Dissertations / Theses: 'Adolescent diabetes'

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Bargren, MaryJean K. "Factors affecting dietary compliance in the adolescent with type 1 diabetes /." View online, 2009. http://repository.eiu.edu/theses/docs/32211131396029.pdf.

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Hillege, Sharon Patricia, University of Western Sydney, College of Social and Health Sciences, and School of Applied Social and Human Sciences. "The impact of type 1 diabetes on the self of adolescents and young adults." THESIS_CSHS_ASH_Hillege_S.xml, 2005. http://handle.uws.edu.au:8081/1959.7/175.

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This qualitative study was designed to gain an insight into the ways in which adolescents and young adults managed ?self? in their day - to - day diabetes management. It also examined the effect that illness self representations had on that management. A grounded theory approach using a symbolic interactionist framework was adopted based on 27 in- depth semi structured interviews with adolescents and young adults with diabetes. Respondents described the effects of diabetes management on the physical, emotional, social and related selves. They also described their various illness self representations. It often took an inordinate amount of work for the respondents to manage their diabetes. This ?management? work could be related to problems with their physiological control, emotional stressors, the need to be socially interactive, differing priorities or relational issues. Certainly even the most resilient respondents experienced periods of vulnerability and needed to nurture the ?self? The study generates new knowledge which builds upon the existing body of knowledge relating to the management of self in adolescents and young adults in the context of T1DM. The study established that whilst some health professionals are sensitive and cognizant of the needs of adolescents and young adults with diabetes, there is room for improvement in the way in which health professionals understand the complexities involved in diabetes management for adolescents and young adults
Doctor of Philosophy (PhD)

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McGinley, Susan. "Exercising to Prevent Adolescent Obesity and Diabetes." College of Agriculture, University of Arizona (Tucson, AZ), 2004. http://hdl.handle.net/10150/295865.

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Lodefalk, Maria. "Adolescent type 1 diabetes : Eating and gastrointestinal function." Doctoral thesis, Karolinska institutet, Stockholm, Sweden, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-46180.

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Adolescents with type 1 diabetes (T1DM) are given nutritional education, but the knowledge about their adherence to the food recommendations and associations between dietary intake and metabolic control is poor. Gastrointestinal symptoms are more prevalent in adults with T1DM than in healthy controls, which may be due to disturbed gastrointestinal motility. The meal content affects the gastric emptying rate and the postprandial glycaemia in healthy adults and adults with type 2 diabetes. Meal ingestion also elicits several postprandial hormonal changes of importance for gastrointestinal motility and glycaemia. Eating disorders are more prevalent in young females with T1DM than in healthy females, and are associated with poor metabolic control. The prevalence of eating disorders in adolescent boys with T1DM is not known. This thesis focuses on eating and gastrointestinal function in adolescents with T1DM. Three population-based, cross-sectional studies demonstrated that adolescents with T1DM consume healthy foods more often and have a more regular meal pattern than age- and sex-matched controls. Yet both boys and girls are heavier than controls. The intake of saturated fat is higher and the intake of fibre is lower than recommended in adolescents with T1DM. Patients with poor metabolic control consume more fat and less carbohydrates than patients with better metabolic control. Gastrointestinal symptoms are common in adolescents with T1DM, but the prevalence is not increased compared with controls. Gastrointestinal symptoms in patients are associated with female gender, daily cigarette smoking, long duration of diabetes, poor metabolic control during the past year, and an irregular meal pattern. Adolescent boys with T1DM are heavier and have higher drive for thinness than healthy boys, but do not differ from them in scales measuring psychopathology associated with eating disorders. In a randomized, cross-over study, we found that a meal with a high fat and energy content reduces the initial (0–2 hours) postprandial glycaemic response and delays gastric emptying in adolescents with T1DM given a fixed prandial insulin dose compared with a low-fat meal. The glycaemic response is significantly associated with the gastric emptying rate. Both a high- and a low-fat meal increase the postprandial concentrations of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) and suppress the postprandial ghrelin levels in adolescents with T1DM. The postprandial changes of these hormones are more pronounced after the high-fat meal. Insulin-like growth factor binding-protein (IGFBP) –1 concentrations decrease after insulin administration irrespective of meal ingestion. The GLP-1 response is negatively associated with the gastric emptying rate. The fasting ghrelin levels are negatively associated with the postprandial glycaemic response, and the fasting IGFBP-1 levels are positively associated with the fasting glucose levels. We conclude that nutritional education to adolescents with T1DM should focus more on energy intake and expenditure to prevent and treat weight gain. It should also focus on fat quality and fibre intake to reduce the risk of macrovascular complications and improve glycaemia. Gastrointestinal symptoms in adolescents with T1DM should be investigated and treated as in other people irrespective of having diabetes. However, adolescents with long duration of diabetes, poor metabolic control, and symptoms from the upper gut should have their gastric emptying rate examined during euglycaemia. There may be an increased risk for development of eating disorders in adolescent males with T1DM since they are heavier than healthy boys and have higher drive for thinness. This should be investigated in future, larger studies. For the first time, we showed that a fat-rich meal delays gastric emptying and reduces the initial glycaemic response in patients with T1DM. The action profile of the prandial insulin dose to a fat-rich meal may need to be postponed and prolonged compared with the profile to a low-fat meal to reach postprandial normoglycaemia. Circulating insulin levels affect postprandial GIP, GLP-1, and ghrelin, but not IGFBP-1, responses less than the meal content. The pronounced GIP-response to a fat- and energy-rich meal may promote adiposity, since GIP stimulates lipogenesis. Such an effect would be disadvantageous for adolescents with T1DM since they already have increased body fat mass and higher weights compared with healthy adolescents. Adolescents with T1DM may have subnormal postprandial ghrelin suppression, which may be due to their increased insulin resistance or elevated growth hormone levels. This needs to be investigated in future, controlled studies.

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Adkins, Jessica. "Using Diabetes Self-Management Education to Enhance Adolescent Transition." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5152.

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Type 1 diabetes is a long-term diagnosis, the prognosis of which is directly related to the patient's ability to self-manage the disorder. Adolescents are not currently taught how to manage diabetes; instead, parents and educators expect self-management to be more of a learned behavior from their parents. The purpose of this project was to create a quality improvement plan which the regional pediatric diabetes center study site could implement to improve adolescent glycemic control. Orem's self-care theory was used as theoretical framework for the design and evaluation of the project. The practice-focused question for this doctoral project was: Can a quality improvement plan focused on diabetes self-management education support better control of the glycemic ranges of Type 1 diabetes in adolescents during the transition of self-management from parent to child? The design of the project included creation of curriculum for classes as well as streamlining blood glucose reporting within the center. The quality improvement plan outcomes provided an improvement on hemoglobin A1c of 0.3% for those utilizing the reporting systems and an improvement of 0.4% for those who had attended the education classes. Of the 11 patients who routinely sent in blood glucose over the 4-month time period, 10 met the goal of checking glucose as directed. These outcomes indicate the potential need for more concise direction within nursing practice to provide individual ages within the pediatric population with specific education plans to improve health outcomes. Improving the glycemic control of adolescents living with diabetes allows for a better transition into adulthood with a decreased risk of long-term complications, significantly contributing to positive social change.

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Rosenberg, Tziporah Esther. "The role of parent-adolescent attachment in the glycemic control of adolescents with type-1 diabetes." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2006. http://proquest.umi.com/login?COPT=REJTPTU0NWQmSU5UPTAmVkVSPTI=&clientId=3739.

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Yule, Sara Davina. "Experiences of adolescents with type 1 diabetes." Thesis, University of Edinburgh, 2013. http://hdl.handle.net/1842/7976.

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Type 1 diabetes is a condition which affects the lives of thousands of young people throughout the UK. Existing research has recognised the difficulties that adolescents have in managing their diabetes, and a large amount of research has focused on glycaemic control, and influential factors. This project attempted to establish what is known about young people’s experiences of living with type 1 diabetes, and to further develop this knowledge pertaining particularly to the school environment through qualitative research. Method A systematic review of the literature in relation to young people’s views of their life with type 1 diabetes was conducted and a synthesising thematic analysis was carried out. A qualitative research study was then carried out involving 7 adolescents aged 13-16 years who had a diagnosis of type 1 diabetes. Semi-structured interviews were carried out with the focus being on the young people’s experiences of type 1 diabetes within the school environment. Interview sessions were transcribed and Interpretative Phenomenological Analysis (IPA) was used to analyse the data. Results Five themes emerged from the systematic review. Analysis of the studies led to the emerging themes of: Normal/Different, Control/Management, Relationships, Health– care and Educational experiences. The articles revealed that the experiences of adolescents varied, and were frequently dependent upon the actions of others. Four major themes emerged from the analysis of the research study: Support, Knowledge and Understanding, Standing out, and Adjusting and Accepting. Discussion Systematic review of the articles revealed that the experiences of adolescents varied, and were frequently dependent upon the actions of others. A sense of normalcy was important, and the strict routine and activities of diabetes management impacted upon their ability to achieve it. The support of friends and family was valued, but could at times become overwhelming and educational and health professionals made a difference to their ability to successfully fit diabetes into their lives. The suggestions made by individuals within the studies were generally consistent, and have implications for healthcare providers, friends and families, and schools in relation to facilitating successful diabetic management. Many of the young people taking part in the present research study had encountered negative experiences within the school environment in relation to both peers and staff. However, they described elements of helpful practice and made suggestions for improvements that could be made within school to facilitate a more positive experience.

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Scott, Daen Eve. "The lived experience of social support in adolescent diabetes patients." Thesis, Montana State University, 2012. http://etd.lib.montana.edu/etd/2012/scott/ScottD0512.pdf.

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Adolescence is a time of change in many aspects of a person's life, and this time is further complicated by the presence of a chronic illness such as diabetes. Further, the metabolic control exhibited by teens is generally worse than at other points in life, with as many as 30-50% being characterized as out of control Despite extensive research on the interaction between the social milieu and diabetes control, results have been inconclusive or contradictory. The purpose of this study was to explore how adolescents ages 12-18 experience social support from friends and peers. A convenience sample of adolescent patients from three clinics in a small city in south central Montana were interviewed regarding friendships, use of insulin delivery devices, social networking, and the impact of diabetes on social interaction and daily life. An inductive analysis approach revealed nine themes: full disclosure, taking care of myself, getting help, making it a part of life, people who know are important, sharing information as positive, adults as negative reactors, age differences make a difference and heavy issues early in life. Technology, such as insulin pumps and online social networking, was found to have a major positive impact in participants' social functioning and control. Peer relationships with other teens with diabetes were found to be important and different from friendships with non-diabetics. Negative reactions and social impacts were found to be much more prominent from adults than from same age peers. Implications include the need for further investigation of how technology might benefit teens with chronic conditions, the potential for positive impact from peer connection and mentoring programs, and the importance of clinicians' awareness of patients' social functioning as it impacts care behaviors and general well being.

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Radcliff, Zach. "The Role Of Authoritative Parenting In Type 1 Diabetes Adolescent Outcomes." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3528.

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Due to psychosocial and hormonal changes, adolescents with Type 1 Diabetes (T1D) are at risk for poorer regimen adherence, quality of life (QOL), and glycemic control (HbA1c). Authoritative parenting (AP) supports youth development during the transition into adolescence. To date, the mechanisms behind authoritative parenting and better HbA1c are yet to be examined. Parent-youth dyads completed measures of authoritative parenting, adherence, and QOL. As hypothesized, more authoritative parenting related to higher socioeconomic status (SES; β = -.13, p = .04) rather than ethnicity. Further, more authoritative parenting related to better glycemic control via the mechanisms of higher youth QOL (β = .24, p < .001) and better diabetes adherence (β = .17, p = .008). Parents who provide more authoritative parenting have youth with better QOL, better adherence, and better glycemic control. More authoritative parenting helps youth achieve better diabetes care and quality of life during the transition into adolescence.

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Silva, Ana Roberta Vilarouca da. "Evaluation of two educative strategies for the prevention of type 2 Diabetes mellitus in adolescents." Universidade Federal do CearÃ, 2009. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=4574.

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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
O estilo de vida estÃ diretamente relacionado com a incidÃncia de diabetes mellitus tipo 2 (DM2) e o excesso de peso, sedentarismo e maus hÃbitos alimentares aumentam drasticamente esse risco. PorÃm sabe-se que esses fatores de risco sÃo passÃveis de modificaÃÃo e que a educaÃÃo em saÃde Ã uma peÃa-chave para a diminuiÃÃo dos casos de DM2 em jovens, o que tem aumentado muito em todo o mundo desde a dÃcada de 1990. Estudo quase-experimental, prospectivo e comparativo cujo objetivo foi avaliar duas estratÃgias educativas para a prevenÃÃo do DM2 em adolescentes com fatores de risco, realizado de marÃo a agosto de 2008, em uma escola pÃblica da cidade de Fortaleza-CE. Participaram noventa adolescentes, divididos em dois grupos, GA (n=45) e GB (n=45). Para o grupo GA foi oferecido atendimento individual utilizando como estratÃgia educativa o folder com explicaÃÃes breves e para o GB um programa educativo contendo cinco encontros, com duraÃÃo de dez horas. Usou-se um formulÃrio (dados sociodemogrÃficos e clÃnicos), um questionÃrio de conhecimento (conceito de diabetes mellitus, tipos, sinais e sintomas, complicaÃÃes agudas e crÃnicas, fatores de risco e formas de prevenÃÃo) e dois questionÃrios para avaliar a atitude diante da alimentaÃÃo e atividade fÃsica. O questionÃrio de conhecimento foi aplicado no inÃcio, imediatamente apÃs as intervenÃÃes e apÃs sessenta dias. Os questionÃrios de atitude foram aplicados somente apÃs sessenta dias da intervenÃÃo. Conforme os resultados evidenciaram, a maioria dos adolescentes Ã do sexo feminino, na faixa etÃria de 14 a 15 anos e cursavam a nona sÃrie; 23,3% tinham excesso de peso e 77,8% eram sedentÃrios. As estratÃgias adotadas mostraram-se eficazes para aumentar o conhecimento dos adolescentes acerca dos fatores de risco para DM2 e formas de prevenÃÃo (p= 0,0001) nos grupos A e B. JÃ em relaÃÃo Ã atitude, ao se comparar as estratÃgias educativas nos grupos A e B, os resultados revelaram-se satisfatÃrios para a alimentaÃÃo e atividade fÃsica, porÃm sem significÃncia estatÃstica. ConcluÃ-se que as duas estratÃgias educativas podem ser utilizadas nas escolas na prevenÃÃo do DM2 em adolescentes com fatores de risco.

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Tow, Regina. "Adolescent Athletes with Type 1 Diabetes: Experiences with Continuous Subcutaneous Insulin Infusion." UNF Digital Commons, 2013. http://digitalcommons.unf.edu/etd/428.

