المؤلفون: Rosenberg, Anna G. W., KéMochèl, Hähner, Lorena M., Ruules, Lara, Davidse, Kirsten, Bos-Roubos, Anja G., van Dijk, Sarah A., Zillikens, M. Carola, Taal, Walter, van der Lely, Aart J., de Graaff, Laura C. G.

المصدر: Frontiers in Endocrinology; 2024, p1-12, 12p

مصطلحات موضوعية: FATIGUE (Physiology), NEUROFIBROMATOSIS 1, ADULTS, VITAMIN D deficiency, LITERATURE reviews

مستخلص: Context: Neurofibromatosis type 1 (NF1) is a complex system disorder, caused by alterations in RAS pathways. NF1 adults often suffer from chronic and severe fatigue, for which they are frequently referred to Internal Medicine/Endocrinology. Seeking medical help often leads to (invasive) diagnostic procedures. To prevent the personal and financial burden of this disabling fatigue, it is crucial to know the causes. Objective: To explore somatic causes and provide practical recommendations for the approach to fatigue in adults with NF1. Design: Cross-sectional. All adults with NF1 (N = 133) who visited our Endocrinology department underwent a systematic health screening, including a medical questionnaire, structured interview, complete physical examination, biochemical measurements and additional tests if indicated. Main outcome measure: Prevalence of endocrine and non-endocrine health problems between NF1 adults with and without fatigue. Results: In our cohort, 75% of NF1 adults experienced fatigue. The most frequent endocrine disorders were vitamin D deficiency (28%), obesity (18%) and hypothyroidism (8%). The most frequent non-endocrine internal disorder was high blood pressure (42%). None of the disorders differed significantly between adults with and without fatigue. Conclusions: Endocrine and non-endocrine disorders were equally present in our cohort of NF1 adults with and without fatigue. This suggests that the high prevalence of fatigue in NF1 adults is not explained by these somatic disorders. An alternative explanation for fatigue might be deficits in cognitive functioning and other neuropsychological processes in NF1. Based on our results and review of the literature, we provide a clinical algorithm for the approach to fatigue in NF1 adults, including somatic and psychological assessment. [ABSTRACT FROM AUTHOR]

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المؤلفون: Núñez-Baila, María-Ángeles, Gómez-Aragón, Anjhara, Marques-Silva, Armando-Manuel, González-López, José Rafael

المصدر: Healthcare (2227-9032); Feb2024, Vol. 12 Issue 3, p309, 21p

مصطلحات موضوعية: CINAHL database, MEDICAL databases, PSYCHOLOGY information storage & retrieval systems, ONLINE information services, TRANSITION to adulthood, TYPE 1 diabetes, HEALTH behavior, RESEARCH funding, MEDLINE, BEHAVIOR modification, HEALTH promotion

مستخلص: Emerging adulthood is a transitional stage with significant lifestyle changes, making it especially challenging for those living with type 1 diabetes mellitus. This systematic review synthesizes qualitative research to explore how emerging adulthood (18–29 years) influences lifestyle behaviors in individuals with type 1 diabetes mellitus. CINAHL, Cochrane Library, Global Health, Nursing & Allied Health Premium, PsycINFO, PubMed, Scopus, and WOS were searched for original qualitative studies addressing the lifestyle of 18–31-year-olds with type 1 diabetes mellitus, published between January 2010 and March 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thirty-five studies met the inclusion criteria and their findings were categorized into eight topics (emotions and feelings, nutrition, perceptions, risky behaviors, self-care, sleep, social relationships, and stigma) using meta-aggregation, as outlined in the Joanna Briggs Institute Manual for Evidence Synthesis. The spontaneity characteristic of emerging adulthood can undermine self-care. This is because new environments, schedules, and relationships encountered during this life stage often lead to the neglect of diabetes management, owing to the various social, academic, and occupational demands. This review highlights the necessity of creating health promotion strategies tailored to the unique lifestyle aspects of emerging adults with type 1 diabetes mellitus. [ABSTRACT FROM AUTHOR]

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المؤلفون: Xinrui Tan, Xiongfeng Pan, Xiaochuan Wu, Songjia Zheng, Yuyao Chen, Donghai Liu, Xingxing Zhang

المصدر: Frontiers in Pharmacology; 2024, p01-10, 10p

مصطلحات موضوعية: GLUCAGON-like peptide-1 receptor, GLUCAGON-like peptide-1 agonists, TYPE 1 diabetes, INSULIN, INSULIN therapy, DIASTOLIC blood pressure, PEPTIDE receptors

