Self-Reported Factors That Affect Glycemic Control in College Students With Type 1 Diabetes

Ramchandani, Neesha; Cantey-Kiser, Jean; Alter, Craig A.; Brink, Stuart; Yeager, Shelley D.; Tamborlane, William V.; Chipkin, Stuart R.

doi:10.1177/014572170002600413

Cited by 69 publications

(82 citation statements)

References 14 publications

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“…In a qualitative study of young adults living with T1D, 71% reported that diabetes was more difficult to manage in college than in high school [1]. A similar study of urban youth with T1D conducted by Gee and colleagues found that challenges in establishing independence as a young adult were similar to those without a chronic condition, but coping with the management of diabetes magnified the difficulties of emerging adulthood and generally resulted in poor diabetes management [3].…”

Section: Background and Rationalementioning

confidence: 99%

“…The presence of a chronic condition such as type 1 diabetes (T1D) can exacerbate the complexities of this period of emerging adulthood by placing additional responsibilities on young adults as they adjust to a new environment and cope with new life situations [1]. Additionally, health care providers (HCPs) may face challenges assisting older adolescents and young adults transitioning from pediatric to adult clinical care due to gaps in patient healthcare utilization among emerging adults with diabetes.…”

Section: Background and Rationalementioning

confidence: 99%

“…Previous studies report several barriers that hinder optimal diabetes management during emerging adulthood, including difficulty finding health professionals with T1D expertise, diminished social networks and support, irregular schedules, the increased presence of drugs and alcohol, and financial struggles [1,2]. These challenges often lead to a wane in diabetes management and self-care during the transition years of emerging adulthood.…”

Section: Background and Rationalementioning

confidence: 99%

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Transitioning from Pediatric to Adult Diabetes Care

Johnson

Melton²,

Wingert

2016

PLAID

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Objective: The clinical transition from pediatric to adult diabetes care is often challenging for both young adults with type 1 diabetes (T1D) and the health care providers (HCPs) who care for this population. This study presents insights into the perceptions and needs of both patients with diabetes and HCPs during the clinical transition.Research Design and Method: Two separate surveys were administered with questions specifically tailored to each audience. Perceptions of the transition phase for both patients with T1D and HCPs were analyzed for general trends and then compared to investigate similarities and differences between patient and provider needs.Results: Both patients and HCPs expressed concerns regarding poor patient-provider communication during transition and the barriers to independently managing diabetes self-care responsibilities (e.g. navigating insurance, ordering supplies, arranging healthcare appointments). Although 45% of HCPs reported screening transition age patients for mental health issues related to diabetes, only 9% of patients stated their provider offered this opportunity. Furthermore, patients reported facing a variety of challenges not discussed with their HCP including: sexual issues (28%), depression or anxiety (17%), and eating disorders (11%). Conclusions:Training in the assessment of young adult T1D needs and effective communication techniques may assist HCPs in working more effectively with young adults. Offering mental health screenings for transition age patients may open the conversation to discuss diabetes concerns such as depression, sexual challenges, and eating disorders not currently being addressed. Both patients and providers desired improved communication with more emphasis on independently managing diabetes responsibilities and adjusting to new life situations.

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Section: Background and Rationalementioning

confidence: 99%

Section: Background and Rationalementioning

confidence: 99%

Section: Background and Rationalementioning

confidence: 99%

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Transitioning from Pediatric to Adult Diabetes Care

Johnson

Melton²,

Wingert

2016

PLAID

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“…In a study by Ramchandani N et al commonly reported barriers to diabetes control included diet and irregular schedules. 12 This highlights the importance of diet control right from the stage of impaired glucose tolerance which is a risk factor in the occurrence and progress of diabetes.…”

Section: Dietmentioning

confidence: 99%

A cross-sectional study of impaired glucose tolerance amongst undergraduate medical students

2016

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Background: Diabetes is an important chronic disease both in terms of prevalence and associated morbidity and early mortality. Mortality rates in diabetics are two- to threefold higher than those without diabetes. Type 2 Diabetes Mellitus is preceded by a period of abnormal glucose homeostasis and hence early diagnosis is important in decreasing this morbidity and mortality. The oral glucose tolerance test (OGTT) is currently the gold standard for the diagnosis of diabetes.Methods: This cross sectional single observer study was conducted amongst all the undergraduate students and interns of a municipal medical college to assess the point prevalence of impaired glucose tolerance and the factors predisposing to the same. After necessary permissions, participants giving written informed consent were interviewed and participants were subjected to an oral glucose tolerance test (OGTT) and their heights, weights were measured.Results: None of the participants had an increased fasting blood glucose but 30 min, 60 min and 90 min post OGTT blood glucose levels were increased in 9 (11.84%) participants and 120 min post OGTT blood glucose was increased in 15 (19.73%) participants. Increase in Body Mass Index (BMI) shows a positive correlation with fasting (r=0.155) and 120 min post OGTT blood glucose (r=0.042). Increase in weekly junk food servings shows a positive correlation with fasting (r=0.014), 90 min (r=0.004) and 120 min post OGTT blood glucose (r=0.009).Conclusions: Impaired glucose tolerance was present in a substantial number of non-diabetic students and had a correlation with BMI, exercise and junk food intake.

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“…Targeting postprandial hyperglycemia is important in order to improve HbA1c levels and this has also been recently highlighted by the International Diabetes Federation guidelines (84,85). In everyday life the control of postprandial hyperglycemia poses even more challenges due to variations in dietary intake and physical exercise or insulin dosage and timing changes (patients may modify the timing of insulin administration in the sense of dosing immediately before or even after meals in order to fit their lifestyle / daily activity requirements) (86). In addition, lack of predictable insulin response may occur with insulin analogues because their absorption can be affected by various factors such as: mechanics of injection, the injection site, and metabolic factors, similar to regular human insulin (87).…”

Section: Insulinmentioning

confidence: 99%