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Adolescent athletes with type 1 diabetes (T1DM) face unique challenges when compared to peers with and without diabetes. Continuous subcutaneous insulin infusion (CSII) provides a method of insulin delivery that can enhance flexibility in insulin regimens and lifestyle that may be especially appealing to the adolescent athlete. No studies have explored the impact of athletics in this population. This descriptive qualitative study explored and described the experiences of adolescent athletes using CSII as their primary insulin delivery method, with a focus on athletic participation and performance. The purposeful sample consisted of four adolescent athletes, ages 13 to 15 years with T1DM, using CSII, in excellent diabetes control, and recently participated in organized sports activities. After written informed consent, data were collected through a semi-structured interview with the adolescent and parent. Results were transcribed verbatim and analyzed for emerging themes. Four themes emerged from the transcripts along with multiple subcategories. The main themes included: protecting the pump and infusion site; dealing with highs and lows; maximizing participation and performance; and keeping watch. Information gathered from this study will prepare healthcare professionals to anticipate the needs of adolescent athletes using CSII when prescribing a diabetes management regimen.

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Markowitz, Jessica Tuttman Lowe Michael R. "Body mass index and disordered eating in adolescent females with Type 1 Diabetes /." Philadelphia, Pa. : Drexel University, 2008. http://hdl.handle.net/1860/2806.

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Holker, Vickie M. "Adolescent diabetic treatment adherence and the impact of parental involvement." Laramie, Wyo. : University of Wyoming, 2008. http://proquest.umi.com/pqdweb?did=1798480951&sid=1&Fmt=2&clientId=18949&RQT=309&VName=PQD.

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Esparza, Annabelle Lucia Sandoval. "The relationship between self-esteem and glycemic control in 13-17 year old adolescent girls with type 1 diabetes mellitus." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2739.

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The purpose of this study was to explore the psychosocial phenomena of self-esteem in relation to gucose control in diabetic adolescent girls living in the Inland Empire. Three central themes emerged: body image, peer acceptance, and stress.

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Togba, Harrisson, and Hanna Richloow. "Support till tonåringar med diabetes typ 1. : En litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-386423.

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Abstract Introduction: Diabetes type 1 is a chronic autoimmune disease requiring lifelong insulin therapy. Type 1 diabetes is one of the most common endocrine disorders affecting children and adolescents and the disease is often accompanied by severe complications. Treatment of type 1 diabetes is greatly facilitated by self-motivation to achieve good self-care and thereby reduce the risk of complications. It is important with good treatment and support to reach young people with type 1 diabetes for them to accept their illness and learn to live with it. Purpose: The purpose of this literature study is to describe the support young people with type 1 diabetes may need to live with their disease. Method: Literature review made up of current scientific journal articles and scientific reports published the last 10 years. The articles were searched on the databases PubMed and Cinahl. Results: Sixteen articles were found. In the analysis of the articles, 5 themes emerged: support from parents and family, support from healthcare, support from friends and support from others with diabetes. The result of the literature study shows that young people need positive support and feedback to manage their illness and self-care. Conclusions: The teenagers with type 1 diabetes need support to manage their illness. This is achieved through a good communication from health care, parents, family, friends and groups, and this in turn leads to a personal development which increases knowledge and gives them experience to take responsibility in their own care.

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Lockhart, Lorraine. "Improving outcomes for young people with type 1 diabetes." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/22891.

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Aims: The thesis aimed to contribute to the current understanding of how to improve comprehensive health outcomes for children and adolescents with type 1 diabetes. Methods: A systematic review was undertaken to identify existing interventions designed to improve health-related quality of life in a paediatric diabetes population. The quality of identified studies was assessed and the effectiveness of the interventions was evaluated. Parent-adolescent dyads were also recruited via paediatric diabetes teams to participate in an empirical study. Participants were asked to complete questionnaires measuring psychological flexibility, mindfulness, perception of parental care and control, adherence to treatment and quality of life. Relationships were explored using correlation and regression analysis. Results: Twenty seven articles were identified in the systematic review. More than half were rated as “acceptable” or “high quality”. Quality of life was a primary treatment target in only three studies. Eight studies reported significant beneficial effects on health-related quality of life. In the empirical study, regression analysis found that both parent and adolescent diabetes-specific psychological flexibility predicted treatment adherence while adolescent mindfulness and insulin administration predicted quality of life. Conclusion: There is some evidence for the effectiveness of intensive structured education and coping skills training in improving health-related quality. However consideration should be given to developing theoretically informed interventions to target quality of life alongside other treatment related outcomes. The empirical study suggested psychological flexibility and mindfulness are useful constructs for understanding health outcomes in adolescents with type 1 diabetes. Acceptance and commitment, and mindfulness-based therapies may prove beneficial for improving outcomes in this population.

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Viégas, Cynthia Griselda Castro. "NECESSIDADES DO CUIDADOR FAMILIAR DE CRIANÇAS E ADOLESCENTES COM DIABETES MELLITUS." Universidade Federal do Maranhão, 2013. http://tedebc.ufma.br:8080/jspui/handle/tede/704.

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Made available in DSpace on 2016-08-18T17:27:39Z (GMT). No. of bitstreams: 1 Dissertacao CYNTHIA GRISELDA CASTRO VIEGAS.pdf: 1758065 bytes, checksum: 5ac92b08e81744b76a86fffec1986f2f (MD5) Previous issue date: 2013-08-29
The demands arising from the care of children and adolescents with the chronical condition of Diabetes can alter de dynamics of a family, especially of the family caregiver. From this process of care emerge needs related to the disease, as well as to the different aspects of Diabetes therapeutic and the human behavior. Thus, the Professional care must be embracing and multidimensional to identify needs and minimize worries, fears and anxiety of the caregiver and the affected child and / or adolescent. Delimited by such assertions are the following research problems: What needs are experienced by family caregivers from the demands of caring for a child or adolescent with diabetes? The investigated objective can take the nurse to understand many situations of care such as physical, psychic, affective and emotional aspects as well as the difficulties and worries that are presented to the family and to caregivers of children and adolescents with diabetes, in a dimension that reach the social practice of the nurse. The research had as an objective to understand the needs of the family caregiver of children and adolescents with diabetes. For that a descriptive exploratory research with qualitative approach with eleven family caregivers of children and adolescents was made, in the Program of Education for Diabetes in the Health center of Liberdade, in the city of São Luís, State of Maranhão. To collect the data it was used an open interview with data analysis from Theme Analysis. After the analytical-reflexive process concerning the data, the needs were grouped from a great simension of support to caregiving, and for the raw data analysis were grouped into three theme characteristics: Needs of Instrumental Support, Needs of Informative Support and Needs of Emotional Support. Among the needs of instrumental support, it is highlighted the difficulty of access for diagnose and treatment, financial support and the unpreparedness and lack of professional skills in managing diabetes; as need of informative support emerged the theme information for caregiving; among the needs of emotional support is it highlighted the changes in the family routine and support and the caregiving inside the familiar and school context. From the comprehension of the needs of the nurse, it is perceived the importance of the proximity of the nurse with the specificities of this caregiver, expanding the action focus to care and establishing actions that support the integrity and integrality of the family and the health-disease-care process.
As demandas advindas do cuidado de crianças e adolescentes com condição crônica do Diabetes podem alterar a dinâmica da família, em especial, do cuidador familiar. Desse processo de cuidado emergem necessidades relativas à doença, assim como aos diferentes aspectos da terapêutica do diabetes e do comportamento humano. Portanto, o cuidado profissional deve ser abrangente e multidimensional, no sentido de identificar necessidades e minimizar preocupações, angústias e ansiedade do cuidador e da criança e/ou adolescente afetado. Mediante tais assertivas delimitou-se o seguinte problema de pesquisa Que necessidades são vivenciadas pelo cuidador familiar a partir das demandas de cuidado à criança ou adolescente com diabetes? O objeto investigado poderá levar o enfermeiro a compreender diversas situações de cuidado tais como aspectos físicos, psíquicos, afetivos e emocionais assim como as dificuldades e as preocupações que se apresentam às famílias e aos cuidadores de crianças e adolescentes com diabetes, numa dimensão que alcance a prática social do enfermeiro. A pesquisa teve como objetivo compreender as necessidades do cuidador familiar de crianças e adolescentes com diabetes. Para tanto foi realizado estudo exploratório descritivo com abordagem qualitativa com onze cuidadores familiares de crianças e adolescentes com diabetes atendidas no Programa de Educação em Diabetes no Centro de Saúde da Liberdade, São Luís-MA. Para apreensão dos dados utilizou-se entrevista aberta com análise dos dados a partir da Análise Temática. Após processo analítico-reflexivo acerca dos dados, as necessidades foram agrupadas a partir de uma grande dimensão de suporte para o cuidado que para a análise dos dados brutos foram agrupadas em três categorias temáticas: Necessidades de Suporte Instrumental, Necessidades de Suporte Informativo e Necessidades de Suporte Emocional. Dentre as necessidades de suporte instrumental, destacaram-se a dificuldade de acesso para o diagnóstico e tratamento, suporte financeiro e o despreparo e a falta de habilidades dos profissionais no manejo do diabetes; como necessidades de suporte informativo emergiu o subtema informação para o cuidado; entre as necessidades de suporte emocional apontam-se as mudanças na rotina familiar e o suporte a partir do compartilhamento de experiências. Conclui-se que cuidar do(a) filho(a) com diabetes requer suporte permanente, seja sob uma dimensão técnico-instrumental ou de informação e cognição que permita autonomia para viver o dia a dia de modo seguro. A partir da compreensão das necessidades do cuidador familiar de crianças e adolescentes enfatiza-se a importância da aproximação do enfermeiro com as especificidades do cuidador, ampliando o foco de ação para o cuidado e estabelecendo ações que apoiam a integridade e a integralidade da família e do processo saúde-doença-cuidado.

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McGrady, Meghan E. "Illness Representations and Glycemic Control in Adolescents with Type 1 Diabetes." University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1335462592.

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Lindholm, Olinder Anna. "Self-management of diabetes in adolescents using insulin pumps." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-122952.

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Insulin pump treatment (CSII) is considered the most physiological way to imitate the healthy body’s insulin profile in adolescents with diabetes. However, despite the use of CSII, achieving the recommended disease control is difficult for adolescents. The aim of this thesis was to explore aspects of self-management of diabetes in adolescents using insulin pumps in order to describe conditions contributing to the recommended disease control. Three methods of bolusing (normal, dual-wave and square-wave) in connection with pasta meals were tested in a crossover study among 15 adolescents with diabetes to assess whether one method was superior in managing glucose levels. A cross-sectional study among 90 adolescents being treated with CSII was conducted to investigate the management of CSII, including the administration of bolus doses. Two qualitative interview studies, based on the grounded theory method, were performed to gain insight into the processes involved in taking bolus doses and to investigate reasons for missed bolus doses and strategies for avoiding missing them. Twelve adolescents, four parents and one diabetes specialist nurse were interviewed. No method of bolusing was found to be superior in managing the glucose levels after these meals. The post-prandial glucose peaks were <10 mmol/L, in 48% of the cases, regardless of bolus methods. This indicates that adolescents can be encouraged to individually test which bolus method gives them the most normal post-prandial glucose levels. The cross-sectional study showed that adolescents were satisfied with CSII, but that 38% had missed more than 15% of the bolus doses the day under study. The frequency of bolus doses correlated with the disease control. Findings from the interview study revealed the need to clarify the responsibility for diabetes self-management in continuous negotiation between adolescents and parents to avoid insulin omission. The main reason for missed boluses was lost focus, and the strategies for remembering them were agreements involving reminders. The thesis describes that individual dose testing, clarification of responsibility and agreements involving reminders are conditions contributing to the recommended disease control. The thesis also describes that lost focus and a lack of responsibility can lead to insulin omission and be a hindrance to achieving disease control.
Anna Kernell avled maj 2010.

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Shabestari, Omid L. "Evaluation of using Web 2.0 technologies in diabetes education for adolescent and young patients." Thesis, City University London, 2010. http://openaccess.city.ac.uk/8721/.

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Diabetes Mellitius is a major chronic disease with multi-organ involvement and high-cost implications. Although it has been demonstrated that structured education can control the risk of developing these complications, there is a substantial room for improvement in the educational services for these patients. E-learning can be a good solution to fill this gap. A system dynamics model was developed in this study to highlight the potential return on investment in these systems.

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Jackson, Katherine. "Exploring the role of self-compassion in adolescent wellbeing and type 1 diabetes management." Thesis, University of East Anglia, 2018. https://ueaeprints.uea.ac.uk/69038/.

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Self-compassion – a self-relating style characterised by kindness, acceptance, and the motivation to soothe emotional distress – has been empirically validated as a correlate of optimal psychological functioning, wellbeing, and physical health among adults. However, literature examining the relationship between self-compassion and positive outcomes during adolescence is in its infancy. The current research portfolio was thus designed to examine self-compassion as a potential intrapersonal resilience resource that may help young people navigate transitions and challenges during the adolescent period, including living with a chronic illness. The association between self-compassion and subjective wellbeing in adolescents was estimated through meta-analytic modelling, while self-compassion was empirically examined as a correlate of effective disease management in adolescents with type 1 diabetes. The meta-analysis revealed a large, positive correlation between self-compassion and subjective wellbeing (r = .46) in studies with adolescents aged 10 to 19. Among a sample of 52 adolescents (aged 11 to 18) with established type 1 diabetes, self-compassion was found to predict improved glycaemic control and regimen adherence, outcomes linked to a reduced risk of short- and long-term health complications. Impaired self-soothing was also discovered to mediate the relationship between emotional distress and poorer diabetes regimen adherence. A compassionate self-approach thus appears to be linked with the subjective experience of wellbeing among adolescents, as well as having specific implications for behavioural and physiological resilience among those living with a chronic health condition. As a trainable resource, self-compassion may provide a valuable tool for promoting positive mental and physical health among young people.

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Savoldelli, Roberta Diaz. "Leptina e ghrelina na fase aguda e de recuperação da cetoacidose diabética em crianças e adolescentes." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-07122016-152749/.