مستخلص: Background: To assess the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) used as an adjunct to insulin therapy in adults with type 1 diabetes. Methods: A search of electronic databases (Medline, Embase, and the Cochrane Central Register of Controlled Trials) from 1 January 1950 to 23 May 2021 was conducted to find randomized controlled trials. The primary outcome was the change in HbA1c. Eight efficacy and six safety secondary endpoints were evaluated via meta-analysis. Weighted mean difference (WMD) and odds ratio (OR), alongside 95% confidence interval (CI), were calculated using the random effects model. Results: Among 1,379 candidate studies, 11 trials comprising 2,856 participants satisfied the inclusion criteria. Overall, GLP-1 RA adjunctive therapy reduced HbA1c by -0.21% (95% CI, -0.33 to -0.10), weight by -4.04 kg (-4.8 to -3.27), systolic pressure by -2.57 mmHg (-4.11 to -1.03), and diastolic blood pressure by -1.02 mmHg (-1.99 to -0.06). In addition, there was a decrease in prandial insulin dose (WMD, -4.23 IU; 95% CI, -5.26 to -3.20), basal insulin dose (-2.40 IU; -3.93 to -0.87), and total insulin dose (-5.73 IU; -10.61 to -0.86). Moreover, GLP-1 RAs did not increase the incidence of severe hypoglycemia, diabetic ketoacidosis, or severe adverse events. However, GLP-1 RAs increased the incidence of gastrointestinal adverse events (OR, 2.96; 95% CI, 2.33-3.77). Conclusion: Our meta-analysis of randomized clinical trials suggests moderate beneficial effects of GLP-1 RAs on the metabolic profile in patients with type 1 diabetes, without an increased risk of serious adverse events. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPEROTest; Identifier: CRD 42020199840. [ABSTRACT FROM AUTHOR]

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المؤلفون: Sińska, Beata I., Rzońca, Ewa, Kucharska, Alicja, Gałązkowski, Robert, Traczyk, Iwona, Rzońca, Patryk

المصدر: European Journal of Investigation in Health, Psychology & Education (EJIHPE); Oct2023, Vol. 13 Issue 10, p2035-2045, 11p

مصطلحات موضوعية: GLYCOSYLATED hemoglobin, TYPE 1 diabetes, GLYCEMIC control, DIABETES, ADULTS, COMPULSIVE eating

مستخلص: Numerous complications of type 1 diabetes (T1D) may be prevented through suitable glycemic control. Glycated hemoglobin (HbA1c) may be one of the markers for the early detection of the metabolic imbalance characteristic of the disease. However, optimal control of diabetes is not achieved in a large group of patients. It was demonstrated that numerous factors (sociodemographic, psychological, and clinical) contributed to this condition. The aim of the study was to identify factors influencing the control of diabetes measured via glycated hemoglobin concentrations in people with T1D. Independent factors influencing better diabetes control measured via HbA1c in the study group included higher disease acceptance, higher nutritional adherence, lower BMI, and a lower risk of eating disorders. Describing the determinants will allow for the improvement of the system of care provided to people with T1D and for it to comprise important psychological variables related to self-care and acceptance of the disease. [ABSTRACT FROM AUTHOR]

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المؤلفون: Due‐Christensen, Mette, Bruun, L. D., Joensen, L. E., Norgaard, O., Andersen, T. H.

المصدر: Diabetic Medicine; May2023, Vol. 40 Issue 5, p1-14, 14p

مصطلحات موضوعية: CINAHL database, PSYCHOLOGY information storage & retrieval systems, MEDICAL information storage & retrieval systems, SYSTEMATIC reviews, TYPE 1 diabetes, PATIENTS' attitudes, PSYCHOSOCIAL factors, RESEARCH funding, PSYCHOLOGY of the sick, LITERATURE reviews, MEDLINE, PEOPLE with diabetes, ADULTS

مستخلص: Aim: To map existing research on psychosocial aspects of adult‐onset type 1 diabetes (T1D), including psychosocial health status, ways psychosocial aspects may affect management of T1D in everyday life, and interventions targeting management of adult‐onset T1D. Methods: We conducted a systematic search in MEDLINE, EMBASE, CINAHL and PsycInfo. Search results were screened with predefined eligibility criteria, followed by data extraction of the included studies. Charted data were summarized in narrative and tabular form. Results: We included 10 reports describing nine studies from the 7302 identified in the search. All studies were conducted in Europe. Participant characteristics were missing in several studies. Five of the nine studies incorporated psychosocial aspects as the main aim of the study. Limited information on psychosocial aspects was available in the remaining studies. We identified three overarching themes related to psychosocial aspects: (1) the impact of the diagnosis on everyday life, (2) the influence of psychosocial health on metabolic levels and adaptation, and (3) provision of self‐management support. Conclusions: Research focussing on psychosocial aspects of the adult‐onset population is scarce. Future research should involve participants across the adult life age span and from a wider geographical area. Sociodemographic information should be collected to explore different perspectives. Further exploration of suitable outcome measures considering adults' limited experience of living with the condition is needed. This would help to better understand how psychosocial aspects may affect management of T1D in everyday life and thus enable healthcare professionals to provide appropriate support to adults with new‐onset T1D. [ABSTRACT FROM AUTHOR]

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المؤلفون: Castricum, J., Tulen, J. H. M., Taal, W., Pel, J. J. M., Elgersma, Y.

