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Outcome measures for physical activity interventions in children with Type 1 Diabetes : A Systematic Literature ReviewEmer, Evindar January 2023 (has links)
This study examines physical activity intervention outcome measures in children with Type 1 Diabetes (T1D). Additionally, it explores medical and psychosocial outcomes. Five databases (CINAHL, PsycINFO, MEDLINE, PubMed, Scopus) were used in this study. The selection of articles was done by using exclusion and inclusion criteria. The articles chosen for this study were restricted to those written in English and had to be peer-reviewed and published between 2012 and 2023. Besides, the focus was on quantitative studies. Six articles were eligible to be used in this study. Intervention types, durations, and outcome measurements have been reported. Results showed that the length of intervention should be more than twelve weeks to see the actual effect of interventions. Additionally, while an effect of physical activity on glycemic control was observed, generalizable psychosocial outcomes could not be obtained. In future research, to reach generalizable conclusions, the sample of this study should be expanded. Also, in addition to clinical data, getting psychosocial data can provide helpful insights. It can offer tips to improve participants' quality of life.
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Att vara förälder till en ungdom med diabetes typ 1 : En litteraturöversikt / Being a parent of an adolescence with type 1 diabetes : A literature reviewFurelid Sparre, Celie, Ikäheimonen, Caisa January 2023 (has links)
Bakgrund Typ 1 diabetes är en kronisk sjukdom som kräver livslång vård och anpassning. Det är en av de vanligaste kroniska sjukdomarna hos barn samtidigt som prevalensen tycks öka världen över. Risken för både akuta och långsiktiga allvarliga komplikationer är stor varpå en adekvat egenvård är viktig. Eftersom föräldrar fortfarande har det yttersta ansvaret för sina ungdomar så faller ansvaret över egenvården på dem. Syfte Syftet är att beskriva erfarenheter av att vara förälder till en ungdom med diabetes typ 1. Metod En litteraturöversikt baserad på tio vetenskapliga artiklar utförda i kvalitativ design. Artikelsökningarna utfördes i PubMed samt CINAHL Complete. Analysen utfördes inspirerad av Fribergs metod. Resultat Litteraturöversikten resulterade i tre centrala teman: 1. Den förändrade vardagen, 2. Att konstant känna oro och 3. Att släppa kontrollen. Slutsats Denna litteraturöversikt undersökte föräldrars erfarenheter av att ha en ungdom med typ 1 diabetes mellitus. Den visade att dessa föräldrar möter betydande utmaningar, med tre huvudteman: 1. Den förändrade vardagen, 2. Att konstant känna oro och 3. Att släppa kontrollen. Det är viktigt att ha förståelse för dessa föräldrars verklighet för att kunna ge bättre stöd och en mer personcentrerad vård. / Background Type 1 diabetes is a chronic disease that requires lifelong care and adaptation. It is one of the most common chronic diseases in children, and its prevalence appears to be increasing worldwide. The risk of both acute and long-term serious complications is significant, making proper self-care essential. Since parents still bear the ultimate responsibility for their adolescents, the responsibility for self-care falls on them. Aim The purpose is to describe the experience of being a parent of an adolescence with type 1 diabetes. Method Searches were performed in PubMed and CINAHL Complete. The analysis was conducted in accordance with Friberg's method. Results The literature review resulted in three central themes: 1. Altered daily life, 2. Constant feelings of anxiety, and 3. Letting go of control. Summary This literature review explored parents' experiences of having a teenager with type 1 diabetes mellitus. It revealed that these parents face significant challenges, with three main themes: 1. Altered daily life, 2. Constant feelings of anxiety, and 3. Letting go of control. Understanding the reality of these parents is crucial for providing better support and more person-centered care.
