Browsing by Subject "glycemic control"
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Item The Effect of Parental Monitoring on Diabetes Management in Adolescents: A Systematic Review of the Literature(Office of the Vice Chancellor for Research, 2015-04-17) Pugh, Samantha; Reaper, Amber; Hart, Kayla; Phillips-Salimi, Celeste R.Objective: Adolescents with Type 1 Diabetes require parental guidance when it comes to the management of their glycemic control. Little is known regarding how parental monitoring affects adolescents’ diabetes control. A systematic review of the literature was performed to gain more insight into how parental monitoring influences glycemic control in adolescents with Type 1 Diabetes. Methods: Databases used to identify articles included: CINAHL, PsycINFO, and Web of Science. Search terms used were teenagers, adolescents, young adults, Type 1 Diabetes, parental monitoring, diabetes management and glycemic control. Inclusion criteria included: peer-reviewed research articles published between 2000 and 2013; involved a sample of adolescents (ages 8-18); conducted in the United States; written in English; and identified parental monitoring as the main independent variable. Results: Nine studies met the inclusion criteria. Six studies were longitudinal and three were cross-sectional. Seven studies collected data from the adolescent and parent while the other two studies collected data only from the adolescent. Sample sizes ranged from n=81-376. The most common glycemic control outcome factors measured were: hemoglobin A1C scores, adherence and glucose monitoring. Findings showed that parental monitoring is positively associated with adolescents’ adherence to diabetes management. There was mixed evidence regarding the father’s role. One study showed the father’s parental monitoring had significant impact on the adolescent adherence and A1C scores; however, another study reported the opposite. Overall, adolescents’ perception of positive parental monitoring provided better adherence. Conclusion: From the nine studies reviewed, it seems that there is some evidence that parental monitoring is positively associated with beneficial outcomes in glycemic control. However, future research is needed and should examine long-term effects of parental monitoring. Additionally, greater attention is needed on diverse populations such as single parent homes, families from different ethnic backgrounds, families of differing socioeconomic statuses and adolescents without parental figures.Item Impact of diabetes (type 2) and glycemic control on health-related outcomes of patients receiving chemotherapy for non-metastatic breast cancer: A retrospective analysis(Springer, 2023-01-13) Phillips, Allison L.; Reeves, David J.; Storey, Susan; School of NursingPurpose To examine the impact of diabetes (type 2) and glycemic control on healthcare-related outcomes (healthcare utilization, adverse effects, and treatment modifications) in non-metastatic breast cancer (NMBC) patients during chemotherapy treatment. Methods This was a retrospective study of 243 NMBC patients (stages 1–3) with/without diabetes receiving neoadjuvant or adjuvant cytotoxic chemotherapy. The primary study endpoint was to compare healthcare utilization between NMBC patients with and without diabetes. Secondary study endpoints included adverse events and chemotherapy treatment modifications. Additional analyses were conducted to compare these health-related outcomes by glycemic control status. Results NMBC patients with diabetes had higher utilization of emergency department (ED) services (52% vs. 33%, p = 0.013) and a higher frequency of unplanned inpatient admissions (35% vs. 19%, p = 0.014). Additionally, NMBC patients with diabetes had a higher incidence of infection and treatment modifications. NMBC patients, regardless of diabetes diagnosis, who had poor glycemic control, specifically hyperglycemia (per random blood glucose), during the study period also had increased healthcare utilization, adverse effects, and treatment modifications. Patients with a baseline HbA1c ≥ 7 had a greater number of ED visits and a higher incidence of infection than those without diabetes. Conclusion Diabetes and glycemic control may impact the health-related outcomes of NMBC patients. Additional studies are needed to confirm these findings and determine optimal monitoring