormones that affect insulin metabolism . However, stress has also been shown to affect metabolic control indirectly by interfering with the completion of daily diabetes management tasks or increasing psychological symptoms (ie, depression) that negatively affect diabetes management . Decreased family support for illness management tasks among emerging adults with T1D may make the transition to adulthood particularly stressful .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Mindfulness‐Based Stress Reduction in Emerging Adults with Poorly Controlled, Type 1 Diabetes: A Pilot Randomized Controlled Trial

et al. 2018

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Background/Objective: The negative effects of stress on persons with type 1 diabetes (T1D) are well-established, but effective interventions to reduce stress among emerging adults with T1D are limited. The study objective was to conduct a pilot randomized controlled trial (RCT) to obtain preliminary data on the efficacy of mindfulness-based stress reduction (MBSR) to reduce stress and improve diabetes health outcomes in a population of high-risk, urban emerging adults with poorly controlled diabetes.Methods: Forty-eight participants aged 16 to 20 years of age with T1D (mean duration = 8 years) were randomly assigned to one of three conditions: MSBR, cognitive-behavioral stress management (CBSM), or a diabetes support group. Data were collected at baseline, end of treatment, and 3 months after treatment completion. Measures of self-reported stress and depressive symptoms, diabetes management, and glycemic control were obtained.Results: MBSR was found to reduce self-reported stress at end of treatment (P = 0.03, d = −0.49) and 3-month follow-up (P = 0.01, d = −0.67), but no effects on diabetes management or glycemic control were found. Diabetes support group participants had improved glycemic control at the end of treatment (P = 0.01, d = −0.62) as well as reduced depressive symptoms at 3-month follow-up (P = 0.01, d = −0.71). Conclusions:Results provide preliminary support for the efficacy of MBSR to improve psychosocial adjustment in emerging adults with poorly controlled T1D but require replication in adequately powered studies. Findings also support the value of peer support in improving health outcomes in this age group. K E Y W O R D Sintervention, stress, type 1 diabetes

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“…Adolescence is a stressful and demanding developmental period, both biologically and psychosocially (Jaser & White, ; Seiffge‐Krenke, Aunola, & Nurmi, ). Adolescents with T1D have high levels of perceived stress, both general and diabetes‐specific (Chao et al, ; Grant et al, ; Rechenberg, Whittemore, Holland, & Grey, ). It is known that managing diabetes is a stressful and time‐consuming endeavor (Chao et al, ; Delamater, de Wit, McDarby, Malik, & Acerini, ; Rechenberg et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Adolescents with T1D have high levels of perceived stress, both general and diabetes‐specific (Chao et al, ; Grant et al, ; Rechenberg, Whittemore, Holland, & Grey, ). It is known that managing diabetes is a stressful and time‐consuming endeavor (Chao et al, ; Delamater, de Wit, McDarby, Malik, & Acerini, ; Rechenberg et al, ). Our results support the extant literature that youth with T1D experience heightened general and diabetes‐specific stress, and that both are important, but are experienced differently (Chao et al, ; Rechenberg et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…It is known that managing diabetes is a stressful and time‐consuming endeavor (Chao et al, ; Delamater, de Wit, McDarby, Malik, & Acerini, ; Rechenberg et al, ). Our results support the extant literature that youth with T1D experience heightened general and diabetes‐specific stress, and that both are important, but are experienced differently (Chao et al, ; Rechenberg et al, ). Youth reported that T1D was a second full‐time job, an added “layer” that further complicated the already challenging experience of adolescence.…”

Section: Discussionmentioning

confidence: 99%

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“Anxiety and Type 1 diabetes are like cousins”: The experience of anxiety symptoms in youth with Type 1 diabetes

Rechenberg

Grey

Sadler

2018

Research in Nursing & Health

Self Cite

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Type 1 diabetes (T1D) is one of the most common chronic health conditions in youth in the United States, and its incidence is rising worldwide. Youth with T1D are at a high risk of psychological comorbidity, for example, anxiety, depression, and eating disorders.Psychological comorbidities, especially anxiety symptoms, have been correlated with poorer diabetes outcomes, but anxiety symptoms have not been well studied in these youth. The primary aim of this study was to describe the experience of anxiety symptoms in youth with T1D, especially as those symptoms relate to diabetes selfmanagement tasks. We used a qualitative descriptive approach, consisting of an indepth, semi-structured interview comprising 10 open-ended questions with follow-up probes. The analysis was guided by the principles of thematic analysis. Demographic data, Hemoglobin A1c levels, and the State-Trait Anxiety Inventory for Children survey data were also collected and analyzed. We identified four themes and seven subthemes. Participants (n = 29, ages 10-16, 55% female) reported that T1D was an extra layer of responsibility that took time away from their ability to participate fully in other aspects of their lives. Some participants were able to integrate diabetes management into their lives, while others were not. Some participants were dependent on parents and the school nurse for diabetes management. Participants described two types of anxiety symptoms, general and diabetes-specific, and they noted that their experience of anxiety was associated with poor quality sleep, general lifestyle factors, and diabetes. K E Y W O R D S adolescence, anxiety, diabetes

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General and diabetes-specific stress in adolescents with type 1 diabetes

Cited by 59 publications

References 33 publications

Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes

Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes

Efficacy of Mindfulness‐Based Stress Reduction in Emerging Adults with Poorly Controlled, Type 1 Diabetes: A Pilot Randomized Controlled Trial

“Anxiety and Type 1 diabetes are like cousins”: The experience of anxiety symptoms in youth with Type 1 diabetes

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