المؤلفون: Gregory, Justin M, Slaughter, James C, Duffus, Sara H, Smith, T Jordan, LeStourgeon, Lauren M, Jaser, Sarah S, McCoy, Allison B, Luther, James M, Giovannetti, Erin R, Boeder, Schafer, Pettus, Jeremy H, Moore, Daniel J

المصدر: Diabetes Care. 44(2)

مصطلحات موضوعية: Diabetes, Prevention, Clinical Research, Infectious Diseases, Metabolic and endocrine, Good Health and Well Being, COVID-19, Comorbidity, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Electronic Health Records, Female, Hospitalization, Humans, Hypertension, Male, Middle Aged, Odds Ratio, Prospective Studies, Severity of Illness Index

الوصف: ObjectiveTo quantify and contextualize the risk for coronavirus disease 2019 (COVID-19)-related hospitalization and illness severity in type 1 diabetes.Research design and methodsWe conducted a prospective cohort study to identify case subjects with COVID-19 across a regional health care network of 137 service locations. Using an electronic health record query, chart review, and patient contact, we identified clinical factors influencing illness severity.ResultsWe identified COVID-19 in 6,138, 40, and 273 patients without diabetes and with type 1 and type 2 diabetes, respectively. Compared with not having diabetes, people with type 1 diabetes had adjusted odds ratios of 3.90 (95% CI 1.75-8.69) for hospitalization and 3.35 (95% CI 1.53-7.33) for greater illness severity, which was similar to risk in type 2 diabetes. Among patients with type 1 diabetes, glycosylated hemoglobin (HbA1c), hypertension, race, recent diabetic ketoacidosis, health insurance status, and less diabetes technology use were significantly associated with illness severity.ConclusionsDiabetes status, both type 1 and type 2, independently increases the adverse impacts of COVID-19. Potentially modifiable factors (e.g., HbA1c) had significant but modest impact compared with comparatively static factors (e.g., race and insurance) in type 1 diabetes, indicating an urgent and continued need to mitigate severe acute respiratory syndrome coronavirus 2 infection risk in this community.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3790z95fTest

المؤلفون: Straton, Emma, Inverso, Hailey, Moore, Hailey, Anifowoshe, Kashope, Washington, Kendall, Streisand, Randi, Datye, Karishma, Jaser, Sarah S.

المساهمون: Division of Diabetes, Endocrinology, and Metabolic Diseases

المصدر: Journal of Diabetes Science and Technology ; ISSN 1932-2968 1932-2968

مصطلحات موضوعية: Biomedical Engineering, Bioengineering, Endocrinology, Diabetes and Metabolism, Internal Medicine

الوصف: Background: Continuous glucose monitor (CGM) use has been linked with better glycemic outcomes (HbA1c), yet many adolescents with type 1 diabetes (T1D) struggle to maintain optimal CGM use. Methods: This study examined CGM use and its association with HbA1c and psychosocial factors among adolescents with T1D experiencing at least moderate diabetes distress (N = 198). We examined mean differences in HbA1c, diabetes distress, diabetes-related family conflict, and quality of life among CGM user groups ( Current Users, Past Users, and Never Users). Results: Current Users demonstrated significantly lower HbA1c than Never Users and significantly lower diabetes distress than Past Users. CGM use was not associated with family conflict or quality of life. Conclusions: CGM use was associated with lower HbA1c and diabetes distress but not with other psychosocial outcomes. Longitudinal data may explain why many adolescents do not experience improvements in quality of life with CGM use.

الإتاحة: https://doi.org/10.1177/19322968231186428Test

المؤلفون: Davis, Sara L., Jaser, Sarah S., Ivankova, Nataliya, Oates, Gabriela, Kaulfers, Anne-Marie, Rice, Marti

المصدر: Journal of Clinical and Translational Science ; volume 7, issue s1, page 57-57 ; ISSN 2059-8661