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Barns och ungdomars erfarenheter av egenvård vid diabetes typ 1 : En litteraturstudie / Children’s and adolescents’ experiences of self-carein type 1 diabetes : A literature reviewMelkersson, Alice, Pahlstad, Agnes January 2023 (has links)
Bakgrund: Diabetes mellitus typ 1 [DMT1] är en sjukdom som drabbar barn och ungdomar. Incidensen ökar globalt. Egenvård innebär dagliga kontroller av bland annat blodsocker. Forskning visar att ungdomen är en skör period och svårigheterna med att kombinera den tiden med en kronisk sjukdom. Syfte: Att undersöka erfarenheter av egenvård hos barn och ungdomar med DMT1. Metod: En litteraturstudie grundad i åtta artiklar med kvalitativ ansats samt en artikel med mixad metod. Innehållsanalys från Graneheim och Lundman (2004) användes som analysmetod. Resultat: Studien visade att barn och ungdomar med DMT1 känner sig annorlunda från de som inte har sjukdomen. Två kategorier; Egenvård kopplat till yttre faktorer och Egenvård kopplat till inre faktorer samt fem underkategorier identifierades; Att hantera sin egenvård i skolan; Upplevda hinder för egenvård; Omgivningens påverkan på egenvården; Att ta ansvar för sin egenvård samt Att inte vara som alla andra. Slutsats: Barn och ungdomar upplever den komplicerade egenvården vid DMT1 som ett hinder i vardagen. En god egenvård kan förbättra deras livskvalitet och förhindra framtida komplikationer. Fortsatt forskning kan minska stigmatiseringen och öka medvetenheten kring DMT1. / Background: Type 1 Diabetes Mellitus [DMT1] is a disease that affects children and adolescents. The incidence increases globally. Self-care includes controls of blood glucose levels among other tasks. Previous research shows that youth is a delicate time, and it is hard to combine with a chronic illness. Aim: To study the experience of self-care in children and adolescents with DMT1. Method: A literature review with eight articles with qualitative approach and one mixed method article. Content analysis from Graneheim and Lundman (2004) was the analysis method. Results: This study showed that children and adolescents with DMT1 feel different than their friends. Two categories were identified; Self-care linked to external factors and Self-care linked to internal factors, as well as five under categories; To deal with self-care in school; Perceived obstacles for self-care; The surroundings effect on self-care; To take responsibility for their self-care and To not be like everybody else. Conclusion: Children and adolescents with DMT1 experience the complicated self-care as an obstacle in their everyday lives. Good self-care can improve their quality of life and prevent future complications. Continued research can reduce the stigma and increase awareness about DMT1.
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Treatment-Induced Neuropathy in Diabetes (TIND)—Developing a Disease Model in Type 1 Diabetic RatsBaum, Petra, Koj, Severin, Klöting, Nora, Blüher, Matthias, Classen, Joseph, Paeschke, Sabine, Gericke, Martin, Toyka, Klaus V., Nowicki, Marcin, Kosacka, Joanna 09 February 2024 (has links)
Treatment-induced neuropathy in diabetes (TIND) is defined by the occurrence of an
acute neuropathy within 8 weeks of an abrupt decrease in glycated hemoglobin-A1c (HbA1c). The
underlying pathogenic mechanisms are still incompletely understood with only one mouse model
being explored to date. The aim of this study was to further explore the hypothesis that an abrupt
insulin-induced fall in HbA1c may be the prime causal factor of developing TIND. BB/OKL (bio
breeding/OKL, Ottawa Karlsburg Leipzig) diabetic rats were randomized in three groups, receiving
insulin treatment by implanted subcutaneous osmotic insulin pumps for 3 months, as follows: Group
one received 2 units per day; group two 1 unit per day: and group three 1 unit per day in the first
month, followed by 2 units per day in the last two months. We serially examined blood glucose
and HbA1c levels, motor- and sensory/mixed afferent conduction velocities (mNCV and csNCV)
and peripheral nerve morphology, including intraepidermal nerve fiber density and numbers of
Iba-1 (ionized calcium binding adaptor molecule 1) positive macrophages in the sciatic nerve. Only
in BB/OKL rats of group three, with a rapid decrease in HbA1c of more than 2%, did we find a
significant decrease in mNCV in sciatic nerves (81% of initial values) after three months of treatment
as compared to those group three rats with a less marked decrease in HbA1c <2% (mNCV 106% of
initial values, p 0.01). A similar trend was observed for sensory/mixed afferent nerve conduction
velocities: csNCV were reduced in BB/OKL rats with a rapid decrease in HbA1c >2% (csNCV 90%
of initial values), compared to those rats with a mild decrease <2% (csNCV 112% of initial values,
p 0.01). Moreover, BB/OKL rats of group three with a decrease in HbA1c >2% showed significantly
greater infiltration of macrophages by about 50% (p 0.01) and a decreased amount of calcitonin
gene related peptide (CGRP) positive nerve fibers as compared to the animals with a milder decrease
in HbA1c. We conclude that a mild acute neuropathy with inflammatory components was induced in
BB/OKL rats as a consequence of an abrupt decrease in HbA1c caused by high-dose insulin treatment.
