The interplay of type 1 diabetes and weight management: A qualitative study exploring thematic progression from adolescence to young adulthood.
Adolescent
Adult
Attitude to Health
Body Weight
/ physiology
Body Weight Maintenance
/ physiology
Diabetes Mellitus, Type 1
/ complications
Feeding Behavior
/ psychology
Female
Health Behavior
/ physiology
Humans
Male
Pediatric Obesity
/ complications
Perception
Self Efficacy
Social Stigma
Transition to Adult Care
Weight Reduction Programs
Young Adult
pediatric obesity
pediatric type 1 diabetes
qualitative research
weight management
Journal
Pediatric diabetes
ISSN: 1399-5448
Titre abrégé: Pediatr Diabetes
Pays: Denmark
ID NLM: 100939345
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
28
02
2019
revised:
04
08
2019
accepted:
05
08
2019
pubmed:
9
8
2019
medline:
26
6
2020
entrez:
9
8
2019
Statut:
ppublish
Résumé
The impact of weight management in persons with type 1 diabetes (T1D) from childhood into adulthood has not been well described. The purpose of the study was to explore qualitative themes presented by young adults with T1D with respect to the dual management of weight and T1D. We analyzed focus group data from 17 young adults with T1D (65% female, age 21.7 ± 2.1 years, HbA1c 8.1% ± 1.5) via inductive qualitative analysis methods. Major themes were compared to themes presented by youth with T1D ages 13-16 years in previously published study in order to categorize thematic progression from early adolescence through adulthood. Themes from young adults with T1D, when compared to those from youth were categorized as: (a) persistent and unchanged themes, (b) evolving themes, and (c) newly reported themes. Hypoglycemia and a sense of futility around exercise was an unchanged theme. Importance of insulin usage and a healthy relationship with T1D evolved to gather greater conviction. Newly reported themes are unique to integration of adulthood into T1D, such as family planning and managing T1D with work obligations. Young adults also reported negative experiences with providers in their younger years and desire for more supportive provider relationships. Issues identified by youth regarding the dual management of T1D and weight rarely resolve, but rather, persist or evolve to integrate other aspects of young adulthood. Individualized and age-appropriate clinical support and practice guidelines are warranted to facilitate the dual management of weight and T1D in persons with T1D.
Sections du résumé
BACKGROUND
The impact of weight management in persons with type 1 diabetes (T1D) from childhood into adulthood has not been well described. The purpose of the study was to explore qualitative themes presented by young adults with T1D with respect to the dual management of weight and T1D.
METHODS
We analyzed focus group data from 17 young adults with T1D (65% female, age 21.7 ± 2.1 years, HbA1c 8.1% ± 1.5) via inductive qualitative analysis methods. Major themes were compared to themes presented by youth with T1D ages 13-16 years in previously published study in order to categorize thematic progression from early adolescence through adulthood.
RESULTS
Themes from young adults with T1D, when compared to those from youth were categorized as: (a) persistent and unchanged themes, (b) evolving themes, and (c) newly reported themes. Hypoglycemia and a sense of futility around exercise was an unchanged theme. Importance of insulin usage and a healthy relationship with T1D evolved to gather greater conviction. Newly reported themes are unique to integration of adulthood into T1D, such as family planning and managing T1D with work obligations. Young adults also reported negative experiences with providers in their younger years and desire for more supportive provider relationships.
CONCLUSIONS
Issues identified by youth regarding the dual management of T1D and weight rarely resolve, but rather, persist or evolve to integrate other aspects of young adulthood. Individualized and age-appropriate clinical support and practice guidelines are warranted to facilitate the dual management of weight and T1D in persons with T1D.
Identifiants
pubmed: 31392807
doi: 10.1111/pedi.12903
pmc: PMC7196280
mid: NIHMS1578715
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
974-985Subventions
Organisme : NIDDK NIH HHS
ID : F30 DK113728
Pays : United States
Organisme : NIDDK NIH HHS
ID : T32 DK007686
Pays : United States
Informations de copyright
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Diabetes Care. 2012 Jun;35(6):1219-24
pubmed: 22474040
Circulation. 2014 Sep 23;130(13):1110-30
pubmed: 25114208
N Engl J Med. 2005 Dec 22;353(25):2643-53
pubmed: 16371630
Pediatrics. 2006 Apr;117(4):1348-58
pubmed: 16585333
Obes Med. 2018 Mar;9:21-31
pubmed: 29984330
Pediatr Diabetes. 2016 Nov;17(7):509-518
pubmed: 25080975
Diabet Med. 2010 Apr;27(4):398-404
pubmed: 20536510
Diabetes Care. 2015 Jun;38(6):971-8
pubmed: 25998289
Curr Diab Rep. 2017 Aug 23;17(10):92
pubmed: 28836234
BMC Public Health. 2009 Sep 29;9:367
pubmed: 19788726
Diabetes Care. 2003 Apr;26(4):1052-7
pubmed: 12663572
Diabetes Care. 2001 Sep;24(9):1536-40
pubmed: 11522695
Int J Eat Disord. 2018 Feb;51(2):112-123
pubmed: 29341203
Health Qual Life Outcomes. 2013 Mar 22;11:50
pubmed: 23521786
Diabetes Care. 2017 Dec;40(12):1790-1799
pubmed: 29042412
Diabetes Care. 2016 Feb;39(2):190-7
pubmed: 26681724
Diabetes Care. 2013 Feb;36(2):463-70
pubmed: 23349150
Pediatr Diabetes. 2016 Aug;17(5):327-36
pubmed: 26153338
Diabetes Care. 2010 Mar;33(3):495-500
pubmed: 20032278
Diabetes Care. 2013 Jul;36(7):2035-7
pubmed: 23340893
Diabet Med. 2014 Dec;31(12):1615-24
pubmed: 24798586
Int J Neurosci. 2007 Mar;117(3):359-68
pubmed: 17365120
Diabetes Care. 1988 Jul-Aug;11(7):567-73
pubmed: 2904881
Diabet Med. 2013 May;30(5):610-5
pubmed: 23157171
Diabetes Res Clin Pract. 2017 Apr;126:68-78
pubmed: 28214669
J Pediatr Psychol. 2006 May;31(4):343-55
pubmed: 16093522
Curr Diab Rep. 2017 Aug;17(8):58
pubmed: 28660565
Diabet Med. 2013 Sep;30(9):1140-4
pubmed: 23758145
Pediatrics. 1997 Mar;99(3):420-6
pubmed: 9041299
Diabetes Care. 2007 Mar;30(3):707-12
pubmed: 17327345
Endocr Rev. 2018 Oct 1;39(5):629-663
pubmed: 30060120
Endocrinol Diabetes Metab. 2019 Jan 19;2(2):e00057
pubmed: 31008365
Diabetologia. 2010 Dec;53(12):2518-25
pubmed: 20820753
Eat Behav. 2006 Aug;7(3):196-203
pubmed: 16843221
Diabetes Care. 2018 Jan;41(Suppl 1):S55-S64
pubmed: 29222377