مصطلحات موضوعية: General Medicine

الوصف: OBJECTIVES/GOALS: The purpose of this mixed methods project was to gain a comprehensive understanding and generate data on factors, including stress and inflammatory biomarkers, that may negatively impact glycemic levels in children aged 8-12 years with type 1 diabetes (T1D) from underrepresented backgrounds. METHODS/STUDY POPULATION: This study employed a two-phase sequential QUAN -> qual mixed methods design. Children and their parents were recruited from a pediatric endocrinology clinic in the southeastern United States. In phase 1 (n=34), we used quantitative methods to measure perceived stress, diabetes distress, cortisol, inflammation (IL-1b, IL-2; IL-6; IL-8; TNF-a; CRP), and glycemic level (HbA1c). Both children and their parent/guardian completed surveys, and children provided salivary and blood samples to measure cortisol and inflammatory markers. Phase 2 qualitative interviews in a subset (n=20) of children and parent/guardians from phase 1 are ongoing; preliminary findings will be included in the presentation. RESULTS/ANTICIPATED RESULTS: Mean age of children was 10.47 (sd=1.44), 67.6% were male, and 41.2% were black. HbA1c ranged from 6.8%-15% and only 2 (5.8%) children met ADA recommendations for HbA1c of 7% or less. HbA1c was associated with child reports of perceived stress (r = .403, p < .05), but not parent reports of child perceived stress (r = -.011, p > .05). Parent reports of perceived stress and diabetes distress in children were not significantly associated with child self-report of perceived stress (r = .11, p > .05) or diabetes distress (r = .018, p > .05). Exploratory models with PROCESS suggest that cortisol slope and IL-8 moderate the relationship between child’s perceived stress and glycemic control. DISCUSSION/SIGNIFICANCE: Stressors are emerging that are unique to this population and may help highlight disparities in care. While the study is ongoing, findings may help health professionals identify and mitigate stressors in children with T1D to help maintain optimal ...

الإتاحة: https://doi.org/10.1017/cts.2023.263Test
https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S2059866123002637Test

المؤلفون: Tilden, Daniel R., Anifowoshe, Kashope, Jaser, Sarah S.

المصدر: Diabetic Medicine; May2024, Vol. 41 Issue 5, p1-11, 11p

مصطلحات موضوعية: TYPE 1 diabetes, EMOTION regulation, RESEARCH funding, GLYCOSYLATED hemoglobin, FAMILY conflict, PARENT-child relationships, PARENTING, DESCRIPTIVE statistics, BLOOD sugar, QUALITY of life, MOTHERHOOD, PSYCHOSOCIAL functioning, ADOLESCENCE

مستخلص: Aims: Maternal caregiver involvement is strongly associated with psychosocial and glycemic outcomes amongst adolescents with type 1 diabetes (T1D); however, previous studies have lacked detailed, objective examinations of caregiver involvement. We examined the relationship between observed parenting behaviors and psychosocial and glycemic outcomes amongst youth with T1D. Methods: Data collected from adolescents with T1D (age 11‐17) and their female caregivers as a part of a randomized controlled trial were analyzed. These included structured, observation‐based scores of adolescent‐caregiver dyads engaged in videotaped interactions and selected psychosocial and glycemic outcome measures. Results: In adjusted analyses, higher levels of intrusive parenting behaviors during observed interactions were associated with higher diabetes distress in adolescents, but no difference in HbA1c. Associations between intrusive parenting behaviors and psychosocial outcomes were stronger for females compared to males for both diabetes distress and quality of life. Similarly, associations between collaborative parenting behaviors and quality of life were stronger for female adolescents than males. No associations were observed between collaborative parenting behaviors and glycemic outcomes. Consistent with previous work, we noted higher levels of adolescent‐reported family conflict were associated with lower adolescent quality of life and higher diabetes distress with no significant difference between male and female adolescents. Conclusion: These findings indicate that high levels of intrusive parenting behaviors, such as lecturing or over‐controlling behaviors, are associated with lower levels of adolescent well‐being, particularly among adolescent girls. This work suggests that interventions to reduce intrusive parenting by maternal caregivers could result in improved psychosocial outcomes for adolescents with T1D. [ABSTRACT FROM AUTHOR]

: Copyright of Diabetic Medicine is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Cai, Leon Y., Del Tufo, Stephanie N., Barquero, Laura, D'Archangel, Micah, Sachs, Lanier, Cutting, Laurie E., Glaser, Nicole, Ghetti, Simona, Jaser, Sarah S., Anderson, Adam W., Jordan, Lori C., Landman, Bennett A.