This experimentally induced neuropathy shares some features with TIND in humans and may be
further explored in studies into the pathogenesis and treatment of TIND.
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Ungdomars upplevelser av att leva med diabetes mellitus typ 1 : En litteraturöversikt / Adolescent’s experiences of Living with diabetes mellitus type 1 : A literature reviewGradstock, Alva, Berg, Caroline January 2022 (has links)
Bakgrund Typ 1-diabetes är en autoimmun sjukdom och kräver en livslång behandling. Kontinuerlig glukosmätning (CGM) sker dagligen då sjukdomen medför att insulin måste tillföras exogent flera gånger per dag. Tiden som ungdom och ung vuxen kan ses som en utmaning i sig då det är under denna period i livet identiteten utvecklas, självständigheten prövas och nya relationer skapas. Syfte Studiens syfte var att sammanställa forskningsbaserad kunskap kring ungdomars upplevelser av att leva med typ 1-diabetes. Metod Studien har genomförts som en strukturerad litteraturöversikt. Ramverket PEO användes för att bryta ner syftet och bilda sökord. Sökningar gjordes i databaserna CINAHL, PubMed och PsycInfo. När sökningarna av materialet till litteraturstudien genomförts, gjordes en analys med syftet att organisera, strukturera och förstå betydelsen av det material som framgick. Resultat Resultatet visade att ungdomars upplevelse av att leva med typ 1-diabetes var utmanande och frambringade en mängd känslor och tankar. Resultatet delades in i två huvudkategorier: Att kastas in i något nytt och främmande samt Att handskas med sjukdomen och vården. / Background Type 1-diabetes is an autoimmune disease and requires lifelong treatmet. Continuous glucose measurement takes place several times a day as the disease requires that insulin must be supplied exogenously several times a day. The time as an adolescent can be seen as a challenge in itself as it is during this period in life that identity develops, independence is tested and new relationships are created. Aim The aim of the study was to compile research-based knowledge about adolescent´s experiences of living with type 1 diabetes. Method The study has been conducted as a structured literature review. The PEO framework was used to break down purpose and form keywords. Searches are made in the databases CINAHL, PubMed and PsycInfo. When the searches for the material for the literature study are carried out, an analysis was made with the aim of organizing, structuring and understanding the meaning of the material that appeared. Results The results showed that young people's experience of living with type 1-diabetes was challenging and produced a range of emotions and thoughts. The results were divided into two main categories: Being thrown into something new and strange and Dealing with the illness and care. Conclusions Young people's experience of living with type 1-diabetes is stressful and that their identity is affected. The care staff's treatment is significant for young people with type 1-diabetes, however, the results show that there are shortcomings that should be improved in order to create an optimal care process.
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THE VALUE OF A FUNCTIONAL EXCIPIENT ADDITIVE TO HUMAN INSULIN THERAPIES: FROM MANUFACTURE TO HUMAN CLINICAL TRIALEl Sanadi, Caroline Elizabeth January 2015 (has links)
No description available.
