Occupational Therapy Intervention Improves Glycemic Control and Quality of Life Among Young Adults With Diabetes: the Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) Randomized Controlled Trial

Pyatak, Elizabeth A.; Carandang, Kristine; Vigen, Cheryl; Blanchard, Jeanine; Díaz, Jesús; Concha-Chavez, Alyssa; Sequeira, Paola A.; Wood, Jamie; Whittemore, Robin; Spruijt‐Metz, Donna; Peters, Anne L.

doi:10.2337/dc17-1634

Cited by 68 publications

(162 citation statements)

References 42 publications

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“…The authors of 34 studies that included adults over a wider age range were contacted, and five replied with study information. The majority of studies (123) were published after 2012 . Five studies were conducted in Europe , five in North America , two in Australia and one in the Western Pacific region .…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies (123) were published after 2012 . Five studies were conducted in Europe , five in North America , two in Australia and one in the Western Pacific region . Most studies were conducted in type 1 diabetes (eight studies) , three studies included both type 1 and 2 diabetes , and two studies included only type 2 diabetes .…”

Section: Resultsmentioning

confidence: 99%

“…Five studies were conducted in Europe , five in North America , two in Australia and one in the Western Pacific region . Most studies were conducted in type 1 diabetes (eight studies) , three studies included both type 1 and 2 diabetes , and two studies included only type 2 diabetes . Ten studies were conducted in tertiary diabetes clinics , two in the community and one in primary care .…”

Section: Resultsmentioning

confidence: 99%

“…The majority of interventions were delivered individually (10 interventions) and three were carried out in groups or were mixed . Communication methods were varied, with five interventions using in‐person communication , three using mobile health technology and five using telemedicine . Each intervention employed one to five behavioural change techniques from 12 different domains (Table ).…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of self‐management interventions in young adults with type 1 and 2 diabetes: a systematic review and meta‐analysis

Wong

Smith²,

Chua³

et al. 2019

Diabet. Med.

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Aim Diabetes in young adulthood has been associated with poor outcomes. Self-management is fundamental to good diabetes care, and self-management interventions have been found to improve outcomes in older adults. We performed a systematic review and meta-analysis to assess the effectiveness of self-management interventions in young adults (aged 15-39 years) with type 1 or type 2 diabetes.Methods We searched five databases and two clinical trial registries from 2003 to February 2019, without language restrictions. We included randomized controlled trials (RCTs) comparing the effectiveness of self-management interventions with usual care or enhanced usual care in young adults. Outcomes of interest included clinical outcomes, psychological health, self-care behaviours, diabetes knowledge and self-efficacy. Pairwise meta-analysis was conducted using a random effects model and quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria. We followed Cochrane gold standard systematic review methodology and reported this systematic review according to PRISMA guidelines. The protocol was registered with PROSEPRO (CRD42018110868). ResultsIn total, 13 studies (1002 participants) were included. Meta-analysis showed no difference between selfmanagement interventions and controls in post-intervention HbA 1c levels, BMI, depression, diabetes-related distress, overall self-care, diabetes knowledge and self-efficacy. Quality of evidence ranged from very low to moderate due to study limitations, inconsistency and imprecision.Conclusions Current self-management interventions did not improve outcomes in young adults with diabetes. Our findings, which contrast with those from systematic reviews in older adults, highlight the need for the development of more effective interventions for young adults with diabetes. Diabet. Med. 37, 229-241 (2020) Self-management is a cornerstone of diabetes care. Yet, many have difficulties accomplishing the complex regimen of self-care behaviours, including healthy eating, regular exercise, taking medications as prescribed, managing negative emotions and making regular clinic visits [8]. Additionally, up to 18% of young adults with type 1 diabetes and 30% with type 2 experience moderate to severe depressive symptoms [9], highlighting the need for self-management interventions to facilitate healthy behaviours and achieve optimal diabetes outcomes, while supporting psychological well-being. Self-management interventions form a diverse group, and differ in their method of delivery, mode of communication and intensity [10]. Self-management interventions also incorporate a variety of behavioural change techniques for self-care. The BCT Taxonomy v1

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of self‐management interventions in young adults with type 1 and 2 diabetes: a systematic review and meta‐analysis

Wong

Smith²,

Chua³

et al. 2019

Diabet. Med.