المصدر: Journal of Intellectual Disability Research; Apr2023, Vol. 67 Issue 4, p362-374, 13p, 1 Diagram, 2 Charts, 1 Graph

مصطلحات موضوعية: THOUGHT & thinking, EXPERIMENTAL design, EYE movements, PSYCHOLOGY of movement, TASK performance, EYE, COMPARATIVE studies, HAND, RESEARCH funding, DESCRIPTIVE statistics, NEUROFIBROMATOSIS 1, SPACE perception, ADULTS

مستخلص: Background: Neurofibromatosis type 1 (NF1) is a neurodevelopmental genetic disorder associated with visual–spatial and visuomotor deficits, which have not been studied well in adults with NF1. Methods: In 22 adults with NF1 and 31 controls, visuomotor functioning was assessed by measuring eye latency, hand latency and hand accuracy during visuomotor tasks. Visual–spatial functioning was assessed by measuring eye movement responses during the Visual Threshold Task. Results: The NF1 group had a significantly shorter eye latency than the control group and was less accurate in their hand movements during specific visuomotor tasks. The groups showed no differences in eye movement responses during the Visual Threshold Task and in hand latency during the visuomotor tasks. Conclusions: In contrast to studies in children with NF1, we found no alterations in visual–spatial information processing in adults. Impairments in eye latency and hand accuracy during specific visuomotor tasks may indicate deficits in visuomotor functioning in adults with NF1. [ABSTRACT FROM AUTHOR]

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المؤلفون: Chen, Shuli, Qian, Yu, Lin, Qiurong, Chen, Zhangling, Xiang, Zhaoyu, Cui, Lipu, Sun, Jiaqi, Qin, Xinran, Xu, Yi, Lu, Lina, Zou, Haidong

المصدر: Acta Diabetologica; Nov2022, Vol. 59 Issue 11, p1505-1513, 9p

مصطلحات موضوعية: DIABETES in children, DIABETIC retinopathy, TYPE 1 diabetes, TYPE 2 diabetes, PEOPLE with diabetes

مصطلحات جغرافية: SHANGHAI (China)

مستخلص: Purpose: To investigate the relationship between serum 12-Hydroxyeicosatetraenoic acid (12-HETE) and diabetic retinopathy (DR) in children with type 1 diabetes mellitus (T1DM) and adults with type 2 diabetes mellitus (T2DM). Methods: Children from the Shanghai Children and Adolescent Diabetes Eye (SCADE) study and adults from the Shanghai Cohort Study of Diabetic Eye Disease (SCODE) were examined in 2021. Serum 12-HETE levels were detected and compared. Multivariate logistic regression was used to analyze the relationship between 12-HETE and the rate of DR in diabetic patients. Results: The child study included 4 patients with new-onset DR and 24 patients with T1DM without DR. In children with T1DM, the 12-HETE level was significantly higher in those with DR (P = 0.003). The adult study had two sets, for testing and verification. The test set included 28 patients with new-onset DR and 24 T2DM patients with a course of ≥ 20 years who had never developed DR. The verification set included 41 patients with DR, 50 patients without DR and 50 healthy controls. In the adult test set, the 12-HETE level was significantly higher in patients with DR than in those with T2DM without DR (P = 0.003). In the verification set, the 12-HETE level of patients with DR was significantly higher than that of patients without DR (P < 0.0001) and the healthy controls (P < 0.0001). Multivariate logistic regression indicated that 12-HETE was independently associated with DR in both children (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.00–1.13, P = 0.041) and adults (test set [OR 9.26, 95% CI 1.77–48.59, P = 0.008], verification set [OR 10.49, 95% CI 3.23–34.05, P < 0.001]). Conclusion: Higher serum 12-HETE levels are positively correlated with an increased risk of DR in children with T1DM and adults with T2DM. [ABSTRACT FROM AUTHOR]

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المؤلفون: Carreon, Samantha A., Cao, Viena T., Anderson, Barbara J., Thompson, Deborah I., Marrero, David G., Hilliard, Marisa E.