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INTRODUÇÃO: a ação dos hormônios contrarreguladores da insulina na cetoacidose diabética tem sido estudada desde a década 1970-80, e é sabido que seus níveis elevados, aumentando a resistência à insulina, têm papel importante na gênese da CAD. Leptina e ghrelina foram mais recentemente associadas à homeostase da glicose, no entanto, seu papel na CAD ainda é controverso. Os objetivos deste estudo foram: avaliar as alterações nas concentrações séricas de leptina e ghrelina presentes ao diagnóstico da CAD durante os primeiros três dias de seu tratamento e após a estabilização completa do quadro, as correlações com a insulina e outros contrarreguladores, comparando com indivíduos saudáveis. MÉTODOS: foram analisados 25 episódios de cetoacidose diabética em 22 pacientes admitidos no setor de emergência pediátrica de um hospital terciário em São Paulo, Brasil, entre março de 2010 e julho de 2013. Os episódios de cetoacidose foram manejados com reposição endovenosa de fluidos e eletrólitos e análogos de ação ultrarrápida de insulina subcutânea intermitente. Amostras para glicose, insulina, leptina, ghrelina, GH, cortisol e catecolaminas foram obtidas no momento da admissão (T0), durante o tratamento da cetoacidose (após 2, 4, 6, 12, 24 e 72 horas) e em um momento estável após a alta (TE). Os dados foram analisados utilizando-se os testes ANOVA ou Kruskal-Wallis para a comparação de variáveis contínuas durante o tratamento, Teste t de Student ou Mann Whitney para a comparação entre pacientes e grupo controle, e testes de Pearson ou Spearman para correlação entre as variáveis; p < 0.05 foi considerado significativo. RESULTADOS: observamos três fases distintas (a): o diagnóstico de CAD (T0) em que prevalecem hiperglicemia, insulinopenia e elevação de hormônios contrarreguladores; nesse momento, as concentrações de leptina foram menores que no grupo controle, provavelmente relacionadas à insuficiência de energia, estado hipercatabólico e elevação dos hormônios contrarreguladores; as concentrações de ghrelina foram menores que no grupo controle, apesar do hipercatabolismo, da hipoinsulinemia e da hiperglucagonemia, todas situações que fisiologicamente elevariam seus níveis, possivelmente devido à hiperglicemia marcante do momento; (b) durante o tratamento da CAD (T2 a T72): com redução gradual da glicemia até T24, elevação gradual da insulina, redução de glucagon, GH, cortisol e norepinefrina; nesse período, ocorreu elevação gradual da leptina após o início do tratamento com insulina, que atingiu níveis comparáveis ao GC no T72; redução da ghrelina (T4 menor que T72), provavelmente inibida pela hiperglicemia e por doses suprafisiológicas de insulina; e (c) após a resolução da CAD (TE): com hiperinsulinização; GH, cortisol e norepinefrina comparáveis ao GC, glucagon reduzido em relação ao GC, possivelmente supresso pelos altos níveis de insulina; as concentrações de leptina foram maiores que em T0 e comparáveis ao GC; os níveis de ghrelina, comparáveis ao diagnóstico e durante o tratamento da CAD, ainda significativamente menores que no GC, provavelmente influenciados pela hiperglicemia, hiperinsulinemia e baixos níveis de glucagon. CONCLUSÕES: as concentrações de leptina diminuídas ao diagnóstico de CAD tornam-se semelhantes em pacientes com DM1 estáveis em relação a indivíduos saudáveis, podendo ser um marcador de hipercatabolismo. As concentrações de ghrelina permaneceram baixas durante todo o estudo em pacientes diabéticos, independentemente da descompensação
INTRODUCTION: The role of glucoregulatory hormones in diabetic ketoacidosis have been investigated since 1970-80s and the elevation of growth hormone, cortisol and norepinephrine reduce the sensitivity to insulin. Leptin and Ghrelin have more recently been shown to regulate glucose and insulin metabolism; however, their functions in DKA are still controversial. The aims of this study were to analyze leptin, ghrelin and their relationships with other glucoregulatory hormones on diagnosis of diabetic ketoacidosis, during the first 72 hours of treatment and after recovery compared with healthy subjects. METHODS: We examined 25 DKA episodes in 22 patients who were admitted to the pediatric emergency department of a tertiary hospital in São Paulo, Brazil, from March 2010 to July 2013. These episodes were managed with fluids and electrolytes replacement and intermittent subcutaneous fast-acting insulin analogues. Samples for blood glucose, insulin, leptin, ghrelin, GH, cortisol, and catecholamines were obtained on admission (T0), during treatment (after 2, 4, 6, 12, 24 and 72 hours) and after discharge (TS). The control group (CG) was comprised by 21 healthy subjects, who submitted a single blood sample. Data were analyzed by ANOVA or Kruskal-Wallis to compare continuous variables during treatment, student t-test or Mann Whitney for comparisons between patients and controls, and Pearson or Spearman correlations between variables; p < 0.05 was considered to be significant. RESULTS: we observed three distinct phases: (a) on diagnosis of DKA (T0) where hyperglycemia, insulinopenia, and elevated glucoregulatory hormones prevail; leptin concentrations were lower than CG at this moment, probably related to energy insufficiency, hypercatabolic state, and elevated glucoregulatory hormones; ghrelin concentrations were lower than CG at this moment, despite hypercatabolism, hypoinsulinemia and hyperglucagonemia, situations that physiologically would increase them, possibly related to marked hyperglycemia at T0; (b) during DKA treatment (T2 to T72): with gradual reduction of blood glucose until T24, gradual rise of insulin; reduction of glucagon, GH, cortisol and norepinephrine. Leptin levels rises gradually after the start of insulin treatment and is comparable to control group at T72; reduction of ghrelin (T4 lower than T72), possibly inhibited by hyperglycemia and supraphysiological doses of insulin, all lower than CG; and (c) After DKA (TS), in an outpatient setting: with marked hyperinsulinization, GH, cortisol and norepinephrine were comparable to CG. Glucagon was lower than CG, possibly suppressed by high insulin levels; leptin was higher than T0 and comparable to CG; ghrelin levels were comparable to all samples during DKA treatment, and still significantly lower than CG, probably influenced by hyperglycemia, hyperinsulinemia and low glucagon levels. CONCLUSIONS: Low leptin levels were a marker of hypercatabolic state, with normalization of its concentrations with DKA resolution. Ghrelin was low in diabetic patients independent of metabolic derangements

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Keough, Lori A. "Self-Management of Type 1 Diabetes Across Adolescence: A Dissertation." eScholarship@UMMS, 2009. https://escholarship.umassmed.edu/gsn_diss/17.

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Little is known about what variables affect self-management practices of adolescents with T1D. Few studies have examined differences in self-management behaviors by stage of adolescence. Similarly, no studies have examined all of the attributes of self-management, including Collaboration with Parents and Goals. In order to fill the gaps in the literature, a secondary data analysis with a descriptive correlation design was conducted to describe T1D self-management behaviors (Collaboration with Parents, Diabetes Care Activities, Diabetes Problem Solving, Diabetes Communication and Goals) during early, middle and late stages of adolescence. This study also examined whether the roles of covariates (regimen, duration of illness (DOI), gender) in self-management behaviors vary by stage of adolescence. Data from 504 subjects aged 13 – 21 years were analyzed and the age variable was transformed into three adolescent stages early (13-14) (n=163), middle (15-16) (n=159) and late (17-21) (n=182). The findings revealed significant differences between adolescent stages on Collaboration with Parents and the Diabetes Problem Solving subscale. The covariate analysis showed no significant effect modification for the covariates and stage on any of the subscales so the results did not differ from the ANOVA model. Covariate analysis showed significant associations between regimen and Collaboration with Parents, Diabetes Care Activities and Diabetes Problem Solving. DOI showed significant associations only with Diabetes Problem solving and gender had significant associations with Diabetes Care Activities and Diabetes Communication. The mean scores on Collaboration with Parents show an incremental decline in collaboration with parents as adolescents move through stages. The higher mean Diabetes Problem Solving scores found in the late adolescent group compared correlated with a higher degree of problem solving in this group when compared to those in the early or middle adolescent stage group. Regimen had significant associations with three of the five subscales suggesting this is an important variable for future study. DOI did not have a significant impact on self-management whereas gender related differences in the areas of Diabetes Activities and Diabetes communication warrant further investigation.

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Jones, Jennifer Michelle. "Eating disorders in adolescent females with type 1 diabetes mellitus, a controlled three-site study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0023/NQ49954.pdf.

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Caccavale, Laura J. "Exploring the role of motivational interviewing in adolescent patient-provider communication about type 1 diabetes." VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/4960.

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Type 1 diabetes (T1D) is one of the most common pediatric chronic illnesses. Glycemic control among patients with T1D often deteriorates during adolescence; yet little is known about the most effective way for providers to communicate with adolescents to prevent this decline. Given the importance of effective communication, examination of effective patient-provider communication strategies is needed. The current investigation used Motivational Interviewing (MI) as a framework to help characterize naturally-occurring adolescent patient-provider communication in medical encounters and examined the relations between provider communication and T1D self-management and control. Participants were five pediatric endocrine providers and 55 adolescents with T1D (49% female; 76% White; M age= 14.8 years, SD= 1.6). Mean T1D duration was 7.9 years (SD= 3.9) and mean baseline HbA1c was 8.58% (SD= 1.4). Adolescents and caregivers completed surveys related to diabetes self-management and psychosocial functioning at a routine endocrinology visit and again at one and three months post-baseline. Medical encounters were audio-recorded and coded. HbA1c was obtained via medical chart review at baseline, three, and six month appointments. Hierarchical multiple regressions revealed that, after controlling for prior MI training (providers) and adolescent baseline HbA1c, age, and race, use of MI non-adherent behavior (e.g., confronting, persuading) was associated with 1) poorer three month HbA1c, F(5,45)= 11.19, p < .001; R2 = .554 and 2) worse adolescent diabetes adherence, F(5, 46)= 9.86, p < .001; R2= .517. MI non-adherent behavior emerged as a significant predictor in each model, t(45)= 2.13,p = .038, β = .242 and t(46) = -2.39, p= .021, β= -.300, respectively. A mediation analysis determined that patient self-efficacy for diabetes self-management mediated the relation between the use of these MI non-adherent behaviors and lower diabetes adherence. In TalkT1me, providers’ overreliance on persuasion and confronting adolescents about the risks of non-adherence was paradoxically associated with poorer glycemic control and adherence. Certain communication techniques that are inconsistent with MI, like confronting or persuading, appear to have a negative impact on diabetes self-care and HbA1c. Results from this evaluation of naturally occurring communication can help guide targeted training efforts to enhance communication and improve diabetes self-care with these vulnerable patients.

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Fragoso, Luciana VlÃdia CarvalhÃdo. "VivÃncias cotidianas de adolescentes com diabetes Mellitus: um estudo compreensivo." Universidade Federal do CearÃ, 2009. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=5066.

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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
Lidar no cotidiano com o diabetes nÃo Ã tarefa fÃcil e cada vez mais se admite que os aspectos emocionais, afetivos e psicossociais, a dinÃmica familiar, as fases da vida, bem como a relaÃÃo com o profissional de saÃde podem influenciar a motivaÃÃo, a habilidade para o aprendizado do controle e manejo do diabetes. Nesse contexto Ã que objetivamos com esse estudo compreender as vivÃncias com o diabetes mellitus tipo 1 , a partir dos discursos dos adolescentes. O estudo foi do tipo descritivo de natureza qualitativa, realizado com 14 adolescentes do ambulatÃrio de endocrinologia de um Hospital de referÃncia no municÃpio de Fortaleza, CearÃ, no perÃodo de junho a outubro de 2008. Para coleta dos dados adotou-se uma entrevista semi-estruturada com trÃs perguntas norteadoras direcionada aos participantes. Os dados foram organizados segundo a anÃlise de conteÃdo de Bardin. Como resultados emergiram dos discursos cinco categorias: Ter que aprender a conviver com a doenÃa, Ter dificuldades para seguir a dieta, Ser cobrado e apoiado pela famÃlia para realizar o tratamento, Ter o apoio dos amigos como suporte para o tratamento e Gostar da assistÃncia prestada pelo mÃdico e enfermeiro do ambulatÃrio de diabetes. Na primeira categoria, observamos que a descoberta do diabetes foi um momento difÃcil devido Ãs mudanÃas que tiveram de adotar em virtude do controle terapÃutico, porÃm o tempo fez com que eles aprendessem a conviver e lidar com o diabetes; na segunda categoria foi evidenciado que seguir a dieta adequada Ã algo bastante difÃcil em conseqÃÃncia dos estÃmulos internos e externos a que estÃo submetidos e tambÃm das dificuldades financeiras devido a uma baixa renda familiar; a terceira e quarta categorias demonstraram que os adolescentes tÃm como suporte para o seu tratamento diÃrio o apoio da famÃlia e dos amigos e por fim a quinta categoria revelou que os adolescentes gostam da assistÃncia realizada pelos profissionais de saÃde do ambulatÃrio. Concluindo o estudo evidenciamos que os adolescentes estÃo avanÃando no seu processo de adaptaÃÃo ao adoecer crÃnico, enfrentando e encarando seu tratamento apesar de encontrarem dificuldades para seguirem, em especial, o tratamento dietÃtico. O apoio da famÃlia acontece atravÃs das cobranÃas para que os mesmos realizem seu autocuidado, os grupos de pares atuam atravÃs do suporte emocional facilitando o seu tratamento e demonstrando empatia e os profissionais de saÃde oferecem o suporte tÃcnico, ressaltando que alguns profissionais se sobressaÃram na assistÃncia, ao exercerem um cuidado humanizado e nÃo apenas tÃcnico. Observamos que ainda assim hÃ muito que avanÃarmos enquanto profissionais de saÃde na valorizaÃÃo das experiÃncias de vida do adolescente com diabetes, identificando fatores que interferem para o bom andamento do seu tratamento, realizando uma assistÃncia que contemple alÃm do aspecto tÃcnico, que valorize a ciÃncia aliada aos aspectos biopsicossociais promovendo qualidade na assistÃncia Ã saÃde do mesmo.

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Passone, Caroline de Gouveia Buff. "Tradução e validação de Diabetes Self-Management Profile (DSMP) para a língua portuguesa do Brasil: um instrumento para avaliar o autocuidado no diabetes tipo 1 numa população brasileira." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-18012017-155241/.

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Objetivo: Traduzir e validar o instrumento Diabetes Self-Management Profile (DSMP)-Regime Convencional e Flexível para a língua portuguesa do Brasil, numa população pediátrica portadora de diabetes mellitus tipo 1 (DM1) e seus cuidadores, para avaliar a qualidade do autocuidado desta população. Método: O DSMP é uma entrevista semiestruturada composta de 25 questões, dividida em 5 subscalas (exercício, hipoglicemia, alimentação, monitorização glicêmica e insulinoterapia). Foi administrado para pacientes com DM1 entre 6 e 18 anos (n=102) e seus cuidadores. Crianças menores de 11 anos foram entrevistadas com os pais e as maiores separadamente. Os pacientes foram entrevistados duas vezes no intervalo de 3 meses pelo mesmo pesquisador, e estas entrevistas foram gravadas e avaliadas por um segundo pesquisador. A análise estatística para confiabilidade e validade incluiu a associação do escore com a Hb1Ac e um questionário de percepção medica. Resultados: O escore do DSMP total mostrou adequada consistência interna (Cronbach=0,79) e adequada confiabilidade inter (r=0,38,p < 000,1) e intraobservador (0,43, p < 000,1). O escore total do DSMP e subscalas tiveram correlação negativa com a HbA1c (r = -0.53, p < 0.001) e positiva com a percepção médica do autocuidado (r=0.67, p < 0.001). Conclusões: A versão traduzida do DSMP demonstrou que este é um instrumento confiável e válido para avaliar o autocuidado do DM1. O escore do DSMP foi correlacionado com HbA1c em nossa população brasileira, sendo agora é o primeiro instrumento de autocuidado validado em nossa língua para avaliar pacientes pediátricos
Objective: To translate and validate the instrument DSMP-Conventional and Flexible Regimens into Brazilian Portuguese language in order to evaluate the quality of diabetes self-management in children and adolescents with type 1 diabetes and their caregivers. Method: DSMP was translated into Brazilian Portuguese language by forward and back translation method and validated in a group of 102 type 1 diabetes youths between 6 and 18 years (n=102) and their families by the analysis of its internal consistency, intra and interobserver reliability and concurrent correlation with HbA1c and physician perception. Results: DSMP total scores demonstrated adequate internal consistency (Cronbach\'s 0.79), 3-month test-retest reliability (r=0.43), inter-interviewer agreement (r=0.38). DSMP total scores and all subscales were significantly correlated to HbA1c (r= -0.53, p < 0,001), as well as physician perception (r=0.67, p < 0,001). Conclusion: DSMP-translated version into Brazilian Portuguese language is a reliable and valid tool to assess diabetes self-management

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Paulino, Maria Fernanda Vanti Macedo 1964. "Crescimento e composição corporal de uma coorte de crianças e adolescentes com diabetes tipo 1." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308142.

