Behavioral Contributions to the Pathogenesis of Type 2 Diabetes

Spruijt‐Metz, Donna; O’Reilly, Gillian; Cook, Lauren; Page, Kathleen A.; Quinn, Charlene C.

doi:10.1007/s11892-014-0475-3

Cited by 34 publications

(30 citation statements)

References 117 publications

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“…Despite the evidence for effectiveness of diabetes self-management [ 46 , 47 ], DAWN2 reported low participation rates for patients and family groups, with participants reporting education and psychosocial support are seldom available [ 45 ]. Advances in mobile technology that enable us to track individual behavior linked to clinical measures within contextual factors (disease severity, comorbidities, age, resources, and distress factors) afford us the opportunity to engage patients and personalize education or emotional needs to address diabetes distress [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of a Mobile Diabetes Health Intervention on Diabetes Distress and Depression Among Adults: Secondary Analysis of a Cluster Randomized Controlled Trial

Quinn

Swasey

Crabbé

et al. 2017

JMIR Mhealth Uhealth

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BackgroundDiabetes is a complex, demanding disease that requires the constant attention of patients. The burden of self-management, including different medication regimens, routine self-care activities, and provider visits, has an impact on patients’ emotional well-being. Diabetes distress and depression are two important components of emotional well-being that may negatively affect diabetes outcomes.ObjectiveThe aim was to determine the impact of the 1-year Mobile Diabetes Intervention Study cluster randomized clinical trial on emotional well-being measured by diabetes distress and depression among adults with type 2 diabetes (T2D).MethodsA total of 163 adults with not-well-managed T2D were enrolled from community primary care practices. Primary care practices were cluster randomized into either a usual care control group or intervention group. Intervention participants were given a mobile phone with coaching software including a Web portal to communicate with providers. A priori established secondary outcomes included distress measured by the Diabetes Distress Scale (DDS), with subscales measuring emotional burden, interpersonal distress, physician-related distress, and regimen-related distress, as well as depression measured by the Patient Health Questionnaire (PHQ-9). Linear mixed models were used to calculate the effect of the intervention on diabetes distress levels over time, both overall and separately by sex, and to determine if the intervention affected distress or depression. The impact of total DDS on changes in HbA1c was also studied.ResultsThere were no significant treatment group effects for DDS total (baseline: P=.07; differences over time: P=.38) or for depression (P=.06 over time). Significant declines in total DDS were observed over the 12-month intervention period (P=.01). Regimen-related distress significantly decreased for all study participants (P<.001), but no significant change over time was observed for emotional burden (P=.83), interpersonal distress (P=.64), or physician-related distress (P=.73). Women in both the usual care and intervention groups were more likely to have higher overall DDS, emotional burden, physician-related distress, and regimen-related distress, but not interpersonal distress. Women also reported higher baseline depression compared to men (P=.006). Overall, depression decreased over the treatment period (P=.007), but remained unaffected by group assignment (P=.06) or by sex (P=.97). Diabetes distress had no effect on the change in HbA1c (P=.91) over the treatment period.ConclusionsAlthough we found no definitive overall or sex-specific effect of the intervention on diabetes distress or depression, this study makes an important contribution to the understanding of mobile health interventions and the impact on emotional health. Our study verified previous work that although diabetes distress and depression are highly correlated, these measures are not evaluating the same construct. Design of future mobile technology provides an opportunity to personalize, contextual...

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Section: Discussionmentioning

confidence: 99%

The Impact of a Mobile Diabetes Health Intervention on Diabetes Distress and Depression Among Adults: Secondary Analysis of a Cluster Randomized Controlled Trial

Quinn

Swasey

Crabbé

et al. 2017

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

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“… 19 20 Cooper et al found that a diet characterised by a high intake of vegetables and fruit may be beneficial for the prevention of pre-diabetes and diabetes. 21 22 It has been proved that sugar intake is associated with an increased risk of diabetes, 23 and too much fat has also been shown to be an important contributor to the development of obesity, insulin resistance and diabetes. 24 Thus, dietary modification is crucial for the prevention and management of pre-existing T2DM.…”

Section: Discussionmentioning

confidence: 99%

Diabetes-related behaviours among elderly people with pre-diabetes in rural communities of Hunan, China: a cross-sectional study