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Linear Mixed Effects Model for a Longitudinal Genome Wide Association Study of Lipid Measures in Type 1 DiabetesWang, Tao 10 1900 (has links)
<p>Hypercholesterolemia is the presence of high levels of cholesterol in the blood, and it is one of the major factors for the development of long-term complications in T1D patients.</p> <p>In the thesis, we studied 1303 Caucasians with type 1 diabetes in the Diabetes Control and Complications Trial (DCCT). With the experience of diabetes study, many factors are associated with diabetes complications, they are age, gender, cohort, treatment, diabetes duration, body mass index (BMI), exercise, insulin dose, etc. We mainly focus on which factors are associated with total cholesterol (CHL) analysis in the thesis.</p> <p>Many measures were collected monthly, quarterly or yearly for average 6.5 years from 1983 to 1993. We used annually lipid measures of DCCT because of their values are sufficient and complete, and they belong to longitudinal data.</p> <p>Different methods are discussed in the study, and linear mixed effect models are the appropriate approach to the study. The details of model selection with CHL model analysis are shown, which includes fixed effect selection, random effects selection, and residual correlation structure selection. Then the SNPs were added on three models individually in GWAS. We found locus (rs7412) is not only genome-wide associated with CHL, but also genome-wide associated with LDL.</p> <p>We will assess whether these SNPs are diabetes-specific in the future, and we will add dietary data in the three models to identify locus are associated with the interaction of diet and SNPs.</p> / Master of Science (MSc)
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Type 1 Diabetes in Older Adulthood: Relationships with Technological TreatmentsMahoney, Julie 10 1900 (has links)
<p>The increased recognition of chronic disease (CD) has been accompanied by an era of medical technology, intended to better treat and manage CDs such as type 1 diabetes. Since the discovery of insulin in 1921, the treatment and management of type 1 diabetes has significantly improved, and witnessed innovations such as the insulin pump. Yet, as the population ages within a technological society, the implications of advancements in diabetes care and its relationship with older adults is of great concern. How do older adults identify and make use of these new technologies? How do technological advances challenge traditional life course models or expected transitions of growing old? How do older adults continue to cope and manage with a CD in their advanced years? The objective of this study was to explore how older adults with type 1 diabetes relate to management devices used in their daily routines. Five open-ended and semi-structured interviews were conducted with older adults living with type 1 diabetes (recruited through the Canadian Diabetes Association [CDA] and the Hamilton Health Sciences [HHS] Diabetes Care and Research Program [DCRP], Hamilton, Ontario). Interviews were transcribed and analyzed drawing on analytic techniques of grounded theory. Open, axial and selective coding was used in accordance to the constant comparative approach. Themes included living longer with type 1 diabetes, how type 1 diabetes challenges traditional models of aging and the lifecourse perspective, and older adults welcoming the use of technology. Overall findings suggested technology used for the daily treatment and management of type 1 diabetes may permit increases in one’s quality of life (QOL), yet challenge policies and practices within healthcare settings to ensure older adults maintain independent self-management strategies.</p> <p>Keywords: aging, chronic disease, technology, treatment, type 1 diabetes, older adult, diabetes community</p> / Master of Arts (MA)
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EXAMINING THE RELATIONSHIP BETWEEN EARLY LIFE ANTIBIOTIC EXPOSURE AND RISK OF AN IMMUNE MEDIATED DISEASE DURING CHILDHOOD THROUGH ADOLESCENCETeneralli, Rachel Ellen January 2018 (has links)