المصدر: Diabetic Medicine; May2022, Vol. 39 Issue 5, p1-11, 11p

مصطلحات موضوعية: RESEARCH methodology, TYPE 1 diabetes, INTERVIEWING, SLEEP disorders, QUALITATIVE research, THEMATIC analysis, PSYCHOLOGICAL distress, DISEASE complications

مصطلحات جغرافية: UNITED States

مستخلص: Aims: Individuals with type 1 diabetes (T1D) experience greater sleep disturbances than people without diabetes. However, the nature, causes and effects of sleep disruption in individuals with T1D and their family are not well understood. The purpose of this study was to explore and characterise the perspectives of parents, partners and individuals with diabetes about T1D‐related sleep issues. Methods: Participants included 44 youth and adults with T1D (ages 9–69), 24 parents of youth with T1D, and 14 partners of adults with T1D, recruited from diabetes clinics at two academic medical centres in the Southwestern and Midwestern United States. Semi‐structured qualitative interviews were transcribed verbatim, coded and analysed using hybrid thematic analysis. Results: We identified two central themes: Emotional Distress and Sleep Disruption. Each theme had multiple subthemes, and the two central themes were related to one another via a shared subtheme, Worry Impacting Sleep. Conclusions: Complex T1D‐related emotional and behavioural factors both contributed to and resulted from sleep difficulties. Diabetes care providers should routinely assess for sleep concerns in people with T1D and their parents and partners. It may be important to consider both diabetes‐related causes of sleep disruptions and potential impacts on self management and emotional functioning. [ABSTRACT FROM AUTHOR]

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المؤلفون: Castricum, Jesminne, Tulen, Joke H. M., Taal, Walter, Rietman, André B., Elgersma, Ype

المصدر: Journal of Attention Disorders; Feb2022, Vol. 26 Issue 4, p563-572, 10p

مصطلحات موضوعية: MOTOR learning, NEUROFIBROMATOSIS 1, ADULTS, ATTENTION control, LEARNING problems, GENETIC disorders, ATTENTION

مستخلص: Objective: Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder that is associated with cognitive disabilities, including attention and motor learning problems. These disabilities have been extensively studied in children with NF1 but limited studies have been performed in adults. Method: Attention, motor learning and intellectual performance were studied with neuropsychological tasks in 32 adults with NF1 and 32 controls. Results: The NF1 and control group performed similarly on attention and motor learning tasks, although controls had shorter reaction times than adults with NF1 during the motor learning task (t [60] = −2.20, p =.03). Measures of attention or motor learning were not significantly associated with reduced intellectual performance in NF1. Conclusion: In contrast to many studies in children with NF1, our findings did not provide evidence for presence of attention or motor learning problems in adults with NF1 in neuropsychological tasks. Our observations may be of clinical importance to determine treatment focus in adults with NF1. [ABSTRACT FROM AUTHOR]

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المؤلفون: Yazidi, Meriem, Gharbi, Radhouane, Chaker, Fatma, Oueslati, Ibtissem, Grira, Wafa, Khessairi, Nadia, Chihaoui, Melika

المصدر: Clinical Diabetology; 2022, Vol. 11 Issue 1, p1-5, 5p

مصطلحات موضوعية: PEOPLE with diabetes, TYPE 1 diabetes, GLYCEMIC control, SELF-management (Psychology), THERAPEUTICS

مستخلص: Background: The objective of the study is to determine the factors associated with the level of knowledge of Tunisian type 1 diabetic (T1D) patients in adulthood. Methods: This is a cross-sectional study including 93 T1D patients over 18 years old. The knowledge assessment was carried out by a questionnaire rated out of 20 points. The subjects with an "unsatisfactory" level of knowledge (score < 10/20) were compared with subjects whose level of knowledge was "satisfactory" according to their socio-demographic, clinical, and paraclinical characteristics. Results: The mean age of the patients was 37.2 ± ± 12.4 years. The level of knowledge was "unsatisfactory" in 21 patients (23%). After univariate analysis, an "unsatisfactory" level of knowledge was associated with a low level of education (p = 0.001), a poor socioeconomic level (p = 0.03), a poor glycemic control (p = 0.003) and the absence of self-monitoring (p = 0.002). After multivariate analysis, only a low level of education and a lack of practice of self-monitoring were associated with an "unsatisfactory" level of knowledge (respectively p = 0.03 and 0.03; adjusted OR [95% confidence interval] = 7.3 [1.2-43.5] and 13.7 [1.3-143.3]). Conclusions: The factors independently associated with the level of knowledge in adult T1D patients are the level of education and the practice of self-monitoring. This encourages better tailoring of educational messages to patients with low levels of education and suggests that a better level of knowledge ensures better self-management of diabetes. However, the relationship with the quality of glycemic control remains uncertain. [ABSTRACT FROM AUTHOR]

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