and management strategies for NMBC patients with diabetes and/or poor glycemic control during cytotoxic chemotherapy.Item Race and Medication Adherence and Glycemic Control: Findings from an Operational Health Information Exchange(2011-10) Zhu, Vivienne J.; Tu, Wanzhu; Marrero, David G.; Rosenman, Marc B.; Overhage, J. MarcThe Central Indiana Beacon Community leads efforts for improving adherence to oral hypoglycemic agents (OHA) to achieve improvements in glycemic control for patients with type 2 diabetes. In this study, we explored how OHA adherence affected hemoglobin A1C (HbA1c) level in different racial groups. OHA adherence was measured by 6-month proportion of days covered (PDC). Of 3,976 eligible subjects, 12,874 pairs of 6-month PDC and HbA1c levels were formed between 2002 and 2008. The average HbA1c levels were 7.4% for African-Americans and 6.5% for Whites. The average 6-month PDCs were 40% for African-Americans and 50% for Whites. In mixed effect generalized linear regression analyses, OHA adherence was inversely correlated with HbA1c level for both African-Americans (−0.80, p<0.0001) and Whites (−0.53, p<0.0001). The coefficient was −0.26 (p<0.0001) for the interaction of 6-month PDC and African-Americans. Significant risk factors for OHA non-adherence were race, young age, non-commercial insurance, newly-treated status, and polypharmacy.Item Sleep in children with type 1 diabetes and their parents in the T1D Exchange(Elsevier, 2017-11) Jaser, Sarah S.; Foster, Nicole C.; Nelson, Bryce A.; Kittelsrud, Julie M.; DiMeglio, Linda A.; Quinn, Maryanne; Willi, Steven M.; Simmons, Jill H.; Pediatrics, School of MedicineObjectives Sleep has physiological and behavioral impacts on diabetes outcomes, yet little is known about the impact of sleep disturbances in children with type 1 diabetes. The current study sought to characterize sleep in children with type 1 diabetes and in their parents and to examine the associations between child sleep, glycemic control and adherence, parent sleep and well-being, parental fear of hypoglycemia, and nocturnal caregiving behavior. Methods Surveys were emailed to parents of 2- to 12-year-old participants in the Type 1 Diabetes (T1D) Exchange clinic registry. Clinical data were obtained from the registry for the 515 respondents. Results In our sample, 67% of children met criteria for poor sleep quality. Child sleep quality was related to glycemic control (HbA1c of 7.9% [63 mmol/mol] in children with poor sleep quality vs 7.6% [60 mmol/mol] in children with non-poor sleep quality; P < 0.001) but not mean frequency of blood glucose monitoring (BGM) (7.6 times/day vs 7.4 in poor/non-poor quality; P = 0.56). Associations were similar for sleep duration. Children with poor sleep quality were more likely to experience severe hypoglycemia (4% in children with poor sleep quality vs 1% in children with non-poor sleep quality; P = 0.05) and more likely to experience DKA (7% vs 4%, respectively; P < 0.001). Poorer child sleep quality was associated with poorer parental sleep quality, parental well-being, and fear of hypoglycemia (P < 0.001 for all). Child sleep was not related to the use of diabetes-related technology (CGM, insulin pump). Conclusions Sleep may be a modifiable factor to improve glycemic control and reduce parental distress.Item Slowing Disease Progression in Type 2 Diabetes: Latest Advances(Association of Kenya Physicians, 2007) Otieno, C. F.; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)Background: Largest head-to-head, double-blind study of metformin, glyburide and rosiglitazone (N = 4,360). Primary objective: To compare the durability of glycemic control using rosiglitazone versus metformin or glyburide as initial monotherapy in patients with recently diagnosed type 2 diabetes. Design: Double-blind, randomized, controlled trial. Inclusion criteria: Type 2 diabetes ≤ 3 years, drug-naive, male and female, aged 30–75 years, FPG 126–180 mg/dl (7–10 mmol/l). Exclusion criteria: Previous use of glucose-lowering therapy, women of child-bearing potential, significant hepatic disease, renal impairment, unstable or severe angina, known CHF (NYHA Class I–IV), uncontrolled hypertension. Treatment duration: Treatment period: 4 to 6 years. Median duration of treatment: 4 years (rosiglitazone and metformin); 3.3 years (glyburide). Interventions: Rosiglitazone, metformin, glyburide.