Luo¹,

Zhang²,

Hu³

et al. 2018

BMJ Open

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ObjectiveTo explore diabetes-related behaviours and their influencing factors among elderly individuals with pre-diabetes in rural areas of China.Design, setting and participantsA cross-sectional survey was conducted among elderly individuals (≥60 years) in rural communities in Yiyang City of China. Multistaged cluster random sampling was carried out to select 42 areas, and interviews were conducted among 434 elderly individuals with pre-diabetes (fasting plasma glucose 6.1–7.0 mmol/L and/or 2-hour post-glucose load of 7.8–11.1 mmol/L) using questionnaires on diabetes-related behaviours. The diabetes-related behaviours included eight categories: average daily sedentary time; frequency of physical activities per week; regular or irregular diet; whether paying attention to diet control or not; daily dietary preferences; frequency of physical examinations per year; current smoking status; and current consumption of alcohol. Each of the risky behaviours was scored −1 and each of the healthy behaviours was scored +1. Each individual’s score of diabetes-related behaviours was the sum of the score for all behaviours.Main outcome measuresParticipants were asked about general information (age, gender, marital status, history of hyperglycaemia, family history of diabetes mellitus, presence of other diseases, body mass index, waist-to-hip ratio and education) and their diabetes-related behaviours. Multivariate linear regression analysis was performed to identify the risk factors for diabetes-related behaviour among elderly individuals with pre-diabetes.ResultsThe average score of diabetes-related behaviours of elderly individuals with pre-diabetes in rural China was 2.7. The prevalences of risky diabetes-related behaviours were as follows: <1 physical examination per year (57.6%), insufficient physical activities (55.3%), lack of attention paid to diet control (51.4%), high-salt and high-fat diets (41.0%), sedentary lifestyle (35.9%), smoking (22.8%), regular alcohol uptake (15.0%) and irregular diet (3.9%). Gender and a history of hyperglycaemia were found to be influencing factors of the diabetes-related behaviour score.ConclusionsThe prevalence of risky diabetes-related behaviours was high among pre-diabetic elderly individuals in rural China. More effort should be made to promote the prevention and control of diabetes in rural China. Future studies should be undertaken on diabetes prevention strategies tailored specially for this population.Trial registration numberChiCTR-IOR-15007033; Results.

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“…The well-documented health benefits of physical activity for young people include improved body composition and the prevention of overweight and obesity; plus benefits for skeletal, cardiovascular and psychological health [ 58 , 59 ]. In contrast, low levels of physical activity and a predisposition to sedentary behaviors are consistent with an early exposure to adult-onset health conditions [ 60 , 61 , 62 ]. Sadly, too many children and adolescents, and young girls in particular, are not sufficiently active to maximize health benefits.…”

Section: Physiological Behavioral and Psychosocial Changes Duringmentioning

confidence: 99%

“…Increasing knowledge and understanding of benefits, plus encouraging enjoyment in physical activity, is consistent with increased individual responsibility for activity participation and health more broadly. An optimal scenario would be to prevent the progression or development of overweight and obesity in adolescents ahead of the adult years [ 61 , 114 , 115 ].…”

Section: Approaches To Assist At-risk Individuals Reduce Obesity Rmentioning

confidence: 99%

Overweight and Obese Adolescent Girls: The Importance of Promoting Sensible Eating and Activity Behaviors from the Start of the Adolescent Period

Todd

Street

Ziviani

et al. 2015

IJERPH

111

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The adolescent period is associated with changes in eating and activity behaviors in girls. Less reliance on parental provision and choice of food, coupled with a decrease in participation in physical activity and sport, can create an energy imbalance, predisposing to weight gain. Physiological alterations to body composition, reduction in insulin sensitivity, and psychological adjustments may further amplify the risk of becoming overweight and maintaining an unhealthy level of body fat into childbearing years. During pregnancy excess body fat is a risk factor for poor pregnancy outcomes and may predispose an infant to a lifelong heightened risk of being overweight and developing chronic disease. Interventions aimed at preventing the accumulation of body fat in adolescent girls and young women may have far reaching impact and be critically important in reducing intergenerational weight gain. Lifestyle interventions in adolescence have the potential to modify adult obesity risk by switching at-risk individuals from a high to lower obesity risk trajectory. This paper discusses multiple approaches to assist at-risk individuals reduce obesity risk. A key focus is placed on engagement in food preparation and choice, and opportunities for physical activity and sport. Support, education, and opportunity at home and at school, are often associated with the success of lifestyle interventions, and may enable adolescents to make positive choices, and engage in health promoting behaviors during adolescence and childbearing years.

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Behavioral Contributions to the Pathogenesis of Type 2 Diabetes

Cited by 34 publications

References 117 publications

The Impact of a Mobile Diabetes Health Intervention on Diabetes Distress and Depression Among Adults: Secondary Analysis of a Cluster Randomized Controlled Trial

The Impact of a Mobile Diabetes Health Intervention on Diabetes Distress and Depression Among Adults: Secondary Analysis of a Cluster Randomized Controlled Trial

Diabetes-related behaviours among elderly people with pre-diabetes in rural communities of Hunan, China: a cross-sectional study

Overweight and Obese Adolescent Girls: The Importance of Promoting Sensible Eating and Activity Behaviors from the Start of the Adolescent Period

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