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Orientadores: André Moreno Morcillo, Sofia Helena Valente de Lemos Marini
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Objetivo: avaliar o crescimento e a composição corporal de crianças e adolescentes, com diabetes tipo 1 (DM1). Sujeitos e métodos: estudo de uma coorte de 44 pacientes com DM1 acompanhados em média por 4 anos, comparados a um grupo controle. Avaliou-se peso, estatura, índice de massa corporal (IMC), massa gorda (MG%), índice de massa gorda, cintura e razão cintura/altura. Resultados: no sexo feminino, na primeira avaliação a MG% das pacientes foi menor, enquanto na segunda, a média da cintura das pacientes foi maior que a dos controles. No sexo masculino, a altura dos pacientes foi menor na primeira avaliação, enquanto o IMC foi maior na segunda. Não foram observadas diferenças entre as variações dos escores z de altura, peso, IMC e da MG% ou na distribuição desses escores entre as duas avaliações em ambos os grupos. A análise multivariada mostrou diferença no IMC e na razão cintura/altura dos dois sexos e também na cintura das meninas. Conclusão: os pacientes apresentaram crescimento adequado, porém diferiram na composição corporal durante o período do estudo
Abstract: Objective: the aim of this study was to evaluate the growth and body composition of children and adolescents with type 1 diabetes mellitus (T1DM). Subjects and methods: a cohort of 44 patients with T1DM were followed for approximately four years and compared with a control group. Weight, height, body mass index (BMI), body fat percentage (BF%), fat mass index, waist circumference (WC) and waist-height ratio were determined. Results: in females, in the first evaluation, BF% was lower in patients, while, in the second, mean WC was higher in patients than in controls. In males, height was lower in the first, while BMI was higher in the second. We did not find any differences among the changes in height, weight, BMI z-scores and BF% or in the distribution of those z-scores between the two evaluations, in both groups. Multiple regression analysis found differences in BMI and waist-height ratio in both sexes and also in WC in females. Conclusion: the patients had adequate growth but showed discrepancy in their body composition during the study
Doutorado
Pediatria
Doutora em Saúde da Criança e do Adolescente

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Cruz, Déa Silvia Moura da. "Vivência de adolescentes com diabetes mellitus tipo 1 na perspectiva da ética da alteridade." Universidade Federal da Paraíba, 2017. http://tede.biblioteca.ufpb.br:8080/handle/tede/9478.

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Introduction: The adolescent with diabetes experiences the conflicts of adolescence and tackles the demands resulting from the disease and the medical therapy. Objective: To know the experience of adolescents with type 1 diabetes mellitus from the perspective of the Ethics of Otherness. Method: This is a qualitative and exploratory-descriptive study, which was performed in the Pediatric Outpatient Clinic of the Lauro Wanderley University Hospital, in the city of João Pessoa, with nine adolescents with type 1 diabetes. Data were collected by means of a focus group and semi-structured interviews, and were interpreted through thematic analysis. The study was approved by a Research Ethics Committee, protocol nº 1.203.218, CAAE 47909515.3.0000.5183. Results: The analysis of the speeches enabled us to build following categories: Living with diabetes; Experiences of adolescents with diabetes in the family environment; Experiences of adolescents with diabetes in the social environment and Experiences of adolescents with diabetes with the multidisciplinary team. Since the diagnosis, parents took the responsibility of caring for their children, and, from the perspective of the Ethics of Otherness, they were present and open to welcoming them as “Other”, thus supporting them in the medical therapy. The adolescents proved to be confident people, with preserved self-esteem, who manage to live in community, taking up their condition before their peers, thus becoming sensitive to their needs, making themselves present, helping them in self-care, as well as respecting them in their Otherness. The assistance received from the multidisciplinary team was considered by the adolescents as “optimal”, because the established relationship is pervaded by empathy, respect and complicity, although some ineffective strategies have been used by one of the team members, which did not contribute to changing the perception and behavior of the adolescent. Final Considerations: The adolescents with diabetes and their families are active subjects in the medical therapy and show peculiarities that need to be addressed in the therapeutic project. By knowing these experiences, from the perspective of the Ethics of Otherness, the multidisciplinary team may reflect on the care provided, thus respecting the otherness of the adolescents with diabetes, through a qualified listening to meet their peculiar demands.
Introducción: El adolescente con diabetes experimenta los conflictos de la adolescencia y afronta las demandas derivadas de la enfermedad y de la terapéutica. Objetivo: Conocer la experiencia de adolescentes con diabetes mellitus tipo 1 desde la perspectiva de la Ética de la Alteridad. Método: Estudio cualitativo, exploratorio-descriptivo, efectuado en el Dispensario de Pediatría del Hospital Universitario Lauro Wanderley, en la ciudad de João Pessoa-PB, con nueve adolescentes con diabetes tipo 1. Los datos fueron recopilados por medio de grupo focal y de entrevistas semiestructuradas, y fueron interpretados con el análisis temático. El estudio tuvo la aprobación de un Comité de Ética en Investigación, protocolo nº 1.203.218, CAAE 47909515.3.0000.5183. Resultados: El análisis de los discursos permitió la construcción de las siguientes categorías: Conviviendo con la diabetes; Experiencias de adolescentes con diabetes en el medio familiar; Experiencias de adolescentes con diabetes en el medio social y Experiencias de adolescentes con diabetes con el equipo multiprofesional. Desde el diagnóstico, los padres asumieron la responsabilidad por el cuidado de los hijos, y, desde la perspectiva de la Ética de la Alteridad, estuvieron presentes y abiertos para acogerlos como “Otro”, apoyándolos en la terapéutica. Los adolescentes demostraron ser personas confiadas, con autoestima preservada, que logran convivir en comunidad, asumiendo su condición ante sus pares, siendo estos sensibles a sus necesidades, haciéndose presentes, auxiliándolos en el autocuidado, y respetándolos en su Alteridad. La asistencia recibida del equipo multiprofesional fue considerada por los adolescentes como “óptima”, ya que la relación establecida se encuentra impregnada por la empatía, el respeto y la complicidad, aunque estrategias ineficaces hayan sido utilizadas por uno de los miembros del equipo, las cuales no contribuyeron a cambiar la percepción y el comportamiento del adolescente. Consideraciones Finales: Los adolescentes con diabetes y sus familias se muestran sujetos activos en la terapéutica y presentan peculiaridades que requieren ser contempladas en el proyecto terapéutico. Conocer estas experiencias, desde la perspectiva de la Ética de la Alteridad, permite a los equipos multiprofesionales reflexionar acerca del cuidado prestado, respetando la alteridad de los adolescentes con diabetes, por medio de una escucha calificada para satisfacer sus demandas peculiares.
Introdução: O adolescente com diabetes vivencia os conflitos da adolescência e enfrenta as demandas decorrentes da doença e da terapêutica. Objetivo: Conhecer a vivência de adolescentes com diabetes mellitus tipo 1 na perspectiva da Ética da Alteridade. Método: Estudo qualitativo, exploratório-descritivo, realizado no Ambulatório de Pediatria do Hospital Universitário Lauro Wanderley na cidade de João Pessoa-PB, com nove adolescentes com diabetes tipo 1. Os dados foram coletados por meio de grupo focal e de entrevistas semiestruturadas, e foram interpretados com a análise temática. O estudo teve aprovação de um Comitê de Ética em Pesquisa, protocolo nº 1.203.218, CAAE 47909515.3.0000.5183. Resultados: Os dados permitiu a construção das seguintes categorias: Convivendo com o diabetes; Vivências de adolescentes com diabetes no meio familiar; Vivências de adolescentes com diabetes no meio social e Vivências de adolescentes com diabetes com a equipe multiprofissional. Desde o diagnóstico, os pais assumiram a responsabilidade pelo cuidado aos filhos, e, na perspectiva da Ética da Alteridade, estiveram presentes e abertos para acolhê-los enquanto Outro, apoiando-os na terapêutica. Os adolescentes demonstraram ser pessoas confiantes, com autoestima preservada, que conseguem conviver em comunidade, assumindo sua condição diante de seus pares, sendo estes sensíveis às suas necessidades, fazendo-se presentes, auxiliando-os no autocuidado, e respeitando-os na sua Alteridade. A assistência recebida pela equipe multiprofissional foi considerada pelos adolescentes como “ótima”, pois a relação estabelecida é permeada pela empatia, respeito e cumplicidade, embora estratégias ineficientes tenham sido utilizadas por um dos membros da equipe, que não contribuiu para mudança de percepção e comportamento do adolescente. Considerações Finais: Os adolescentes com diabetes e suas famílias mostram-se sujeitos ativos na terapêutica e apresentam singularidades que precisam ser contempladas no projeto terapêutico. Conhecer essas vivências, na perspectiva da Ética da Alteridade, possibilita às equipes multiprofissionais refletirem acerca do cuidado prestado, respeitando a alteridade dos adolescentes com diabetes, por meio da escuta qualificada para atender suas demandas singulares.

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Santos, Vanessa Cabral dos. "As interações familiares de adolescentes com diabetes tipo 1 diante das demandas da doença." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/7/7141/tde-12012011-081237/.

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Este trabalho teve como objetivo conhecer como se dão as interações familiares de adolescentes com diabetes tipo 1 desde o diagnóstico da doença.Utilizou-se como referencial metodológico a História Oral .Os dados coletados mediante entrevistas gravadas com sete adolescentes foram analisados à luz do Modelo Calgary para Avaliação da Família de Wright e Leahey.As narrativas demonstraram que apesar do acréscimo de atividades na rotina diária do adolescente e da família, relacionadas à manutenção e controle do diabetes, as interações familiares sofrem poucas modificações com a chegada da doença e que os conflitos entre os pais e o adolescente com diabetes não diferem tanto daqueles ocorridos entre os pais e adolescentes saudáveis.A superproteção foi um sentimento percebido pelos adolescentes após o surgimento da doença,pois os pais têm preocupações com complicações imediatas e em longo prazo. O principal vínculo demonstrado pelos adolescentes entrevistados com a suas famílias foi o vínculo de confiança. Para eles é muito importante saber que conquistaram a confiança de seus pais de que podem ter certa autonomia em relação ao manejo do diabetes.Com os irmãos compartilham superficialmente o diabetes,mesmo aqueles que mantêm relações mais estreitas.A família extensa também oferece contribuições em diferentes fases da doença. Os adolescentes entrevistados forneceram dados de que sua comunicação verbal com sua família é ampla e direta. Sentem-se livres e confiantes em falar abertamente sobre assuntos diversos com os pais e os outros membros que coabitam, relatando também com quem se relacionam melhor em casa. Percebe-se também que a família tenta de alguma maneira moldar-se de acordo com as necessidades da pessoa que tem diabetes,na organização e funcionamento.Sentimentos de gratidão são demonstrados pela associação especializada em educação em diabetes, citada como a responsável por todo ou grande parte do conhecimento adquirido,principalmente pelas atividades oferecidas no acampamento para jovens, e também como fonte de solução de problemas oriundos do diagnóstico do diabetes para os pais e para os próprios adolescentes.
This study aimed to understand how to give the family interactions of adolescents with type 1 diabetes since diagnosis of illness. The method used was Oral History y. Data collected through recorded interviews with seven adolescents were examined in the light of Wright e Leaheys Calgary Family Evaluation Model .Narratives demonstrated that despite the increased activities in the daily routine of the adolescent and family for care and control of diabetes, family interactions experience little change with the arrival of the illness and that conflicts between parents and adolescents with diabetes do not differ from those that occurred between parents and healthy adolescents. Overprotection was a sentiment felt by the teenagers after the onset of the disease because parents have concerns about immediate complications and long term. The main bond shown by the adolescents interviewed with their families was the bond of trust. Adolescents share the diabetes management with brothers superficially, even those who maintain more closed. Extended family also offers contributions in different stages of the disease. The adolescents interviewed communicate with your family is extensive and direct, feeling confident to talk about various issues with parents and other members, also reporting to whom they relate better at home. Family tries shape up according to the needs of the person who has diabetes, the organization and function.

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Garcia, Leila Ferreira dos Santos. "Tradução e validação do instrumento Pediatric Quality of Life Inventory(TM) 3.0 Type 1 Diabetes Module para a língua portuguesa do Brasil." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-29112017-092315/.