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“…Current literature has demonstrated the utility and effectiveness of educational interventions in improving transition outcomes in chronic pediatric conditions such a congenital heart disease and diabetes. [7][8][9][10][11] Using an educational approach may be ideal in the SCD population, as cerebrovascular injury and cognitive impairment are hallmarks of the disease. 12 Prior to Transcranial Doppler screening and transfusion therapy, patients with the most severe genotypes (SS and S thal0 ) have an absolute risk of overt stroke of 11% by 20 years of age, with a cumulative stroke risk of 12.8% by age 20.…”

Section: Introductionmentioning

confidence: 99%

Implementation of an educational intervention to optimize self‐management and transition readiness in young adults with sickle cell disease

Calhoun

Abel

Pham

et al. 2019

Pediatric Blood & Cancer

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Background The transition from the pediatric setting to adult care is a well‐described period of morbidity and mortality for persons with sickle cell disease (SCD). We sought to measure the feasibility and effectiveness of providing skill‐based educational handouts on improving self‐management and transition readiness in adolescents with SCD. Methods This was a single‐center study in which participants completed a self‐assessment, the Adolescent Autonomy Checklist (AAC), to assess transition readiness and self‐management skills at baseline. After results were reviewed by the study coordinator, participants were provided with skill‐based handouts on noted areas of deficit. The AAC was subsequently completed at a follow‐up visit. All data were stored electronically and transferred into SAS for statistical analyses. Results Sixty‐one patients completed the AAC at baseline and postintervention. At baseline, patients reported needing the most help with skills in money management, living arrangements, vocational skills, and emergency and healthcare skills. Postintervention, statistically significant improvements (P < 0.05) occurred in skills related to laundry, housekeeping, healthcare, and sexual development. A regression model exploring the time to follow‐up showed that most improvements could not be attributed to maturation alone. Conclusion This study showed that educational handouts are a readily implementable and well‐accepted intervention among adolescents with SCD who identify challenges with skills necessary to successfully transition to adult care. Distinguishing which transition needs are best improved with this type of intervention will help to strengthen the multidisciplinary approach necessary to support adolescents and young adults with SCD as they matriculate to adult care.

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Diagnose und Management der Osteoporose bei Diabetes mellitus (Update 2023)

Muschitz

Kautzky‐Willer

Winhofer

et al. 2023

Wien Klin Wochenschr

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ZusammenfassungDiabetes mellitus und Osteoporose zählen zu den häufigsten chronischen Erkrankungen und kommen deshalb beide häufig in ein und demselben Individuum vor. Da die Prävalenz beider mit steigendem Alter zunimmt, wird in Anbetracht der Altersstruktur unserer Bevölkerung deren Häufigkeit zunehmen.Patient:innen mit Diabetes haben ein erhöhtes Risiko für Fragilitätsfrakturen. Die Pathophysiologie ist unklar und vermutlich multifaktoriell.Longitudinale Studien haben den Nachweis erbracht, dass das Fracture Risk Assessment Tool (FRAX) und die Knochendichte (BMD) mittels DXA (T-score) Messungen und einem eventuell vorhandenen Trabecular Bone Score (TBS) das individuelle Frakturrisiko vorhersagen können. Hierfür muss allerdings eine Adjustierung vorgenommen werden, um das Risiko nicht zu unterschätzen.Es gibt derzeit aus osteologischer Sicht noch nicht den optimalen Ansatz, da es keine Studien mit rein diabetischen Patient:innen und Osteoporose gibt.Patient:innen mit Diabetes mellitus und einem erhöhten Frakturrisiko sollten genauso wie Patient:innen ohne Diabetes und einem erhöhten Frakturrisiko behandelt werden.Der Vitamin-D-Spiegel sollte auf jeden Fall immer optimiert werden und auf eine ausreichende Kalziumaufnahme (vorzugsweise durch die Nahrung) ist zu achten.Bei der Wahl der antihyperglykämischen Therapie sollten Substanzen mit nachgewiesen negativem Effekt auf den Knochen weggelassen werden. Bei Vorliegen einer Fragilitätsfraktur ist auf jeden Fall – unabhängig von allen vorliegenden Befunden – eine langfristige spezifische osteologische Therapie indiziert.Zur Prävention von Fragilitätsfrakturen sind antiresorptive Medikamente die erste Wahl, entsprechend den nationalen Erstattungskriterien auch anabole Medikamente. Das Therapiemonitoring soll im Einklang mit der nationalen Osteoporose Leitlinie erfolgen.

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Occupational Therapy Intervention Improves Glycemic Control and Quality of Life Among Young Adults With Diabetes: the Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) Randomized Controlled Trial

Cited by 68 publications

References 42 publications

Effectiveness of self‐management interventions in young adults with type 1 and 2 diabetes: a systematic review and meta‐analysis

Effectiveness of self‐management interventions in young adults with type 1 and 2 diabetes: a systematic review and meta‐analysis

Implementation of an educational intervention to optimize self‐management and transition readiness in young adults with sickle cell disease

Diagnose und Management der Osteoporose bei Diabetes mellitus (Update 2023)

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