Adolescent and Parent Perceptions of Long-Term Type 1 Diabetes Complications

Katz, Michelle; Kaushal, Tara; Guo, Zijing; Cheema, Alina; Gerrard, Rachel; Laffel, Lori M.

doi:10.2337/ds20-0042

Cited by 6 publications

(7 citation statements)

References 26 publications

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“…Palmer et al (2004) indicate that the shift of diabetes management responsibilities from mothers to children can be influenced by conflict between family members. Mothers who receive enough support can judge whether their children are at the right age or stage of development and can manage the illness (Gutierrez‐Colina et al, 2020); adolescents with T1D and their parents prefer to avoid threats to motivate self‐care behaviours (Katz et al, 2021). In our study, the parents described rearranging their family tasks, using different ways to explain to their children the importance of injections and helping them participate in disease management.…”

Section: Discussionmentioning

confidence: 99%

Managing type 1 diabetes of a child: Parents' perspectives

Lin,

Lee

2024

Child

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PurposeManaging type 1 diabetes (T1D) challenges children and their parents. Parents need to learn the necessary skills and later transfer the responsibility of care to their children as they develop. The transition process involves autonomy in behaviour and decision‐making. This study explores the shared management experiences of Taiwanese parents and their children with type 1 diabetes.Design and methodsThis study employed a qualitative design using a grounded theory approach. Purposive sampling was used at a medical centre in Taiwan for participant recruitment. Twenty‐nine parents of children who had been diagnosed with T1D were interviewed in‐depth. Data were analysed using constant comparison and repeated verification.ResultsAfter a child was diagnosed with T1D, the parents initiated ‘Life‐long lesson: Growing together with the child on the road to normality’. Three main categories emerged: ‘confronting the disease diagnosis’, ‘establishing supportive and collaborative involvement’ and ‘assisting the child in building a sense of belonging’. Sub‐categories within each significant category were also included.ConclusionsTaiwanese parents perhaps have a controlling or directive role for a long period in their child's lives and shared management of their health condition. This study's findings can help healthcare workers better understand the process of parents' shared management of T1D with their children and how to best communicate with children about the disease and care in accordance with the child's stage of development.

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Section: Discussionmentioning

confidence: 99%

Managing type 1 diabetes of a child: Parents' perspectives

Lin,

Lee

2024

Child

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“…Adherence to medications other than insulin may present a barrier, particularly during adolescence [76]. Dyslipidaemia has no symptoms and the risk of ASCVD seems distant [77]. As glycaemic control and lifestyle modifications also improve lipid profiles in T1D, ongoing efforts to address these initially might be prioritized over statin use.…”

Section: Barriers To Optimal Carementioning

confidence: 99%

Lipid-lowering therapies and cardiovascular risk-stratification strategies in adults with type 1 diabetes

Lan

Bell

Watts

et al. 2022

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of reviewAtherosclerotic cardiovascular disease (ASCVD) is a leading cause of mortality in adults with type 1 diabetes (T1D). Although dyslipidaemia is a modifiable and prevalent risk factor in individuals with T1D, determining when to initiate lipid-lowering therapy for primary prevention of ASCVD can be challenging. In this article, recommendations for lipid-lowering therapy from updated clinical guidelines over the last 5 years, additional risk-stratification methods, hypertriglyceridaemia management and potential barriers to optimal care in adults with T1D are discussed. Recent findingsLow-density lipoprotein cholesterol (LDL-C) is the primary target for lipid-lowering. However, international guidelines recommend differing approaches to ASCVD risk-stratification, lipid-lowering, and LDL-C goals in individuals with diabetes, predominantly reflecting evidence from studies in type 2 diabetes. Despite guideline recommendations, several studies have demonstrated that statins are underused, and LDL-C goals are not attained by many individuals with T1D. Additional risk-stratification methods including T1D-specific ASCVD risk calculators, coronary artery calcium scoring, and lipoprotein(a) may provide additional information to define when to initiate lipid-lowering therapy. SummaryClinical trial evidence for lipid-lowering therapies in T1D is lacking, and further studies are needed to inform best practice. Optimization and harmonization of ASCVD risk-stratification and lipid management in individuals with T1D is required.

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“…Data based on semi-structured interviews have clearly shown poor awareness of complications among adolescents as well their reluctance to know about them ( 66 ). Even when patients are aware, however, a combination of insufficient support for how to implement lifestyle changes, lack of confidence to follow these changes, and lack of knowledge on other means for controlling blood pressure and lipid levels may all limit uptake of preventative measures ( 67 ).…”

Section: Motivational and Psychological Interventionsmentioning

confidence: 99%

Preventing Cardiovascular Complications in Type 1 Diabetes: The Need for a Lifetime Approach

Chiesa

Marcovecchio

2021

Front. Pediatr.

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Cardiovascular disease (CVD) remains the main cause of morbidity and mortality in individuals with type 1 diabetes (T1D). Adolescence appears to be a critical time for the development of early subclinical manifestations of CVD, with these changes likely driven by a deterioration in glycemic control during the progression through puberty, combined with the emergence of numerous other traditional cardiometabolic risk factors (e.g., hypertension, dyslipidemia, smoking, alcohol use, obesity, etc.) which emerge at this age. Although hemoglobin A1C has long been the primary focus of screening and treatment strategies, glycemic control remains poor in youth with T1D. Furthermore, screening for cardiovascular risk factors—which are often elevated in youth with T1D—is suboptimal, and use of pharmacological interventions for hypertension and dyslipidemia remains low. As such, there is a clear need not only for better screening strategies for CVD risk factors in youth, but also early interventions to reduce these, if future CVD events have to be prevented. Accumulating evidence has recently suggested that early increases in urinary albumin excretion, even within the normal range, may identify adolescents with T1D who are at an increased risk of complications, and results from pharmacological intervention with statins and ACE inhibitors in these individuals have been encouraging. These data join a growing evidence highlighting the need for a whole-life approach to prevention starting from childhood if efforts to improve CVD outcomes and related mortality in T1D are to be maintained.

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Adolescent and Parent Perceptions of Long-Term Type 1 Diabetes Complications

Cited by 6 publications

References 26 publications

Managing type 1 diabetes of a child: Parents' perspectives

Managing type 1 diabetes of a child: Parents' perspectives

Lipid-lowering therapies and cardiovascular risk-stratification strategies in adults with type 1 diabetes

Preventing Cardiovascular Complications in Type 1 Diabetes: The Need for a Lifetime Approach

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