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A Qualidade de Vida Relacionada à Saúde (QVRS) tem se tornado essencial na avaliação do impacto das doenças crônicas na vida dos pacientes, levando ao desenvolvimento de vários instrumentos de medida. Entretanto, até o momento, nenhum deles englobava crianças menores de 11 anos portadoras de diabetes mellitus tipo 1 (DM1), na língua portuguesa do Brasil. Este estudo teve como objetivos produzir uma versão do questionário Pediatric Quality of Life Inventory(TM)3.0 Type 1 Diabetes Module (PedsQLTM 3.0 Diabetes Module) para a língua portuguesa do Brasil, que fosse conceitualmente equivalente à versão original em inglês, e proceder à sua validação linguística numa população pediátrica brasileira portadora de DM1 e seus pais ou cuidadores. MÉTODOS: A tradução do instrumento foi realizada conforme a metodologia proposta pelos idealizadores do questionário PedsQLTM 3.0 Diabetes Module. A validação linguística seguiu as seguintes fases: 1. Tradução; 2. Retro tradução; 3. Entrevistas cognitivas; 4. Estudo de campo. O questionário foi aplicado a 127 portadores de DM1, entre 2 e 18 anos de idade, mas destes, apenas 108 crianças e adolescentes com seus pais ou cuidadores preencheram todas as questões da versão traduzida na língua portuguesa do Brasil. A confiabilidade desta versão denominada PedsQLTM 3.0 Módulo Diabetes foi avaliada pelas seguintes análises: consistência interna, confiabilidade teste-reteste e validade concorrente. RESULTADOS: O coeficiente alfa de Cronbach para o total da escala do questionário das crianças/adolescentes (alfa=0,85) e seus pais/cuidadores (alfa=0,82) excedeu o mínimo recomendado 0,70 para comparação entre grupos. Na confiabilidade do teste-reteste dos questionários respondidos pelos pais/cuidadores das crianças de 2 a 18 anos, os resultados demonstraram correlações positivas, estatisticamente significativas, de média a grande associação com exceção do domínio comunicação na faixa etária de 2 a 4 anos. Nos questionários para autoavaliação das crianças/adolescentes de 5 a 18 anos com exceção do domínio preocupações, observou-se uma correlação positiva, média e estatisticamente significativa para todos os escores entre os dois momentos de avaliação. Houve correlação positiva e estatisticamente significativa entre os escores totais das escalas dos questionários PedsQLTM 3.0 Módulo Diabetes e o Questionário pediátrico sobre qualidade de vida Versão 4.0 - Português (Brasil). Na comparação entre os escores totais obtidos por pais/cuidadores e crianças/adolescentes, houve uma correlação positiva, pequena e significativa. Não houve correlações estatisticamente significativas entre os níveis de hemoglobina glicada e os escores obtidos nos questionários respondidos pelos pacientes e seus pais/cuidadores. CONCLUSÃO: As análises do instrumento PedsQLTM 3.0 Módulo Diabetes demonstraram propriedades psicométricas adequadas em termos de confiabilidade e validade quando aplicado nessa amostra de crianças/adolescentes brasileiros portadores de DM tipo 1 e seus cuidadores
Quality of Life Related to Health (HRQoL) has become essential in assessing the impact of chronic diseases on patients, leading to the development of several measurement instruments. However, to date, none of them included children under 11 years of age with type 1 diabetes mellitus (DM1) in the Portuguese language of Brazil. This study aimed to produce a version of the Pediatric Quality of Life Inventory (TM) 3.0 Type 1 Diabetes Module (PedsQLTM 3.0 Diabetes Module) into Portuguese language of Brazil, which is conceptually equivalent to the original English version, and validate it in a Brazilian pediatric population with DM1 and their parents or caregivers. METHODS: The instrument translation was performed according to the methodology proposed by the authors of the PedsQLTM 3.0 Diabetes Module. The linguistic validation followed the following phases: 1. Forward translation; 2. Backward translation; 3. Patient testing; 4. Proofreading and finalization. The questionnaire was applied to 127 DM1 patients, between 2 and 18 years of age, but of these, only 108 children and adolescents with their parents or caregivers filled out all questions of the translated version in the Portuguese language of Brazil, which was called \"PedsQLTM 3.0 Módulo Diabetes\". Its reliability was evaluated by the following analyzes: internal consistency, testretest reliability and concurrent validity. RESULTS: Cronbach\'s alpha coefficient for child/adolescent self-report (alpha = 0.85) and parent proxy-report (alpha = 0.82) exceeded the recommended minimum of 0.70 for comparison between groups. In the test-retest reliability of parent proxy-report of children aged 2 to 18 years, the results showed statistically significant positive, from medium to high correlations, except for the communication domain in the age group of 2 to 4 years. In the child/adolescent self-report (5 to 18 years old), except for the worry domain, a positive, medium and statistically significant correlation was observed for all scores between the two assessment phases. There was a positive and statistically significant correlation between the total scales of the \"PedsQLTM 3.0 Módulo Diabetes\" and the \"Pediatric Quality of Life Questionnaire version 4.0 - Portuguese (Brazil)\". In the comparison between the total scores obtained by parents/caregivers and children/adolescents reports, there was a positive, low but significant correlation. There were no statistically significant correlations between glycated hemoglobin levels and scores obtained in questionnaires answered by patients and their parents/caregivers. CONCLUSION: The reliability and concurrent validity analyzes of \"PedsQLTM 3.0 Módulo Diabetes\" demonstrated adequate psychometric properties when applied in this sample of Brazilian children with type 1 DM and their caregivers

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Silva, Andréa Cristina Oliveira. "Adolescentes com diabetes mellitus tipo 1: fatores associados com a qualidade de vida relacionada à saúde e autoestima." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-30032015-183931/.

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O diabetes mellitus tipo 1 é uma doença crônica, complexa, de difícil controle e tratamento doloroso. As dificuldades referentes ao diabetes são mais evidentes na adolescência, período de transição da dependência parental para uma vida mais autônoma, permeada por alterações físicas, nas relações com a família, amigos e sociedade, as quais podem repercutir na adesão ao tratamento e no controle metabólico. Identificar os fatores que interferem na qualidade de vida dos adolescentes permite intervenção adequada da equipe de saúde visando o controle adequado da doença. O objetivo geral desse estudo foi avaliar a qualidade de vida relacionada à saúde e autoestima de adolescentes com diabetes mellitus tipo 1. Estudo quantitativo, transversal, realizado de março a novembro de 2013. A amostra foi composta por 83 adolescentes, com idade entre 10 e 18 anos, matriculados no Programa de Educação em Diabetes em São Luís-MA, que responderam a três instrumentos: o Instrumento de Qualidade de Vida para Jovens com Diabetes (IQVJD) composto pelos domínios Satisfação, Impacto e Preocupações; a Escala de Autoestima de Rosenberg (EAR) e um formulário de dados sociodemográficos, clinicolaboratoriais e de tratamento. Os dados foram analisados por estatística descritiva e regressão logística univariada e multivariada por meio do Oddsratio (OR), com intervalo de confiança de 95% e nível de significância de 5% (p<0,05). Realizou-se a análise de confiabilidade do instrumento, por meio do alfa de Cronbach. Os escores médios do IQVJD Total e os domínios Satisfação, Impacto e Preocupações foram respectivamente, 111,34±18,46; 35,25±9,86; 52,81±9,19 e 23,27±6,73. Esses escores estiveram abaixo do ponto médio do IQVJD, caracterizando boa QVRS. Os fatores associados à QVRS no domínio Satisfação foram escolaridade, início dos sintomas, glicemia pré-prandial, estado de saúde, atividade física, renda familiar e pressão arterial, ensino fundamental I, ensino fundamental II, ensino médio incompleto e LDL colesterol, permanecendo na análise multivariada associação com o estado de saúde, grupo social, ensino fundamental II, renda familiar e glicemia pré-prandial. Ao domínio Impacto foram associadas as variáveis sexo, estado de saúde e glicemia pré-prandial e após análise multivariada permaneceram associados sexo, início dos sintomas e estado de saúde. No domínio Preocupações foram associadas renda familiar, colesterol total, tempo de tratamento e glicemia pré-prandial e após a análise multivariada permaneceu associada apenas a glicemia pré-prandial. As variáveis associadas ao IQVJD Total foram glicemia pré- prandial, estado de saúde, atividade física e sexo, após análise multivariada permaneceram associados glicemia pré-prandial e estado de saúde. As variáveis associadas ao Estado de Saúde referido foram início dos sintomas, hiperglicemia, triglicerídeos e atividade física, início dos sintomas, cor da pele, triglicerídeos e LDL colesterol e após análise multivariada apenas cor da pele permaneceu associada. Os adolescentes com melhor autoestima estavam no grupo melhor QVRS no domínio Satisfação, Preocupações e IQVJD Total. Espera-se que esses resultados contribuam com o planejamento de ações desenvolvidas pelos profissionais de saúde responsáveis pelo cuidado aos adolescentes com DM1, particularmente com a equipe de saúde do Programa de Educação em Diabetes do município de São Luís-MA
Type 1 diabetes mellitus is a complex chronic illness that is difficult to control and whose treatment is painful. The difficulties related to diabetes are more evident during adolescence, a transition period from parental dependence to a more autonomous life, permeated by physical alterations, in the relations with the family, friends and society, which can influence the treatment compliance and metabolic control. Identifying the factors that interfere in the adolescents\' quality of life permits appropriate intervention from the health team with a view to appropriate control of the disease. The general objective in this study was to assess the health-related quality of life and self-esteem of adolescents with type 1 diabetes mellitus. Quantitative, cross-sectional study, developed between March and November 2013. The sample consisted of 83 adolescents, between 10 and 18 years of age, enrolled in the Diabetes Education Program in São Luís-MA, who answered three instruments: the Quality of Life Instrument for Young People with Diabetes (QoLIYD), which includes the domains Satisfaction, Impact and Concerns: Rosenberg\'s Self-Esteem Scale (SES) and a formwith sociodemographic, clinical-laboratory and treatment data. The data were analyzed through descriptive statistics and univariate and multivariate logistic regression through the odds ratio (OR), with a 95% confidence interval and 5% significance level (p<0.05).The reliability analysis of the instrument was performed through Cronbach\'s alpha. The mean scores for the Total QoLIYD and the domains Satisfaction, Impacts and Concerns were, respectively, 111.34±18.46; 35.25±9.86; 52.81±9.19 and 23.27±6.73. These scores were inferior to the midpoint on the QoLIYD, characterizing a good HRQoL. The factors associated with HRQoL in the Satisfaction domain were education, symptoms onset, pre-prandial glucose, health condition, physical activity, family income and arterial pressure, primary education I, primary education II, unfinished secondary education and LDL cholesterol. In the multivariate analysis, associations continued with the health condition, social group, primary education II, family income and pre-prandial glucose. In the Impact domain, the associated variables were sex, health condition and pre- prandial glucose and, after the multivariate analysis, the associations with sex, onset of symptoms and health condition were maintained. In the Concerns domain, the associated variables were family income, total cholesterol, length of treatment and pre-prandial glucose and, after the multivariate analysis, only the association with pre-prandial glucose was maintained. The variables associated with the Total QoLIYD were pre-prandial glucose, health condition, physical exercise and sex. After the multivariate analysis, the associations with pre-prandial glucose and health condition were maintained. The variables associated with the referred Health Status were onset of symptoms, hyperglycemia, triglycerides and physical exercise, onset of symptoms, skin color, triglycerides and LDL cholesterol and, after the multivariate analysis, only the association with skin color remained. The adolescents with better self-esteem were found in the group with the best HRQoL in the Satisfaction and Concerns domains and in the Total QoLIYD. These results are expected to contribute to the planning of actions by the health professionals responsible for care to adolescents with DM1, particularly to the health team of the Diabetes Education Program in São Luís-MA

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Sato, Eiko, Isao Ohsawa, Jun Kataoka, Miki Miwa, Fumie Tsukagoshi, Juichi Sato, Yoshiharu Oshida, and Yuzo Sato. "Socio-psychological problems of Patients with late adolescent onset type 1 diabetes : analysis by qualitative research." Nagoya University School of Medicine, 2003. http://hdl.handle.net/2237/5388.

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Hanna, Lauren E. "The metabolic response to acute exercise in adolescent boys with NIDDM relatives." Virtual Press, 2008. http://liblink.bsu.edu/uhtbin/catkey/1398714.

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Individuals with NIDDM and low insulin sensitivity (Si) have altered fuel use, which may appear in NIDDM relatives. Adolescent males, six with NIDDM relatives (POS) and six controls (CON), matched for fitness and fatness, participated. Peak oxygen uptake (V02pea), ventilatory threshold (VT) and body composition were measured. Insulin and glucose values were used for Si estimates. Oxygen consumption (V02) and respiratory exchange ratio (RER) measurements were made at rest and during exercise at 80,100 and 120% of VT for substrate use. No group differences were found in anthropometric data, V02pea, VT or blood measurements, although fat free mass (FFM) tended to be greater in CON. CON tended to use a higher percentage carbohydrate and a lower percentage of fat than POS, but differences were no longer present after normalization to FFM. Trends towards fuel use differences may suggest metabolic abnormalities are present in POS, but further investigation is necessary.
School of Physical Education, Sport, and Exercise Science

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Vasconcelos, HÃrica Cristina Alves de. "Diabetes mellitus tipo 2: investigaÃÃo dos fatores de risco em adolescentes de escolas particulares de fortaleza." Universidade Federal do CearÃ, 2008. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=2820.

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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
Objetivou-se, com este estudo, identificar os fatores de risco para diabetes tipo 2 numa populaÃÃo de adolescentes de escolas particulares da cidade de Fortaleza.Trata-se de um estudo transversal realizado com 794 alunos de 12 a 17 anos nos meses de maio, junho, agosto e setembro de 2007. Doze escolas particulares das seis regionais que compÃem a cidade de Fortaleza foram selecionadas. Utilizou-se um formulÃrio onde se registraram dados pessoais, caracterÃsticas sociodemogrÃficas, hÃbitos alimentares e de exercÃcios fÃsicos dos consultados. TambÃm se mensurou o peso, a altura, a pressÃo arterial e a glicemia capilar de todos os alunos. Os pais dos alunos responderam sobre os casos de DM2 em familiares atravÃs de um questionÃrio enviado aos respectivos domicÃlios. Os dados sofreram dupla digitaÃÃo e foram analisados com base em literatura especÃfica. Este estudo atendeu as exigÃncias das Diretrizes e Normas da Pesquisa em Seres Humanos. Dos 794 adolescentes participantes 57,3% eram do sexo feminino e 42,7% do sexo masculino. A idade variou de 12 a 17 anos, com mÃdia de 14 anos, sendo a maioria compreendida na faixa etÃria de 12 a 14 anos (53,4%). A maior parte deles estava entre o 8Â e o 9Â ano do ensino fundamental (43,6%). Foram investigados os fatores de risco excesso de peso, sedentarismo, antecedentes familiares de DM2 em parentes de primeiro e segundo graus e nÃveis elevados de pressÃo arterial e glicemia capilar. Dos adolescentes participantes 23,7% tinham o IMC elevado, 65,1% eram sedentÃrios, 51,1% tinham antecedentes familiares de DM2, 19,7% tinham pressÃo arterial elevada e 4,9% tinham glicemia capilar fora dos padrÃes de normalidade. Os dados, em relaÃÃo ao nÃmero de fatores de risco apresentados por cada adolescente, apontam que 10,5% deles nÃo tinham nenhum dos fatores investigados, mostrando que eles nÃo estavam, portanto, expostos ao risco de adquirir DM2. No entanto, 33,8% dos jovens tinham pelo menos um fator, 39,2% dois, 14,2% trÃs e 2,3% quatro fatores associados. Apenas um adolescente tinha os cinco fatores presentes, estando esse jovem, portanto, com grande chance de adquirir a doenÃa. Essa investigaÃÃo permitiu Ã enfermagem ter o conhecimento dos fatores de risco para DM2 nos jovens participantes e os resultados encontrados podem proporcionar ao enfermeiro a atuaÃÃo no ambiente escolar atravÃs da proposta e a atuaÃÃo efetiva na realizaÃÃo de oficinas educativas com o objetivo de incentivar mudanÃas de comportamento para combater, sobretudo, o excesso de peso e o sedentarismo, contribuindo dessa forma com a promoÃÃo da saÃde e a prevenÃÃo de DM2 naquela populaÃÃo.

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Nylander, Charlotte. "Protective factors, health-risk behaviours and the impact of coexisting ADHD among adolescents with diabetes and other chronic conditions." Doctoral thesis, Uppsala universitet, Pediatrik, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-282964.