Rates of immune-mediated diseases (IMDs) have rapidly increased. Although the exact etiology has not yet been fully elucidated, disruptions to the microbiome has been proposed as a potential mechanism. We conducted a retrospective, longitudinal, birth cohort study utilizing electronic health records (EHR) to investigate the association between early life antibiotic exposure and the risk of developing juvenile idiopathic arthritis (JIA), pediatric psoriasis, or type 1 diabetes. Incident rate ratios (IRR) were estimated using modified Poisson regression models and adjusted for significant confounders. Children exposed to two or more antibiotics prior to 12 months of age had a 69% increased risk of developing JIA (1.69 IRR, 95% CI [1.04-2.73]), which rose to 97% when exposed prior to 6 months (1.97 IRR, 95% CI [1.11-3.49]). Children exposed to a penicillin antibiotic had a 62% increase in risk for psoriasis (1.62 IRR, 95% CI [1.06-2.49]), which rose slightly to 64% when exposure occurred between 6 and 12 months of age [(1.64 IRR, 95% CI [1.04-2.59]). We found a moderate to strong association between early antibiotic exposure and risk for JIA and psoriasis when exposure was examined by age, frequency, and type of antibiotic, but not for type 1 diabetes. Potential interactions effects between infection and antibiotics with an increased susceptibility to early life infections among children with an IMD was also observed. Overall, children exposed to antibiotics at an early age have an increased probability of developing an IMD after 12 months of age. However, alternative explanations for this association should be considered. / Public Health
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Unga vuxnas erfarenheter av att leva med Diabetes mellitus typ 1 : En kvalitativ litteraturstudieAndersson, Julia, Boric Svärd, Sandra January 2021 (has links)
Bakgrund: Diabetes mellitus typ 1 är en autoimmun sjukdom där antalet insjuknade ökar för varje år. Att vara ung vuxen med en kronisk sjukdom kan leda till omställningar när det nya självständiga livet och sjukdomen behöver samverka. Syfte: Att belysa unga vuxnas erfarenheter av att leva med Diabetes mellitus typ 1. Metod: En kvalitativ litteraturstudie utfördes. Databassökning genomfördes i CINAHL och PubMed. Åtta kvalitativa studier granskades enligt Olsson och Sörensens mall för kvalitativa studier. Analysen utfördes med hjälp av Popenoe et al. (2021) analysmodell. Resultat: Resultatet sammanställdes i tre huvudkategorier och åtta subkategorier. Att hantera sin egenvård upplevdes utmanande, rädslor för hypoglykemi gjorde att många misskötte sin diabeteshantering. Att känna sig annorlunda gjorde att strävan efter ett liv utan diabetessjukdomen var stor, där olika hanteringsstrategier hjälpte att successivt bearbeta acceptansen. Slutligen, stöd från anhöriga och närståendes men även från sjukvårdspersonalen var betydelsefullt. Konklusion: Unga vuxna upplevde sig vara i en fas i livet där de ständigt ställs inför nya utmaningar. Att dessutom ha en kronisk sjukdom upplevdes leda till ytterligare utmaningar och omställningar i livet att anpassa sig till. Omvårdnaden inkluderar att främja personens helhet, stödja delaktigheten och hitta strategier för egenvårdshantering. / Background: Type 1 diabetes mellitus is an autoimmune disease where the incidence of diagnosis increases annually. Being a young adult with a chronic disease can lead to readjustment when the new independent life and disease need to cooperate. Aim: To illuminate young adults' experience of living with type 1 diabetes mellitus. Methods: A qualitative literature study was performed. Database searches were done through CINAHL and PubMed. Eight qualitative studies were reviewed using Olsson and Sorensen’s assessment template for qualitative studies. The analysis method was accomplished by means of Popenoe et al. (2021) analysis model. Results: The result was compiled into three main categories and eight subcategories. Manage self-care were perceived as challenging where fear of hypoglycemia led to miss care of diabetes management. To feel different increased the aspire for life without diabetes, where different management strategies were a successive help for acceptance. Finally, support from relatives and healthcare professionals was perceived as meaningful. Conclusion: Young adults experienced a phase in life where they constantly faced new challenges. Having a chronic disease leads to further challenges and readjustments in life to adjust to. Nursing care includes encouraging the person as a whole, supporting participation, and finding strategies for self-care management.
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