المساهمون: Colliot, Olivier, Mitra, Jhimli

المصدر: Medical Imaging 2024: Image Processing

الإتاحة: https://doi.org/10.1117/12.3005391Test

المؤلفون: Barnard-Kelly, Katharine, Marrero, David, de Wit, Maartje, Pouwer, Frans, Khunti, Kamlesh, Hermans, Norbert, Pierce, Jessica S., Laffel, Lori, Holt, Richard I.G., Battelino, Tadej, Naranjo, Diana, Fosbury, Jacqueline, Fisher, Lawrence, Polonsky, William, Weissberg-Benchell, Jill, Hood, Korey K., Schnell, Oliver, Messer, Laurel H., Danne, Thomas, Nimri, Revital, Skovlund, Soren E., Mader, Julia K., Sherr, Jennifer L., Schatz, Desmond, O'Neill, Simon, Doble, Emma, Town, Marissa, Lange, Karin, de Beaufort, Carine, Gonder-Frederick, Linda, Jaser, Sarah S., Liberman, Alon, Klonoff, David, ElSayed, Nuha A., Bannuru, Raveendhara R., Parkin, Christopher G., Snoek, Frank

المصدر: Barnard-Kelly , K , Marrero , D , de Wit , M , Pouwer , F , Khunti , K , Hermans , N , Pierce , J S , Laffel , L , Holt , R I G , Battelino , T , Naranjo , D , Fosbury , J , Fisher , L , Polonsky , W , Weissberg-Benchell , J , Hood , K K , Schnell , O , Messer , L H , Danne , T , Nimri , R , Skovlund , S E , Mader , J K , Sherr , J ....

الوصف: Diabetes is unique among chronic diseases because clinical outcomes are intimately tied to how the person living with diabetes reacts to and implements treatment recommendations. It is further characterised by widespread social stigma, judgement and paternalism. This physical, social and psychological burden collectively influences self-management behaviours. It is widely recognised that the individual's perspective about the impact of trying to manage the disease and the burden that self-management confers must be addressed to achieve optimal health outcomes. Standardised, rigorous assessment of mental and behavioural health status, in interaction with physical health outcomes is crucial to aid understanding of person-reported outcomes (PROs). Whilst tempting to conceptualise PROs as an issue of perceived quality of life (QoL), in fact health-related QoL is multi-dimensional and covers indicators of physical or functional health status, psychological and social well-being. This complexity is illuminated by the large number of person reported outcome measures (PROMs) that have been developed across multiple psychosocial domains. Often measures are used inappropriately or because they have been used in the scientific literature rather than based on methodological or outcome assessment rigour. Given the broad nature of psychosocial functioning/mental health, it is important to broadly define PROs that are evaluated in the context of therapeutic interventions, real-life and observational studies. This report summarises the central themes and lessons derived in the assessment and use of PROMs amongst adults with diabetes. Effective assessment of PROMs routinely in clinical research is crucial to understanding the true impact of any intervention. Selecting appropriate measures, relevant to the specific factors of PROs important in the research study will provide valuable data alongside physical health data.

العلاقة: https://research.vumc.nl/en/publications/209066bc-1bec-443a-b71b-3306de5e7ceaTest

الإتاحة: https://doi.org/10.1111/dme.15332Test
https://research.vumc.nl/en/publications/209066bc-1bec-443a-b71b-3306de5e7ceaTest
http://www.scopus.com/inward/record.url?scp=85193316206&partnerID=8YFLogxKTest

المؤلفون: Tilden, Daniel R., French, Benjamin, Datye, Karishma A., Jaser, Sarah S.

المصدر: Diabetes Care; Mar2024, Vol. 47 Issue 3, p346-352, 7p

مصطلحات موضوعية: CONTINUOUS glucose monitoring, BLOOD sugar monitors, TYPE 1 diabetes, CITIES & towns, RURAL geography, RURAL health clinics

مستخلص: OBJECTIVE: Despite evidence that continuous glucose monitoring (CGM) use is associated with lower HbA1c among children with type 1 diabetes, uptake of this technology remains lower among those with difficulty accessing health care, including those from lower socioeconomic status backgrounds and racial and ethnic minorities. In this study, we sought to explore the impact of rural location in use of CGM technology to guide patient and provider decision making. RESEARCH DESIGN AND METHODS: In this retrospective study of electronic health record demographic and visits data from a single diabetes program from 1 January 2018 through 31 December 2021, we compared the odds of completing a visit with (+) and without (−) CGM interpretation between rural-urban commuting area (RUCA) designations. RESULTS: Among the 13,645 visits completed by 2,008 patients with type 1 diabetes younger than age 18 years, we found children living in small rural towns had 31% lower odds (6.3% of CGM+ visits, 8.6% of CGM− visits; adjusted odds ratio [aOR] 0.69, 95% CI 0.51–0.94) and those living in isolated rural towns had 49% lower odds (2.0% of CGM+ visits, 3.4% of CGM− visits; aOR 0.51, 95% CI 0.28–0.92) of completing a CGM-billed clinic visit compared with those living in urban areas (70.0% of CGM+ visits, 67.2% of CGM− visits). We also found significant differences in CGM-billed visits by neighborhood deprivation as well as race/ethnicity and insurance payor. CONCLUSIONS: Geographic location presents a meaningful barrier to access to care for patients living with type 1 diabetes. Further work is needed to identify and address the needs of children and families living in rural areas to improve the care of these patients. [ABSTRACT FROM AUTHOR]