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Mental health problems are increasing in Swedish adolescents and mortality rates are higher in this age group than among younger. 10-20% of all adolescents suffer from a chronic medical condition (CC). Few protective factors (PF) and clustering of health-risk behaviours (HRB) are frequent among adolescents with CCs. One of the most common CC in Swedish adolescents is type 1 diabetes mellitus (T1DM). Metabolic control often deteriorates during adolescence, especially in girls. Poor metabolic control is associated with increased risk for long-term complications, of which cognitive problems are common. However, the implication of cognitive/executive problems in patients with T1DM has not been sufficiently studied. Neither has the impact of neurodevelopmental problems (NDP), such as ADHD, on HRB in adolescents with CCs been analysed. Methods: In paper I and II the questionnaire ”Life and Health in Youth” was distributed to all students in year nine and year two of the upper secondary school in the county of Sörmland, 2008 (n=5771) and 2011 (n=5550). Adolescents with CCs were compared to healthy peers with regard to PFs and HRBs. In paper III, the ”Five to Fifteen” questionnaire was used in 175 paediatric patients with T1DM. Patients with indications of NDPs were compared with patients without such problems with regard to metabolic control. In paper IV, the BRIEF questionnaire and the ADHD Rating Scale as well as data from the Swedish Childhood Diabetes Registry was used in 241 adolescents with T1DM. Patients with indications of executive problems were compared with patients without such problems with regard to diabetes control. Results: CCs were associated with few PFs and clustered HRBs. The combination of CCs and low numbers of PFs was found to be associated with an increased risk of clustered HRBs. In the presence of coexisting ADHD the pattern of few PFs and clustering of HRBs was aggravated. ADHD was more common among adolescents with other CCs. Definite memory and learning problems as well as mild executive problems were associated with poor metabolic control, especially among adolescents. Executive problems were also associated with many outpatient visits and low physical activity. Girls with T1DM tended to self-report executive problems to a larger extent than boys, while parents more often reported these problems in boys. Conclusion: Knowledge about factors influencing treatment adherence and life in general is essential in the work with chronically ill adolescents. Focus must be put on enhancing PFs in order to avoid HRBs. Identification of coexisting NDPs, such as ADHD, is crucial, since such problems can adversely influence treatment adherence, HRBs and school achievements

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Souza, Maria AmÃlia de. "Qualidade de vida relacionada Ã saÃde em adolescentes com diabetes mellitus tipo 1." Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=11710.

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FundaÃÃo de Amparo a CiÃncia e Tecnologia de Pernambuco
A preocupaÃÃo com a qualidade de vida das pessoas tem sido alvo de interesse de pesquisadores nacionais e internacionais em virtude do aumento da expectativa de vida e maior prevalÃncia de condiÃÃes crÃnicas de saÃde. A qualidade de vida em indivÃduos com condiÃÃes crÃnicas foi, por muito tempo, avaliada exclusivamente em termos de sobrevida e sinais da presenÃa da doenÃa, sem considerar as suas consequÃncias psicossociais, fÃsicas e espirituais. Dessa forma, o objetivo desta pesquisa Ã avaliar a qualidade de vida relacionada Ã saÃde de adolescentes com diabetes mellitus tipo 1. Trata-se de uma pesquisa observacional, quantitativa com desenho transversal. Foram avaliados 92 adolescentes em seguimento terapÃutico no Centro MÃdico Senador JosÃ de Moraes durante janeiro e julho de 2013. Os dados foram coletados por meio da tÃcnica de entrevista e consulta aos prontuÃrios mediante a utilizaÃÃo de formulÃrios para investigaÃÃo de indicadores sociodemogrÃficos e clÃnicos; antropomÃtricos, pressÃo arterial e bioquÃmicos e do instrumento especÃfico para mensurar qualidade de vida de jovens com diabetes (IQVJD). Os dados sofreram dupla digitaÃÃo e foram analisados no software Statistical Package for Social Sciences (SPSS) para Windows, versÃo 20.0, e analisados por meio de estatÃstica descritiva, inferencial bivariada e anÃlise mÃltipla. Para os procedimentos descritivos, foram apresentados os dados absolutos e relativos (frequÃncias e percentuais), medidas de tendÃncia central (mÃdia) e de variabilidade (desvio-padrÃo). Os procedimentos de inferÃncia estatÃstica, por sua vez, foram realizados por meio dos testes t de Student e AnÃlise de VariÃncia (ANOVA), que identificam diferenÃas entre grupos por meio da comparaÃÃo de suas mÃdias e cÃlculo do coeficiente de correlaÃÃo r de Pearson. Foi adotado um intervalo de confianÃa de 95%, e nÃvel de significÃncia de 5% (p<0,05). Procedeu-se, tambÃm, a anÃlise da confiabilidade do instrumento, por meio do cÃlculo do coeficiente α de Cronbach. Para a anÃlise mÃltipla foi aplicado o Modelo de RegressÃo LogÃstica atravÃs do Odds Ratio (OR). A amostra compÃs-se, na sua maioria, por adolescentes do sexo masculino, de raÃa branca, solteiros, estudantes cursando o ensino fundamental e com idade mÃdia de 14,6 anos (desvio-padrÃo = 2,9). Os escores mÃdios da qualidade de vida total e seus respectivos domÃnios (satisfaÃÃo, impacto e preocupaÃÃo) estÃo mais prÃximos dos escores mÃnimos reportados por esta amostra, o que caracteriza uma avaliaÃÃo de qualidade de vida alta, com os respectivos escores e desvio-padrÃo 117,5Â20,1, 38,6Â9,3, 53,0Â10,4 e 25,8Â6,6. Para o cenÃrio econÃmico foram identificadas diferenÃas estatisticamente significativas para a qualidade de vida total (p=0,02) e para o domÃnio impacto (p=0,009). O teste post hoc de Tukey identificou um maior comprometimento naqueles indivÃduos pertencentes Ã classe D (M=132,2), se comparados Ãqueles da classe B2 (108,0). Quanto Ãs caracterÃsticas clÃnicas, observa-se que, a maioria, estava na fase crÃnica da doenÃa, com mÃdia de 6,8 anos de diagnÃstico (desvio-padrÃo de 4,5 anos), com mÃdia da idade do surgimento dos primeiros sintomas aos 7,6 anos (desvio-padrÃo de 4 anos) e com mÃdia da pressÃo arterial menor que o percentil 90. 70,7% faziam uso de insulina de aÃÃo intermediÃria e 57,6% de aÃÃo rÃpida, sendo que 59,8% realizam quatro ou mais aplicaÃÃes por dia. Verificou-se predominÃncia de Ãndices glicÃmicos nÃo controlados e lipÃdeos sÃricos acima do desejÃvel, com exceÃÃo da lipoproteÃna de baixa densidade. Quanto Ã presenÃa de complicaÃÃes associadas Ã doenÃa, foram identificadas diferenÃas estatisticamente significativas para o escore geral da qualidade de vida (p=0,004) e para o domÃnio âimpactoâ (p=0,002). Em relaÃÃo Ã ocorrÃncia de internaÃÃes no Ãltimo ano, foram identificadas diferenÃas significativas para a pontuaÃÃo geral da qualidade de vida (p=0,01), e para os domÃnios âsatisfaÃÃoâ (p=0,01) e âpreocupaÃÃoâ (p=0,02). Na comparaÃÃo entre os escores de qualidade de vida total e seus domÃnios, e a variÃvel hipoglicemia foram observadas diferenÃas estatisticamente significativas entre os escores de qualidade de vida total (p=0,01) e o domÃnio satisfaÃÃo (p=0,02). NÃo foram identificadas correlaÃÃes significativas, segundo critÃrios estatÃsticos, da qualidade de vida e seus domÃnios com as variÃveis clÃnicas Ãndice de massa corporal, pressÃo sistÃlica mÃdia, pressÃo diastÃlica mÃdia, tempo de tratamento e idade do primeiro sintoma. Para o instrumento geral, observou-se um alfa de Cronbach de 0,85, configurando um nÃvel satisfatÃrio de confiabilidade. Portanto, conclui-se que os escores mÃdios da qualidade de vida total e de seus domÃnios estÃo mais prÃximos dos escores mÃnimos reportados pela amostra, o que caracteriza uma avaliaÃÃo da qualidade de vida alta e reforÃa o fato de que a presenÃa de uma doenÃa crÃnica nÃo influenciou, de forma geral, negativamente na qualidade de vida desse nicho populacional. Este estudo reforÃa a ideia de que Ã importante realizar investigaÃÃes sobre diabetes na adolescÃncia, particularmente, na valorizaÃÃo da percepÃÃo da qualidade de vida relacionada a saÃde, na tentativa de minimizar a carÃncia de estudos nacionais e identificar fatores que deterioram a qualidade de vida para que se possa intervir em tempo hÃbil.

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Faulds, Eileen. "Self-Management Among Pre-teen and Adolescent Insulin Pump Users (SPIN)." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1587390858875183.

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Lemmons, Kaitlyn. "The Relationship between Fiber Consumption and Postprandial Glucose Excursions in Adolescents with Type 1 Diabetes." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1535459193803657.

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Souza, Netto Maria Caroline Azevedo. "Avaliação do registro alimentar de tres dias, desenvolvimento pondero-estatural e perfil metabolico de adolescentes com diabetes melitus tipo 1 com e sem microalbuminuria." [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312250.

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Orientador: Vera Maria Santoro Belangero
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-09T19:37:00Z (GMT). No. of bitstreams: 1 SouzaNetto_MariaCarolineAzevedo_M.pdf: 2303787 bytes, checksum: cceb6beee7102212f29f9d5381ff0fa7 (MD5) Previous issue date: 2005
Resumo: Foram avaliados 30 adolescentes com diabetes melitus tipo 1, sendo 14 com microalbuminúria e 16 sem microalbuminúria, acompanhados no Ambulatório de Diabetes da FCM - UNICAMP, com o objetivo de estudar as possíveis diferenças destes grupos quanto à ingestão referida dos principais nutrientes, à distribuição do índice de massa corporal, ao perfil lipídico, à hemoglobina glicosilada, ao clearance de Cr EDTA, à dose de insulina, ao desenvolvimento pôndero-estatural e ao tempo de doença. Materiais e Métodos - Para a avaliação da ingestão alimentar foi utilizado o registro alimentar de 3 dias, sendo avaliados a calorias total / kg e os macronutrientes (carboidrato, proteína e lipídio). A avaliação da adequação do peso foi realizada através do cálculo do índice de massa corporal. A microalbuminúria foi medida por radioimuno-ensaio, em amostra de urina noturna. Os dados laboratoriais seguiram a rotina do laboratório de Patologia Clínica do HC da UNICAMP. Resultados - Foi demonstrado que os únicos dados que foram significativamente diferentes entre os grupo foi o maior tempo de doença e a prevalência do sexo feminino no grupo com microalbuminúria. Ambos os grupos apresentaram valores elevados de hemoglobina glicosilada, e dislipidemia. A distribuição do percentil de adequação do IMC mostrou maior risco de sobrepeso no grupo com microalbuminúria. A dose média de insulina foi elevada (0.98 u/kg), sem diferenças entre os grupos. A análise do sesenvolvimento pôndero-estatural após a instalação do diabetes mostrou que 83% dos pacientes não atingiram o percentil 50 de estatura e, houve um aumento significativo do percentil do peso em ambos os grupos. Conclusões - O grupo de pacientes estudado apresenta como um todo, mau controle metabólico do diabetes, de tal forma que o dado discriminatório mais significativo foi o tempo de doença maior nos pacientes com microalbuminúria. O registro alimentar mostrou elevados índices de sub-relato, tendo como padrão o valor do gasto energético total. A pequena confiabilidade do registro alimentar neste grupo de pacientes é relevante em dois aspectos: dificulta a abordagem e o impacto que as orientações nutricionais poderiam trazer ao paciente
Abstract: Thirty adolescents carrying type 1 mellitus diabetes were evaluated, fourteen of them with microalbuminuria and sixteen without, followed at Unicamp MCF Diabetes Ambulatory with the aim to study the possible differences between these groups regarding the referred ingestion of main nutrients, body mass distribution, lipid profile, glycacated hemoglobin, Cr EDTA clearance, insulin dose, weight-stature development and length of disease. Materials and Methods - for the evaluation of the food intake a 3-day food report was used, evaluating the total calories/kg as well as the macronutrients (carbohydrates, proteins and lipids). The evaluation of the weight adequacy was established from the BMI calculation. The microalbuminuria was measured through radioimmune-essay, in night sample urine. The laboratory data followed Unicamp CH Clinical Pathology laboratory routine. Results - it was shown that the only data significantly different between the two groups was the longer time of disease and the prevalence of the female gender in the group containing microalbuminuria. Both groups presented high levels of glycacated hemoglobin and dislipidemy. The distribution of BMI adequacy percentile presented a higher risk of overweight in the group with microalbuminuria. The average dose of insulin was high (0.98 u/kg), presenting no differences between the groups. The analysis of the weight-stature development after the diabetes installation showed that 83% of the patients did not reach the 50 percentile of stature and there was a significant increase of weight percentile in both groups. Conclusions - the group of patients studied presents, as a whole, a bad metabolic control of the diabetes, in such way that the most significant discriminative data was the longer time of the disease in the patients with microalbuminuria. The food report showed high levels of under report, having as a pattern the total energetic expense. The little reliability in the food register in this group of patients is relevant in two aspects: it renders it difficult the approach and the impact that the nutritional orientations could bring to the patient
Mestrado
Saude da Criança e do Adolescente
Mestre em Saude da Criança e do Adolescente

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Andersson, Jessica, and Klara Östlund. "Barn och ungdomars upplevelser av att leva med Diabetes Mellitus typ 1 : En kvalitativ litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-431826.

