Portadores de diabetes mellitus tipo 1 enfrentam muitas e variadas dificuldades para o tratamento: a necessidade de modificações no estilo de vida, de monitoração constante dos valores de glicemia capilar e de múltiplas aplicações de insulina estão freqüentemente associadas a sintomas depressivos que podem se manifestar como não adesão aos diversos procedimentos necessários para o tratamento adequado. Conhecer as estratégias usadas pelos pacientes no enfrentamento dos fatores estressores da doença pode ser um importante recurso para melhorar a relação entre eles e a equipe multidisciplinar. Por isso estudamos essas características psicológicas de 47 pacientes com DM1 com complicações crônicas decorrentes da doença por meio de entrevista semi-dirigida, as estratégias de enfrentamento da doença pelo Inventário de estratégias de coping; analisamos a qualidade de vida geral pelo Questionário WHOQOL-Breve assim como a qualidade de vida especifica do diabetes pelo Questionário DQol-Brasil. Observamos que embora os pacientes tenham razoável conhecimento sobre a doença e da necessidade de seu tratamento adequado, e medos relacionados a o risco de complicações, suas estratégias de enfrentamento e de adesão são em geral de fuga e esquiva, o que se reflete em baixa adesão. O impacto da doença na vida de seus portadores foi muito importante, tendo como resultado grande necessidade de tratamentos com drogas estabilizadoras de humor ou de psicoterapia. Há relações entre as estratégias de enfrentamento entre si e entre elas e a baixa qualidade de vida relacionada à doença. Ainda assim, os pacientes foram capazes de se desenvolver socialmente, embora com considerável grau de isolamento / Patients with type I diabetes mellitus confront many difficulties: the urgency of changing routines, glicemic control and multiple application of insulin. The events are usually associate with psychological disturbs such as depression and non-adherence. The comprehension of these factors and coping strategies represent important tools for multidisciplinary approaches in DMI treatments. For this, we collected data of 47 patients with chronicle complications, analyzing the coping strategies and the quality of life. The following questionnaires were used: Semi Directed Interview (SDI), WHOQOL BRIEF and DQoL Brasil. Despite the fact patients have reasonable comprehension of their diagnosis, the coping strategies are, usually, of escape avoidance and distancing, which reflects the lower levels of adherence. The impact of disease results psychological needs, as the use of medicines to control the humor and psychotherapy. There are relations between coping strategies, non-adherence, quality of life and the disease. These patients improve their social skills, however, with considerable isolation

Background: Type 1 diabetes is a common chronic disease in children. Approximately 1.1 million children worldwide live with this diagnosis and the incidence increases from year to year.  Aim: The aim of this study was to compile children’s experiences of living with type 1 diabetes, through a systematic literature study.  Method: After the systematic search, 15 articles were selected that formed the basis of the study. The study's selected articles were analysed through three steps based on a thematic synthesis. Results: The results are presented in two main themes and eight sub-themes. The first main theme "being controlled by the disease" includes four sub-themes: "the feeling of stress and anxiety", "the feeling of being controlled", "the feeling of limitation" and "the feeling of being forced to accept". The second main theme "being different" includes four sub-themes: "the feeling of wanting to conceal", "the feeling of lack of comprehension", "the feeling of loneliness and fear" and "the feeling of being affected in school". Conclusion: Children with type 1 diabetes perceive different experiences and difficulties due to changes that the disease causes. The children must take great responsibility in their stressful everyday life, this as a result of the restrictions the disease entails.

Diabetes type 1 is an autoimmune, incurable disease which requires careful monitoring and treatment to not result in life threatening complications. Managing the disease is to a great extent made by the patients themselves, implying the disease needs to be constantly taken into consideration when doing even the most simple and regular everyday tasks and activities.This study aims to examine the use of AI in everyday treatment for patients with diabetes type 1. The study investigated what areas AI is already used in diabetes care management, and where there is room for development. The purpose is to give an indication of what role AI has and potentially can have in making the life for patients with diabetes type 1 easier. The research was conducted by a combined literature review and a cross sectional multiple case-study, with semi-structured interviews with people diagnosed with diabetes type 1. The gathered data were analyzed in relation to the triangle of diabetes management and technology acceptance model 2. The first indicates what factors are of highest relevance to not create dangerous situations for a diabetic, and the second relates to whether users would accept the use of a complex technology. The result suggested wide current and further potential use of AI in creating functionality in treatment and everyday management of the disease. Further, it became evident that technological tools simplify the lives of diabetics but there are several areas where AI could be further implemented in order to improve it even further.