: Copyright of Diabetes Care is the property of American Diabetes Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Abadula, Fayo, Garretson, Sydney, Okonkwo, Nkemjika, LeStourgeon, Lauren M, Jaser, Sarah S

المصدر: Journal of Pediatric Psychology; Feb2024, Vol. 49 Issue 2, p89-94, 6p

مصطلحات موضوعية: DEPRESSION in women, MENTAL depression, GLYCOSYLATED hemoglobin, TYPE 1 diabetes, PARENT-teenager relationships, PARENT-child relationships, DIABETES

مستخلص: Objective  Previous research in families of children with type 1 diabetes demonstrates that maternal depressive symptoms are a known risk factor for poor diabetes outcomes. We sought to examine whether maternal diabetes relationship distress or maternal depressive symptoms were more strongly associated with adolescent glycemic outcomes. Methods  Analyses were conducted using data from mothers who consented to screen for a behavioral intervention. The screener included the Patient Health Questionnaire and the Parent Diabetes Distress Scale, Parent/Teen Relationship Distress subscale. Hemoglobin A1c (HbA1c) was extracted from adolescents' medical records. Results  Our sample consisted of 390 maternal caregivers of adolescents with type 1 diabetes aged 11–17. Screening data revealed that 35% of mothers reported clinically significant diabetes distress related to their relationship with their adolescents, and 14% of mothers reported clinically significant depressive symptoms. The adolescents of mothers who reported diabetes relationship distress had significantly higher mean HbA1c levels (9.7 ± 2.2%) compared to those whose mothers were not distressed (8.2 ± 1.8%, d =.72). Similarly, adolescents whose mothers reported clinically significant depressive symptoms had higher mean HbA1c levels (9.6 ± 2.4%) than those whose mothers were not depressed (8.6 ± 2.0%, d =.48). After adjusting for clinical and demographic factors, mothers' reports of diabetes relationship distress were more strongly associated with adolescents' HbA1c than maternal depressive symptoms. Conclusions  Our findings suggest that screening for maternal distress—particularly distress related to the caregiver–adolescent relationship—could match families with psychosocial support or other resources to improve both psychosocial and glycemic outcomes. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Pediatric Psychology is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Jaser, Sarah S.

مرشدي الرسالة: David Cole, Kirsten Haman, Judy Garber, Lynn Walker, Bruce Compas

مصطلحات موضوعية: Psychology

الوصف: Observed mothers with and without a history of depression interacting with their adolescent children in a positive and a stressful task to determine possible mechanisms for the transmission of the effects of maternal depression. Mothers with a history of depression, who were not currently depressed, were significantly more likely to exhibit negative affect and disengaged and hostile parenting behaviors than mothers with no history of depression across the two interactions. Mothers current depressive symptoms were also related to higher levels of negative affect and child and mother-reported intrusive and withdrawn parenting behaviors. Findings from this study indicate that mothers prior history of depression and their current depressive symptoms are sources of risk for internalizing problems in children, and that these effects are mediated by the presence of negative affect in mothers interactions with their children. Results have implications for interventions with mothers with a history of depression to prevent internalizing problems in their adolescent offspring.

وصف الملف: application/pdf

الإتاحة: http://etd.library.vanderbilt.edu/available/etd-07242006-085300Test/

المؤلفون: Tilden, Daniel R., French, Benjamin, Shoemaker, Ashley H., Corathers, Sarah, Jaser, Sarah S.

المصدر: Diabetes Research and Clinical Practice ; volume 192, page 110113 ; ISSN 0168-8227

مصطلحات موضوعية: Endocrinology, General Medicine, Endocrinology, Diabetes and Metabolism, Internal Medicine

الإتاحة: https://doi.org/10.1016/j.diabres.2022.110113Test
https://api.elsevier.com/content/article/PII:S0168822722009275?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0168822722009275?httpAccept=text/plainTest