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Bakgrund: Omkring 900 barn och ungdomar insjuknar i typ 1-diabetes (T1D) varje år i Sverige, vilket gör den till en av landets vanligaste kroniska sjukdomar hos barn. Sjukdomen påverkar livet fysiskt och psykiskt och leder till allvarliga och potentiellt livshotande komplikationer om behandlingen inte sköts. Kunskap om sjukdomen är grunden för att behandlingen ska skötas optimalt, varför information och stöd från omgivningen och hälso- och sjukvården är av stor betydelse. Syfte: Syftet med denna litteraturstudie var att beskriva barn och ungdomars upplevelser av att leva med T1D. Metod: Litteraturstudie baserad på 12 kvalitativa originalartiklar hämtade från databaserna PubMed och CINAHL. Artiklarna har efter kvalitetsgranskning erhållit medelhög till högkvalitet. Resultatet har bearbetats och analyserat, därefter har huvudteman samt underteman identifierats. Resultat: Resultatet visade att barn och ungdomar med T1D upplevde många svårigheter. Sjukdomen innebar stora praktiska och psykosociala förändringar i vardagen och bidrog till flera negativa känslor samt oro gällande egenvård och komplikationer. Känslor av att vara annorlunda jämfört med jämnåriga var vanligt förekommande liksom känslor av ensamhet och utanförskap. Stödet från familj, vänner, skolpersonal samt hälso- och sjukvården var emellanåt bristfälligt men samtidigt viktigt och betydelsefullt och underlättade de negativa upplevelserna av att leva med T1D. Slutsats: Litteraturstudien visar på att barn och ungdomar med T1D möter svårigheter i vardagen och att sjukdomen påverkar livets fysiska som psykosociala aspekter. Sjukdomsförståelse och stöd från omgivningen har positiva effekter och underlättar livet förden drabbade. God kommunikation, ett personcentrerat förhållningssätt och gott bemötande från hälso- och sjukvården är andra faktorer som kan påverka sjukdomsupplevelsen positivt och bidra med de förutsättningar som krävs för att leva ett så gott liv som möjligt, trots sjukdom.
Background: About 900 children and adolescents are diagnosed with type 1 diabetes (T1D) every year in Sweden, which makes it one of the country's most common chronic diseases in children. The disease affects life physically and mentally and leads to severe and potentially life-threatening complications if left untreated. Knowledge of the disease is the key to successful treatment, which highlights the importance of information and support from a personal support system as well as the health care service. Aim: The aim of this literature review was to describe children and adolescents experiences of living with T1D. Method: A literature review based on 12 qualitative original articles retrieved from the databases PubMed and CINAHL. After quality analysis, the articles have been received medium to high quality. The results have been processed and analyzed, thereafter main themes and sub-themes were identified. Results: The results showed that children and adolescents with T1D experienced many difficulties. The disease involved major practical and psychosocial changes in everyday life and contributed to several negative emotions as well as concerns regarding self-care and complications. Feelings of being different from peers were common, as well as feelings of loneliness and exclusion. The support from family, friends, school staff and the health care service was sometimes deficient but at the same time important and significant and facilitated the negative experiences of living with T1D. Conclusion: This literature review shows that children and adolescents with T1D face difficulties in everyday life and that the disease affects the physical and psychosocial aspects of life. Understanding of the disease and support from the people in the child’s and adolescents surroundings has positive effects and makes life easier for the affected. Good communication, a person-centered approach and good treatment from the health care service are other factors that can positively affect the experience of T1D and contribute with the conditions required to live as good a life as possible, despite the disease.

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Novato, Tatiana de Sá. "Fatores preditivos de qualidade de vida relacionada à saúde em adolescentes com diabetes mellitus do tipo 1." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-14052009-102402/.

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A avaliação da Qualidade de Vida Relacionada à Saúde (QVRS) de jovens com Diabetes Mellitus do Tipo 1 (DM1) tem sido considerada como parâmetro de avaliação de tratamento, além das medidas de controle fisiológico. A identificação dos fatores que influenciam na QVRS desses adolescentes permite a elaboração de estratégias que minimizem o impacto da doença e favoreçam a adesão ao tratamento e bem-estar. Os objetivos deste estudo foram avaliar a QVRS de jovens com DM 1, identificar os fatores associados e preditivos da QVRS de adolescentes com DM1 e comparar os adolescentes em fase de remissão e crônica do DM 1 em relação à QVRS e as variáveis psicossócio-demográficas, clínicas e de tratamento. O estudo foi realizado no Instituto da Criança com Diabetes (ICD) de Porto Alegre (RS). A amostra compôs-se de 245 adolescentes, com idades entre 10 e 19 anos, que responderam ao Instrumento de Qualidade de Vida para Jovens com Diabetes (IQVJD), composto de 50 itens distribuídos nos domínios Satisfação, Impacto e Preocupações em que o menor escore corresponde à melhor QVRS; ao instrumento de Autoestima de Rosenberg (AE) e ao formulário de dados sócio-demográficos e clínicos. As análises foram realizadas por meio de estatística univariada, para identificação dos fatores associados de QVRS, e multivariada para a identificação dos fatores preditivos de QVRS. Os escores médios do IQVJD foram 37,49±9,89 para o domínio Satisfação, 49,04±11,37 para Impacto, 23,73±7,96 para Preocupações e 110,26±24,43 para o Total. Todos estes valores estiveram abaixo do ponto médio dos domínios e do total, caracterizando boa QVRS referida. Os fatores associados à QVRS no domínio Satisfação foram idade, frequência de realização de exercícios físicos, hemoglobina glicada atual e média do último ano, AE, sexo, duração do DM1, contagem de carboidratos e frequência de hiperglicemias no último mês. Os fatores preditivos de QVRS do domínio Satisfação foram hemoglobina glicada atual e média do último ano, AE e idade. O domínio Impacto teve como fatores associados à QVRS a frequência diária de verificações da glicemia capilar, a hemoglobina glicada atual e média do último ano, a AE, a raça, a presença de outras doenças e a contagem de carboidratos. Os fatores preditivos de QVRS no domínio Impacto foram raça, AE, esquema de insulina, hemoglobina glicada atual e frequência diária de verificações da glicemia capilar. Os fatores associados à QVRS no domínio Preocupações foram idade, sexo, frequência diária de verificações da glicemia capilar, frequência de hiperglicemias no último mês, AE, hemoglobina glicada atual e média do último ano, contagem de carboidratos e IMC. O único fator preditivo de QVRS do domínio Preocupações foi a AE. Os fatores associados ao IQVJD Total foram sexo, frequência diária de verificações da glicemia capilar, frequência de hiperglicemias no último mês, hemoglobina glicada atual e média do último ano, contagem de carboidratos, AE e tempo de tratamento no ICD. Os fatores preditivos do IQVJD Total foram hemoglobina glicada atual e média do último ano e AE. Os fatores associados ao Estado de Saúde referido foram AE, duração do DM1, frequência de hiperglicemias no último mês e hemoglobina glicada atual e média do último ano. Os fatores preditivos para o Estado de Saúde foram hemoglobina glicada atual e AE. Os adolescentes em fase de remissão eram mais jovens, mais velhos ao diagnóstico, com menor frequência de hiperglicemias, com maiores alterações de IMC, em uso, principalmente, de insulina de ação intermediária + rápida, com menor frequência diária de aplicações de insulina e com menor tempo de tratamento no ICD em relação aos em fase crônica. Acredita-se que estes resultados tenham impacto na prática clínica e estimulem a realização de outros estudos com o propósito de continuar as investigações a respeito das variáveis que permeiam a QVRS dos adolescentes com DM1
The evaluation of Health Related Quality of Life (HLQL) of youths with type 1 diabetes mellitus (T1DM) has been considered as a parameter of treatment evaluation, beyond the measures of physiological control. The identification of the factors that influences HRQL allows the elaboration of strategies in order to minimize the impact of disease and facilitate treatment´s compliance and well-being. The aims of this study were to evaluate the HRQL of T1DM youths, to identify associated and predictive factors of HRQL of T1DM adolescents and to compare adolescents in remission and chronic phase of T1DM in relation to HRQL and psycho-socio-demographic, clinical and treatment variables. The study carried out in Instituto da Criança com Diabetes (ICD) in Porto Alegre, RS. The sample was composed by 245 adolescents, aged from 10 to 19 years old, that answered to the Instrumento de Qualidade de Vida para Jovens com Diabetes (IQVJD), with 50 items distributed on Satisfaction, Impact and Worries domains, in which the lower score corresponds to the best HRQL; to the Rosenbeg´s Self-Esteem (SE) instrument and to the socio-demographic and clinical formulary. Analyses were taken by univariated statistics, for identification of associated factors of HRQL, and multivariated statistics, for identification of HRQL´s predictive factors. Mean scores of IQVJD were 37,49±9,89 for Satisfaction domain, 49,04±11,37 for Impact, 23,73±7,96 for Worries and 110,26±24,43 for Total. All values were below the mean point of domains and total characterizing good referred HRQL. Associated factors of HRQL on Satisfaction domain were age, frequency of physical activity, glycated hemoglobin (actual and mean of last year), SE, sex, duration of T1DM, carbohydrate counting and frequency of hyperglycemia. Predictive factors of HRQL on Satisfaction domain were glycated hemoglobin (actual and mean of last year), SE, and age. Associated factors of Impact domain were diary frequency of blood glucose monitoring, glycated hemoglobin (actual and mean of last year), SE, race, other diseases and carbohydrate counting. Predictive factors of Impact domain were race, SE, insulin scheme, glycated hemoglobin (actual and mean of last year) and diary frequency of blood glucose monitoring. Associated factors of Worries domain were age, sex, diary frequency of blood glucose monitoring, frequency of hyperglycemia, SE, glycated hemoglobin (actual and mean of last year), carbohydrate counting and BMI. SE was the only predictive factor of Worries domain. Associated factors of Total IQVJD were sex, diary frequency of blood glucose monitoring, frequency of hyperglycemia, glycated hemoglobin (actual and mean of last year), carbohydrate counting, SE and duration of treatment on ICD. Predictive factors of IQVJD Total were glycated hemoglobin (actual and mean of last year) and SE. Associated factors of Health Status were SE, duration of T1DM, frequency of hyperglycemia and glycated hemoglobin (actual and mean of last year). Predictive factors of Health Status were glycated hemoglobin (actual and mean of last year) and SE. Adolescents on remission phase were younger, older at diagnosis, reporting lower frequency of hyperglycemia, more alterations of BMI, using, principally, intermediate + rapid insulin action, with lower frequency of diary insulin injections and lower duration of treatment on ICD in relation to adolescents in chronic phase. It´s believed that these results have impact on clinical practice and stimulate other studies in order to continue the investigations about variables involved on HRQL of adolescents with T1DM

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Mattsson, Johanna, and Joanna Simonsson. "Min sjukdom mitt ansvar! Ungdomars erfarenheter av att ta ansvar för sin diabetes." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-17007.

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Diabetes är en vanlig sjukdom i Sverige och ungefär 800 barn och ungdomar får diagnosen varje år. Det är en sjukdom som kräver mycket planering för regelbundna måltider, insulindoser, blodsocker kontroller och motion. Svåra och hastiga komplikationer kan uppstå om sjukdomen inte behandlas korrekt. Bakom varje ungdom finns en familj som också påverkas. Mycket oro kan finnas hos föräldrar som tar ansvar för sina barn med diabetes och när barnet blir ungdom kan det vara svårt för föräldrarna att lämna över ansvaret till ungdomen. Detta är dock nödvändigt för att ungdomen ska kunna bli självständig. Syftet med denna uppsats är att utifrån ungdomars egna erfarenheter belysa vad de anser vara viktigt för att ta ansvar för sin diabetes i vardagen. En litteraturöversikt valdes som inkluderade tio kvalitativa artiklar med utgångspunkt från ungdomars egna erfarenheter och upplevelser av att ta ansvar för sin diabetes. Artiklarna analyserades utifrån Fribergs (2006) metod för analysera studier och resultatet presenteras i fem teman; stöd, kommunikation, kunskap, tillåtas ta ansvar samt stegvis ansvarstagande. Ungdomarna i artiklarna uttryckte att det var viktigt att känna föräldrarnas, sjuksköterskans, vänners och signifikanta andras stöd för att våga ta mer ansvar och bli mer självständiga. Det framkom även att relevant och anpassad information för ökad kunskap var viktigt för ungdomarna. God kommunikation med föräldrar och diabetesteam var viktigt samt att tillåtas ta mer ansvar, steg för steg. I diskussionen beskrivs de mest framträdande teman i resultatet och vi reflekterar över hur sjuksköterskor kan underlätta och bemöta ungdomar med diabetes.
Program: Sjuksköterskeutbildning

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Alvesand, Caroline, and Charlotte Linder. "Ungdomars upplevelse av att leva med Diabetes Mellitus typ 1. : En deskriptiv litteraturstudie." Thesis, Högskolan i Gävle, Medicin- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-25511.

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Bakgrund: Diabetes Mellitus typ 1 debuterar under barn- och ungdomsåren. Behandlingen är egenvård som innebär blodglukoskontroller, läkemedelsbehandling och att följa rekommendationer om kost och motion. Sjuksköterskans yrkesområde innefattar barn- och ungdomar. Avvikande från egenvårdsaktiviteter och hemlighetsmakeri kring sjukdomen påverkar vårdkvaliteten för ungdomar. Syfte: Att beskriva ungdomars upplevelse av att leva med Diabetes Mellitus typ 1 samt att beskriva de granskade studiernas undersökningsgrupper. Metod: Deskriptiv litteraturstudie med tolv vetenskapliga artiklar med kvalitativ samt kvalitativ- och kvantitativ ansats. Samstämmigheter och olikheter i artiklarnas resultat har kategoriserats och teman och subteman har identifierats. Huvudresultat: En del ungdomar upplevde svårigheter att acceptera sin sjukdom och önskade ha kontroll över och ta eget ansvar för sin sjukdom och öka oberoendet. Ungdomar upplevde känslan av att vara annorlunda och undvek att utföra egenvård i sociala sammanhang. Svårigheter att följa kostrekommendationer varierade och att utföra blodglukoskontroller upplevdes ansträngande. Stöd från vänner och jämnåriga underlättade utförandet av egenvård. Det upplevdes positivt att sjuksköterskor visade intresse för ungdomarnas liv utöver deras DMT1. Sjuksköterskor upplevdes brista i att kunna sätta sig in i ungdomarnas situation och vara ett känslomässigt stöd. Slutsats: Det finns ett behov av ökat stöd och förståelse från sjuksköterskor. Genom ökad förståelse kan sjuksköterskan bidra med stöd för att underlätta överföringen av ansvar. Detta kan leda till en ökad trygghet och känsla av kontroll hos ungdomarna, vilket kan bidra till att de vågar dela med sig av sin sjukdom till omgivningen.
Background: Diabetes Mellitus Type 1 debuts in childhood and adolescence. The treatment is self-care that involves blood glucose control, drug treatment and following recommendations on diet and exercise. Nursing's professional area includes children and adolescents. Deviating from self-care activities and secrecy around the disease affects the quality of care for young people. Purpose: To describe the young people's experience of living with Diabetes Mellitus type 1 as well as describing the study groups of the studies examined. Method: Descriptive literature study with twelve scientific articles with qualitative as well as qualitative and quantitative approach. Consequences and differences in the results of the articles have been categorized and themes and subthemes have been identified. Results: Young people experienced difficulties in accepting their illness and wanted to have control over and take responsibility for their illness and increase independence. Young people experienced the feeling of being different and avoiding self-care in social contexts. Difficulties to follow dietary recommendations varied and blood glucose controls were exerted. Support from friends and peers facilitated the performance of self-care. It was positive that nurses showed interest in the lives of adolescents in addition to their DMT1. Nurses were found to fail to get into the situation of young people and to be an emotional support. Conclusion: There is a need for increased support and understanding from nurses. Through increased understanding, the nurse can help to facilitate the transfer of responsibility. This can lead to increased safety and sense of control among adolescents, which may help them dare to share their illness with the environment.

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Granudd, Cecilia, and Veronica Wallenbert. "Faktorer som hindrar och främjar följsamhet till livsstilsförändringar hos ungdomar med diabetes typ II : En litteraturöversikt." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-21372.