Pancreatic transplantation is the only possible treatment to induce independence from exogenous insulin administration in type 1 diabetes mellitus. However, the shortage of donor organs remains the main limitation of pancreas transplantations. The goal of the research is the preparation of a bioartificial organ based on cell therapy. Parts of the extracellular matrix obtained by decellularization of the pancreas are used for its preparation. The protein scaffolds prepared in this way are then repopulated by different cell types again. The extracellular matrix provides structural support to cells, mediates signaling for differentiation, proliferation or migration. Mesenchymal stromal cells are used in clinical therapy, have a positive effect on tissue regeneration processes, modulating the function of the extracellular matrix, suppress inflammation and promote angiogenesis. After pancreas decellularization, we repopulated the extracellular matrix with islets, mesenchymal cells and endothelial cells. Then, the pancreas was transplanted subcutaneously into syngeneic diabetic rats to observe islet revascularization. Based on sections of explanted scaffolds, we found out that revascularization of the islets was higher without the endothelial cells in the transplanted extracellular matrix. Key words:...

Diabetes Mellitus typ 1 är en kronisk sjukdom som medför drastiska livsstilsförändringar samt kräver ständig planering och anpassning i vardagen för att optimera god egenvård och förebygga kort- samt långsiktiga komplikationer. Det är således av intresse att utforska barn och unga vuxnas upplevelser av att leva med diabetes typ 1 under den redan utmanande tidpunkten i livet som utgörs av tiden mellan barndom och vuxenliv. Syftet med denna litteraturstudie är att belysa barn och unga vuxnas upplevelser av att leva med diabetes typ 1. Vald metod för följande studie är en litteraturöversikt med kvalitativ design som utgångspunkt för data. Funnet resultat belyser att barn och unga vuxna med diabetes typ 1 upplever utmaningar med psykisk ohälsa relaterat till ångest och oro samt rädsla för komplikationer. Likaså synliggörs omgivningens påverkan på individens egenvårdsförmåga, orsakat av stigmatisering och okunskap gällande diabetes typ 1. Fortsättningsvis belyser resultatet hur relationer i olika former kan påverka egenvårdsförmågan genom upplevelsen av emotionellt och praktiskt stöd samt adekvat informationsgivande. Slutligen visar resultatet hur acceptans och integrering av diabetes typ 1 i livet påverkar tillvarons samtliga aspekter; från identitet, följsamhet och ansvar, till inverkan på vardag, relationer och framtidsplanering. Under diskussionen tillkommer reflektioner om de subjektiva upplevelserna av att leva med diabetes typ 1, utgjort av egenvårdsförmåga, synen på sig själv samt relationen till omgivningen och andra, samt en reflekterande metoddiskussion om litteraturstudiens vetenskapliga kvalitet och etiska medvetenhet. / Diabetes Mellitus type 1 (T1D) is a chronic disease that entails drastic lifestyle changes and requires constant planning and adaptation in everyday life to optimize good self-care and prevent short- and long-term complications. It is therefore of interest to explore children's and young adults' experiences of living with T1D during the already challenging time between childhood and adulthood. The purpose of this literature study is to shed light on children and young adults' experiences of living with diabetes type 1. The chosen method for the following study is a literature review with a qualitative design. The results highlight that children and young adults with T1D experience challenges with mental illness related to anxiety and worry as well as fear of complications. Likewise, the influence of the environment on the individual's self-care ability is made visible, caused by stigmatization and ignorance regarding type 1 diabetes. The result further highlights how relationships in various forms can affect self-care ability through the experience of emotional and practical support as well as adequate information provision. Finally, the results show how acceptance and integration of T1D affects all aspects of life; from identity, compliance and responsibility, to the impact on everyday life, relationships and future planning. During the discussion, reflections are added on the subjective experiences of living with T1D, consisting of self-care skills, the view of oneself and the relationship with the environment and others, as well as a reflective methodological discussion on the scientific quality and ethical awareness of this literature study.

Bakgrund: Orsaken till diabetes typ 1 är i dagsläget okänt, vilket innebär att sjukdomen är obotlig och kan medföra allvarliga komplikationer. Patientens egenansvar är därav nödvändigt i egenvården med stöd från hälso-och sjukvården. Sjuksköterskans roll är betydelsefull för att ge patienten stöd och kunskap som kan främja patientens egenvård samt hälsa. För att patienten ska få makt och kontroll över hälsan utgör begreppet empowerment en betydande del i egenvården. Syfte: Syftet var att beskriva vuxna patienters erfarenheter av egenvård vid diabetes typ 1 i vardagen. Metod: Litteraturöversiktens design var kvalitativ med en induktiv ansats, där 13 vetenskapliga artiklar inkluderades som publicerades mellan 2015–2022. Använda databaser var CINAHL och MEDLINE. Analys utfördes enligt Fribergs fem steg. Resultat: Första huvudkategorin blev strategier med underkategorierna; hanteringsstrategier i egenvården, rutinernas betydelse i vardagen, den mentala inställningens påverkan på egenvården samt teknikens betydelse i egenvården. Andra huvudkategorin blev utmaningar med underkategorierna; svårigheter att hitta balans i vardagen samt faktorer som kan påverka egenvården negativt. Tredje huvudkategorin blev stöd med underkategorierna; påverkan från familj och vänner samt påverkan från vårdpersonal.  Slutsats: Genom strategier och stöd kan egenvårdens utmaningar hanteras, vilket kan främja en god egenvård.

