Article
The transition to young adulthood in youth with type 1 diabetes on intensive treatment.
Yale University School of Nursing, New Haven, CT, USA.
Pediatric Diabetes (impact factor:
2.16).
09/2007;
8(4):228-34.
DOI:10.1111/j.1399-5448.2007.00266.x
pp.228-34
Source: PubMed
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Citations (0)
- Cited In (3)
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Article: Continuity and change in glycemic control trajectories from adolescence to emerging adulthood: relationships with family climate and self-concept in type 1 diabetes.
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ABSTRACT: To determine developmental classes of glycemic control in young people with type 1 diabetes throughout adolescence and emerging adulthood and assess relationships with general family climate and self-concept. In an eight-wave longitudinal study, 72 individuals (37 females) completed questionnaires assessing family climate (at times 1-4) and self-concept (at times 1-4 and 6). Times 1-4 covered adolescence (mean ages were 14-17 years, respectively); times 5-8 covered emerging adulthood (mean ages were 21-25 years, respectively). At each time point, patients visited their physicians to determine A1C values, and questionnaires were sent to the physicians to obtain these values. Latent class growth analysis was used to identify developmental classes of glycemic control. Latent class growth analysis favored a three-class solution, consisting of optimal control (n = 10), moderate control (n = 51), and deteriorating control (n = 11). From time 3 on and especially during emerging adulthood, mean A1C levels were substantially different among the classes. Additional ANOVAs indicated that at times 1, 2, and 4, the optimal control class was characterized by the most optimal family climate, whereas at times 3, 4, and 6, the deteriorating control class was characterized by the lowest score on positive self-concept. From late adolescence on, a multiformity of glycemic control trajectories emerged, which became more diversified throughout emerging adulthood. Family climate and self-concept in mid-to-late adolescence served as psychosocial markers of these developmental classes.Diabetes care 03/2009; 32(5):797-801. · 8.09 Impact Factor -
Article: Annotated bibliography of NINR findings on women's health across the lifespan, 2008 update.
Journal of Obstetric Gynecologic & Neonatal Nursing 37(6):702-4. · 1.03 Impact Factor -
Article: Incremental value of continuous glucose monitoring when starting pump therapy in patients with poorly controlled type 1 diabetes: the RealTrend study.
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ABSTRACT: To compare the improvements in glycemic control associated with transitioning to insulin pump therapy in patients using continuous glucose monitoring versus standard blood glucose self-monitoring. The RealTrend study was a 6-month, randomized, parallel-group, two-arm, open-label study of 132 adults and children with uncontrolled type 1 diabetes (A1C >or=8%) being treated with multiple daily injections. One group was fitted with the Medtronic MiniMed Paradigm REAL-Time system (PRT group), an insulin pump with integrated continuous subcutaneous glucose monitoring (CGM) capability, with instructions to wear CGM sensors at least 70% of the time. Conventional insulin pump therapy was initiated in the other group (continuous subcutaneous insulin infusion [CSII] group). Outcome measures included A1C and glycemic variability. A total of 115 patients completed the study. Between baseline and trial end, A1C improved significantly in both groups (PRT group -0.81 +/- 1.09%, P < 0.001; CSII group -0.57 +/- 0.94%, P < 0.001), with no significant difference between groups. When the 91 patients who were fully protocol-compliant (including CGM sensor wear >or=70% of the time) were considered, A1C improvement was significantly greater in the PRT group (P = 0.004) (PRT group -0.96 +/- 0.93%, P < 0.001; CSII group -0.55 +/- 0.93%, P < 0.001). Hyperglycemia parameters decreased in line with improvements in A1C with no impact on hypoglycemia. CGM-enabled insulin pump therapy improves glycemia more than conventional pump therapy during the first 6 months of pump use in patients who wear CGM sensors at least 70% of the time.Diabetes care 09/2009; 32(12):2245-50. · 8.09 Impact Factor
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Keywords
117 adolescents
adolescent levels
cohort initiating intensive therapy
complications
Complications Trial
diabetes
diabetes complications
Diabetes Control
diabetes duration
disease-related worries
large pediatric diabetes clinic
metabolic control
Metabolic control worsens
negative impact
prospectively patterns
psychosocial outcomes
randomized intervention study
treatment group
young adulthood
young adults