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Diabetes typ II är en kronisk sjukdom som ökar bland ungdomar. Fetma och övervikt ses som en bidragande faktor till att diabetes typ II ökar. Mer stillasittande och sämre kostvanor påverkar kroppen med insulinresistens och trötta insulinproducerande celler som till slut kan leda till diabetes typ II. Att som ungdom drabbas av en kronisk sjukdom kan upplevas som en turbulent tid i ungdomars liv. Familjens och samhällets stöd påverkar ungdomarnas levnadsvanor och deras val av livsstil. För att sjuksköterskan skall kunna arbeta preventivt med stöd och motivation samt sätta in rätt resurser måste sjuksköterskan veta vilka faktorer som främjar och hindrar följsamhet till de livsstilsförändringar som ungdomarna behöver göra. Bra kostvanor och regelbunden fysisk aktivitet kan bidra till att förebygga diabetes typ II. Syftet med denna studie är att beskriva faktorer som främjar och hindrar livsstilsförändringar hos ungdomar med diabetes typ II. Litteraturstudien innehåller tio artiklar, både kvalitativa och kvantitativa. Det framkommer av resultatet att familj och vänner spelar en avgörande roll i följsamheten till livsstilsförändringar. Att som ungdom ha tillgång till bra mat och att utöva fysisk aktivitet med vänner, ökade följsamheten hos ungdomen. Resultatet visar också betydelsen av att ungdomar vill vara som alla andra och inte känna sig annorlunda.

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Cavalcanti, Tatiana Nunes. "A experi?ncia de adolescentes portadores de diabetes Mellitus Tipo 1: seus significados e sentido." Universidade Federal do Rio Grande do Norte, 2008. http://repositorio.ufrn.br:8080/jspui/handle/123456789/17421.

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Made available in DSpace on 2014-12-17T15:38:42Z (GMT). No. of bitstreams: 1 TatianaNC.pdf: 292627 bytes, checksum: 567a01916e52d4c875ccad101311ad3d (MD5) Previous issue date: 2008-08-11
Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico
Worldwide, the diabetes mellitus is considered a serious problem of public health; it also involves high costs for its treatment and its complications. Even though the onset of diabetes mellitus type 1 is on 5% to 10% of the diabetic population, it is the most aggressive type of anifestation; furthermore, it is the commonest chronic disease in childhood and adolescence. Such data show the importance of understanding the development of this disease from the moment the individual perceives it, according to their experience, observing the complexity of the phenomenon thoroughly. This study aimed to comprehend the experience of the adolescent with onset of diabetes mellitus type 1 in order to learn how these young individuals perceive and reason their place in the world when they experience this illness. The methodological strategy was based on qualitative research of phenomenological inspiration. We applied the main ideas of heideggerian ontology and some concepts of existential phenomenological psychology to guide our reflexive path. The participants were 10 young individuals (06 female and 04 male), ages between 15 and 18, under treatment in the city of Recife, Pernambuco. The methodological resource was the narrative, which allowed us access to the adolescents experience. The comprehension of the reports was based on the heideggerian hermeneutics, whose priority is the interpretation of the meaning expressed by the participants speech. The results showed that factors such as social, family, economic and cultural context greatly influence the perception and the way the individuals deal with, perceive and reason their experience. We noticed that the diabetes type 1 may often represent a limitation, but it does not make it impossible to be part of the world with others. The data show a significant affective ambivalence regarding the content more directly related to the disease. This demonstrates the unique way which each one gives meaning and reasons their condition of existence. This research points out the need to understand the complexity of this phenomenon in a more complete manner, considering the adolescent in their timely and historical context. We believe we can encourage thinking that may become actions which are more fit to the reality researched regarding all the parties involved with the subject, such as health professionals, adolescents, family, support programs and public health policies
O diabetes mellitus, no cen?rio mundial, ? considerado como um problema s?rio de sa?de p?blica, al?m de envolver altos custos no seu tratamento e das suas complica??es. Embora acometa de 5% a 10% da popula??o diab?tica, o diabetes mellitus tipo 1 ? o tipo mais agressivo de suas representa??es, al?m de ser a doen?a cr?nica mais comum na inf?ncia e adolesc?ncia. Tais dados indicaram a import?ncia de se compreender o processo dessa doen?a a partir da percep??o da pessoa acometida, de acordo com a sua experi?ncia, observando a complexidade do fen?meno em sua totalidade. Esse estudo objetivou compreender a experi?ncia do adolescente portador de diabetes mellitus tipo 1 no sentido de apreendermos como esses jovens significam e d?o sentido ao seu estar no mundo, ao experienciar essa enfermidade. A estrat?gia metodol?gica teve como fundamento a pesquisa de abordagem qualitativa de inspira??o fenomenol?gica. Utilizamos as principais id?ias da ontologia heideggeriana e alguns conceitos da psicologia fenomenol?gico-existencial para nortear o nosso percurso reflexivo. Participaram do estudo 10 jovens (06 do sexo feminino e 04 do sexo masculino), com idades entre 15 e 18 anos, sob tratamento, na cidade do Recife, Pernambuco. O recurso metodol?gico utilizado foi a narrativa que nos permitiu acesso ? experi?ncia dos adolescentes. A compreens?o dos relatos teve como base a hermen?utica heideggeriana que prioriza a interpreta??o do sentido que emerge atrav?s das falas dos participantes. Os resultados revelaram que fatores como o contexto social, familiar, econ?mico e cultural influenciam, sobremaneira, a percep??o e a forma como os jovens lidam, significam e d?o sentido a sua experi?ncia. Percebemos que ter o diabetes tipo 1 pode representar, muitas vezes, uma limita??o, mas n?o uma impossibilidade de estar-no-mundo-com-os-outros. Os dados revelaram uma significativa ambival?ncia afetiva quanto ao conte?do mais especificamente relacionado ? doen?a. Isso demonstra a singularidade com que cada um significa e atribui sentido a sua condi??o de exist?ncia. Esse estudo evidenciou a necessidade de se compreender a complexidade desse fen?meno de uma forma mais integrada, considerando o adolescente em seu contexto hist?rico e temporal. Acreditamos poder favorecer reflex?es que possam ser revertidas em a??es mais condizentes com a realidade estudada a todos os envolvidos que lidam com a tem?tica, a saber, profissionais de sa?de, adolescentes, familiares, programas de apoio e pol?ticas p?blicas de sa?de

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Särnblad, Stefan. "Body Composition in Adolescents with Type 1 Diabetes : Aspects of Glycaemic Control and Insulin Sensitivity." Doctoral thesis, Uppsala University, Department of Women's and Children's Health, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4056.

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Excessive weight gain has frequently been reported in adolescents with type 1 diabetes, especially in girls. In general, puberty is associated with reduced insulin sensitivity that is further diminished by overweight. The causes and consequences of excessive weight gain in adolescents with type 1 diabetes are not fully understood. The studies described in this thesis addressed body composition in adolescents with type 1 diabetes and the relationships between physical activity, energy intake and changes in body composition. Furthermore, the effect of metformin as additional therapy on glycaemic control and insulin sensitivity was examined in a randomised placebo-controlled study. Body mass index (BMI) and percentage body fat (%BF) were significantly higher in girls with type 1 diabetes compared to healthy control girls. Mean HbA1c during puberty, but not mean insulin dose, was positively related to BMI at the age of 18 in girls with diabetes. A centralised fat distribution was associated with poor glycaemic control, increased daily dosage of insulin and elevated cholesterol and triglyceride levels. Neither total physical activity nor total energy intake differed between adolescent girls with type 1 diabetes and healthy age-matched control girls. A high dietary fat intake was positively related to gain in %BF in girls with type 1 diabetes. Additional therapy with metformin for three months improved glycaemic control and peripheral insulin sensitivity in adolescents with poorly controlled type 1 diabetes. The improvement in glycaemic control was related to insulin sensitivity at baseline, implying that the most insulin resistant subjects benefited most from the metformin therapy. It is concluded that the excessive weight gain observed in girls with type 1 diabetes is mainly attributable to an increased fat mass and that dietary fat intake is of importance for this gain in body fat. Additional treatment with metformin improves glycaemic control in adolescents with poorly controlled type 1 diabetes.

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Robinson, Victoria Margaret. "The relative roles of family and peer support in metabolic control and quality of life for adolescents with type 1 diabetes." Thesis, University of Edinburgh, 2008. http://hdl.handle.net/1842/3427.

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Background: Metabolic control declines during adolescence, increasing the risk of severe medical complications. Numerous burdensome treatments including insulin management, blood glucose monitoring, diet and exercise are necessary to prevent such complications. Adolescence is characterised by the transition from reliance on the family to independence and increased peer affiliation. It is therefore important to examine the roles of family and peer support for diabetes management tasks within a developmental context. Previous research indicates that family may have a role in supporting practical diabetes management, whilst peers may provide emotional support. Currently there is no research that compares the impact of diabetes-specific family and peer support on both metabolic control and quality of life. The present study addresses these issues. Methods: Ninety adolescents aged 13-18 with type 1 diabetes participated in this crosssectional study. Data included youth report of diabetes-specific social support (DSSQ) from peers and family, quality of life (PedsQL) and metabolic control (HbA1c). The relationships between social support, quality of life and HbA1c were examined using t-tests and correlations. Fishers Z transformations and hierarchical multiple regression were used to investigate the social support measures as potential predictors of HbA1c and quality of life. Results: Family provided significantly more support for practical diabetes management tasks than did peers. Peers provided significantly more support for exercise, but less emotional support, than did family. Better metabolic control was predicted by lower levels of peer support for insulin management, higher levels of peer support for blood glucose monitoring, increased mood and higher levels of family support for exercise. Quality of life was predicted by increased mood, higher levels of family emotional support, family support for diet, lower levels of peer support for insulin management and higher levels of peer support for exercise. Conclusion: Whilst family support remains important throughout adolescence, peer support also has an important role in the metabolic control and quality of life of adolescents with diabetes. This has implications for clinical practice, the most significant of which being the education and inclusion of peers in diabetes care.

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ALBUQUERQUE, Izabela Zibetti de. "Contagem de carboidratos e perfil metabólico de adolescentes com diabetes melito tipo 1 atendidos no Hospital das Clínicas/UFG, Goiânia." Universidade Federal de Goiás, 2012. http://repositorio.bc.ufg.br/tede/handle/tde/1478.

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Objective: The aim of the study was evaluated the effect of carbohydrate counting, for four months, on anthropometric parameters, body composition, biochemical and food intake in adolescents with type 1 diabetes mellitus. Methods: Clinical trial, controlled and randomized study at the Clinic of Endocrinology, Hospital das Clinicas, Federal University of Goiás, with 28 patients divided into intervention group (IG - carbohydrate counting) and control (CG - no counting carbs) and monitored fortnightly. At the beginning and end of the study data were collected on: anthropometric (weight, height and waist circumference), body composition (skinfold thickness and subscapular), biochemical (fasting glucose - FPG, postprandial glucose - GPP, glycated hemoglobin - A1C, total cholesterol - TC, triglycerides - TG, high density lipoprotein - HDL-c and low density lipoprotein - LDL-c) and, fortnightly, 24-hour recalls. Statistical analysis was performed using the statistical package SPSS version 18.0. For categorical variables used the chi-square and Fisher exact test. Shapiro-Wilk test to assess the normality of continuous variables, paired t test or Wilcoxon test for intragroup analysis, and Student's t test or Mann-Whitney test for intergroup analysis. The significance level was 5%. Results: The CG increased A1C (p=0.024) and both groups decreased energy intake (CG: p=0.005; IG: p=0.002). IG decreased A1C (p=0.002), but increased the CT (p=0.009) and LDL-c (p=0.012). This group also increased the caloric intake of carbohydrates (p=0.005) and decreased caloric intake of fat (p=0.002). There were a decreased in FPG and A1C (p=0.033 and p<0.001, respectively) in IG and increased CT and LDL-c (p=0.004 and p=0.019, respectively). The mean capillary glucose pre-and post-prandial were not affected between groups (p>0.005), although the oscillation glucose was lower in IG. Conclusion: Carbohydrate counting resulted in improved glycemic control and glucose concentrations more constant. However, this practice was associated with increased CT and LDL-c. Patients who have applied this strategy increased the caloric intake of carbohydrates and decreased consumption of fat.
Objetivo: Avaliar o efeito da contagem de carboidratos, por quatro meses, sobre parâmetros antropométricos, de composição corporal, bioquímicos e de consumo alimentar de adolescentes portadores de Diabetes Melito tipo 1. Metodologia: Ensaio clínico, controlado, randomizado, realizado no Ambulatório de Endocrinologia do Hospital das Clínicas da Universidade Federal de Goiás, com 28 pacientes, divididos em grupo intervenção (GI - contagem de carboidratos) e controle (GC - sem contagem de carboidratos), e acompanhados quinzenalmente. Ao início e ao final do estudo foi feita avaliação antropométrica (peso, altura e circunferência da cintura), da composição corporal (pregas cutâneas tricipital e subescapular), bioquímica (glicemia de jejum - GJ, glicemia pós-prandial - GPP, hemoglobina glicada - A1C, colesterol total - CT, triglicerídeos - TG, lipoproteína de alta densidade - HDL-c e lipoproteína de baixa densidade - LDL-c) e, quinzenalmente, de consumo alimentar (recordatórios de 24 horas). A análise estatística foi procedida por meio do pacote estatístico SPSS versão 18.0. Para as variáveis categóricas utilizou-se o teste Qui-Quadrado e teste Exato de Fisher. Teste de Shapiro-Wilk para avaliar a normalidade das variáveis contínuas, teste t-pareado ou teste de Wilcoxon para análise intragrupo, e teste t de Student ou teste de Mann-Whitney para a análise intergrupo. O nível de significância adotado foi de 5%. Resultados: O GC aumentou a A1C (p=0,024) e ambos os grupos diminuíram o consumo calórico (GC: p=0,005; GI: p=0,002). GI diminuiu a A1C (p=0,002), mas aumentou o CT (p=0,009) e o LDL-c (p=0,012). Este grupo também aumentou o consumo calórico de carboidratos (p=0,005) e diminuiu o consumo calórico de lipídeos (p=0,002). Verificou-se a diminuição de GJ e A1C (p=0,033 e p<0,001, respectivamente) no GI e o aumento de CT e LDL-c (p=0,004 e p=0,019, respectivamente). As médias glicêmicas pré e pós-prandiais não foram afetadas entre os grupos (p>0,005), embora a oscilação glicêmica tenha sido menor no GI. Conclusão: A contagem de carboidratos resultou na melhora do controle glicêmico e em concentrações glicêmicas mais constantes. Entretanto, a sua prática esteve associada ao aumento de CT e LDL-c. Os pacientes que aplicaram essa estratégia aumentaram o consumo calórico de carboidratos e diminuíram o consumo de lipídeos.

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Särnblad, Stefan. "Body composition in adolescents with type 1 diabetes : aspects of glycaemic control and insulin sensitivity /." Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4056.

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Dissertations / Theses on the topic 'Adolescent diabetes'

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