Introdução - Pacientes portadores de diabetes tipo 1 que manifestam comportamentos de risco para transtornos alimentares (TA) possuem grandes chances de complicações microvasculares e macrovasculares e maiores taxas de mortalidade. Objetivo Avaliar a freqüência de comportamento de risco para TA em adolescentes e adultos portadores de diabetes tipo 1 bem como sua relação com variáveis socioeconômicas, nutricionais, relacionadas ao diabetes e satisfação corporal. Metodologia: Foram aplicados: Teste de Investigação Bulímica de Edinburgh (BITE), Teste de Atitudes Alimentares (EAT), Escala de Compulsão Alimentar Periódica (ECAP) e Escala de Silhuetas de Stunkard, além da mensuração de peso, estatura e cálculo do IMC. Foram verificadas associações ou diferenças estatísticas por meio dos testes de Qui-Quadrado e T-Student e Regressão Logística para identificar fatores que influenciaram o risco da doença. Resultados: Um total de 58,7% dos pacientes apresentaram escore positivo em algum dos testes utilizados para risco de TA. Houve diferença significante entre os grupos com e sem risco para TA com relação ao IMC (p=0,009), gênero (p=0,001), omissão de insulina (p=0,003), uso de insulina NPH (p=0,006), ausência do uso da insulina Glargina (p=0,021), ausência do uso da técnica de contagem de carboidratos (p=0,019), controle da glicemia (p=0,049) e insatisfação corporal (p=0,001). Conclusão: Portadores de diabetes tipo 1 apresentaram grande freqüência de comportamentos de risco para o TA, o que requer atenção e cautela dos profissionais de saúde. / Introduction - Patients suffers of type 1 diabetes that reveal risk behavior for eating disorders (ED) have more chances of micro and macro vascular complications and a high mortality level. Objective Evaluate the frequency of risk behavior for ED in teenagers and adults suffers of type 1 diabetes as well as its relation to the socially economical variable, nutritional variable, related to diabetes and body satisfaction. Methodology: There was applied: The Bulimic Inventory Test of Edinburgh (BITE), Eating Attitudes Test (EAT), Binge Eating Scale (BES) and The Stunkard´s Figure Rating Scale, besides weight measure, height and BMI calculation of the patients. There were verified associations or statistical differences through tests of Chi-Square and T-student and Logistical Regression to identify the factors that influenced the risk of the disease. Results: A total of 58,7% patients presented positive score in tests used for ED risk. There was a significant difference among the groups with and without risk for ED in relation to the BMI (p=0,009), gender (p=0,001), omission of insulin (p=0,003), usage of NPH insulin (p=0,006), lack of usage of Glargine insulin (p=0,021), lack of usage of the technique of carbohydrate counting (p=0,019), blood glucose control (p=0,049) and body dissatisfaction (p=0,001). Conclusion: The suffers of type 1 diabetes presented high frequency of risk behavior for ED, which require more attention when caring for patients for the prevention of the disease.

Introdução - Pacientes portadores de diabetes tipo 1 que manifestam comportamentos de risco para transtornos alimentares (TA) possuem grandes chances de complicações microvasculares e macrovasculares e maiores taxas de mortalidade. Objetivo Avaliar a freqüência de comportamento de risco para TA em adolescentes e adultos portadores de diabetes tipo 1 bem como sua relação com variáveis socioeconômicas, nutricionais, relacionadas ao diabetes e satisfação corporal. Metodologia: Foram aplicados: Teste de Investigação Bulímica de Edinburgh (BITE), Teste de Atitudes Alimentares (EAT), Escala de Compulsão Alimentar Periódica (ECAP) e Escala de Silhuetas de Stunkard, além da mensuração de peso, estatura e cálculo do IMC. Foram verificadas associações ou diferenças estatísticas por meio dos testes de Qui-Quadrado e T-Student e Regressão Logística para identificar fatores que influenciaram o risco da doença. Resultados: Um total de 58,7% dos pacientes apresentaram escore positivo em algum dos testes utilizados para risco de TA. Houve diferença significante entre os grupos com e sem risco para TA com relação ao IMC (p=0,009), gênero (p=0,001), omissão de insulina (p=0,003), uso de insulina NPH (p=0,006), ausência do uso da insulina Glargina (p=0,021), ausência do uso da técnica de contagem de carboidratos (p=0,019), controle da glicemia (p=0,049) e insatisfação corporal (p=0,001). Conclusão: Portadores de diabetes tipo 1 apresentaram grande freqüência de comportamentos de risco para o TA, o que requer atenção e cautela dos profissionais de saúde. / Introduction - Patients suffers of type 1 diabetes that reveal risk behavior for eating disorders (ED) have more chances of micro and macro vascular complications and a high mortality level. Objective Evaluate the frequency of risk behavior for ED in teenagers and adults suffers of type 1 diabetes as well as its relation to the socially economical variable, nutritional variable, related to diabetes and body satisfaction. Methodology: There was applied: The Bulimic Inventory Test of Edinburgh (BITE), Eating Attitudes Test (EAT), Binge Eating Scale (BES) and The Stunkard´s Figure Rating Scale, besides weight measure, height and BMI calculation of the patients. There were verified associations or statistical differences through tests of Chi-Square and T-student and Logistical Regression to identify the factors that influenced the risk of the disease. Results: A total of 58,7% patients presented positive score in tests used for ED risk. There was a significant difference among the groups with and without risk for ED in relation to the BMI (p=0,009), gender (p=0,001), omission of insulin (p=0,003), usage of NPH insulin (p=0,006), lack of usage of Glargine insulin (p=0,021), lack of usage of the technique of carbohydrate counting (p=0,019), blood glucose control (p=0,049) and body dissatisfaction (p=0,001). Conclusion: The suffers of type 1 diabetes presented high frequency of risk behavior for ED, which require more attention when caring for patients for the prevention of the disease.

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This study explored the needs and challenges faced by diabetics and healthcare personnel in the context of diabetes consultations in Sweden, with the aim of identifying improvements for Clinical Decision Support Systems (CDSS). Given the global prevalence of diabetes, understanding the use and implications of CDSS in patient consultations is crucial. This research aimed to fill that knowledge gap by exploring ways to improve CDSS, considering the needs of both diabetics and healthcare workers. A qualitative approach was used, including 12 interviews, 1 observation, and 6 document reviews. A thematic analysis revealed four key themes which highlighted various challenges and needs, experienced from both diabetics and healthcare personnel. The underlying causes of these challenges were linked to recent technological advancements and the increase in available data points. This results infrustration, suboptimal care outcomes, and an increased reliance on alternative solutions by both parties. The DeLone and McLean IS Success Model was used to identify potential technological solutions and provides a clear recommendation on what needs to be improved for future solutions. The findings contribute significantly to understanding the utilization of CDSS in diabetes care and associated challenges. The study is particularly relevant for healthcare personnel, diabetics, policymakers, entrepreneurs, and scholars interested in healthcare information systems. Future studies should focus on generalizing these findings by exploring other healthcare systems and to what extent this findings are applicable for type 2 diabetics, as well as practically exploring how new systems can address the identified needs in this study. Ultimately, this study contributes to the potential for improved care and quality of life for diabetics. / Denna studie utforskade behov och utmaningar som diabetiker och sjukvårdspersonal står inför i samband med diabeteskonsultationer i Sverige, med målet att identifiera förbättringar för kliniska beslutsstödssystem (CDSS). Med tanke på diabetes globala prevalens, är det avgörande att förstå användningen och implikationerna av CDSS i patientkonsultationer. Denna forskning syftade till att fylla detta kunskapsgap genom att utforska möjligheter att förbättra CDSS, med hänsyn till både diabetikers och vårdgivares behov. Kvalitativa metoder användes, inklusive intervjuer, observationer och dokumentgranskningar. En tematisk analys identifierade fyra nyckelteman som belyste flera utmaningar och behov från både diabetiker och sjukvårdspersonal. De underliggande orsakerna till dessa utmaningar var kopplade till tekniska utveckling och ökningen av tillgängliga datapunkter. Detta resulterade i frustration, suboptimala vårdresultat och en ökad användning av alternativa lösningar från båda parter. DeLone och McLean IS Success Model användes för att översätta behoven till tekniska krav för potentiella framtida lösningar. Studiens resultat bidrar till förståelsen av användningen av CDSS inom diabetesvård och relaterade utmaningar. Studien är särskilt relevant för sjukvårdspersonal, diabetiker, politiker, entreprenörer och forskare som är intresserade av hälso- och sjukvårdsinformationssystem. Framtida studier bör fokusera på att generalisera dessa resultat genom att undersöka andra sjukvårdssystem och i samband med typ 2 diabetes, samt utforska hur mer praktiskt utveckling av nya system kan gå till för möta de identifierade behoven i denna studie. Slutligen bidrar denna studie till potentialen för förbättrad vård och livskvalitet för diabetiker.