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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Birth weight is a popular topic, because it is precisely recorded, a major determinant of infant survival, associated with infant mortality, and health outcomes later in life. Low birth weight (LBW) is a predisposing factor for metabolic abnormalities such as atherosclerosis, renal disease, non-insulin diabetes mellitus, asthma, low IQ, hypertension, obesity, psychological distress. They have all been reported to be more common among those who were small at birth. Due to lack of studies suggesting a linkage between LBW and diseases of liver; evidences, which support the hypothesis on the creation of a link between LBW, an indicator of unfavourable intrauterine environment, and liver diseases emerging in the adult life, and possible direct associations of LBW with liver diseases, e.g., hepatitis, non-alcoholic fatty liver disease, cirrhosis, hepatoblastoma, or hepatocellular carcinoma were discussed. The associations between LBW and hepatitis vaccination as well as paediatric parental nutrition were also noted.
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PMID:Low birth weight: a possible risk factor also for liver diseases in adult life? 1367 7

Athough education is considered an integral part of diabetes management, it remains low in the practical priorities of clinicians. We performed the first structured educational intervention in a diabetic outpatient department, where patients were controlled with no provider autonomy support available. We recruited 77 Type 1 (T1DM) and 154 Type 2 diabetic (T2DM) patients as well as 87 matched control subjects. Baseline evaluation included: medical interview; questionnaires concerning diabetes knowledge, diabetes quality of life, state-trait anxiety, depression and general perceived self-efficacy; biochemical examination (fasting blood glucose, HbA1c, lipids, uric acid, urinary glucose and albumin excretion). Of the 231 diabetic patients, 154 agreed to attend an educational course, yet only 101 patients (37 T1DM and 64 T2DM) completed it (intervention group) due to organisational barriers. Intervention and reference (non-participant patients) groups received identical medical care, except that the educational group met with the educator during five teaching sessions. Three to six months after the completion of the course, they underwent a final assessment. Prospective results were: 1) in T1DM, a reduction in HbA1c levels and an increase in plasma HDL cholesterol with no change in drug treatment (the reference group showed no change in HbA1c values despite an increased insulin dose), improved technical skill, knowledge, quality of life and self-efficacy; 2) in T2DM, a reduction in fasting plasma glucose and an improvement in knowledge and quality of life. Analysis of the cross-sectional data at baseline evidenced: 3) the same levels of anxiety, depression and general self-efficacy in diabetic patients compared with healthy control subjects; 4) lower diabetes-specific quality of life associated with established insulin treatment in T2DM; 5) significant gender differences among healthy as well as diabetic subjects in degree of psychological distress. Education by itself is more than simply offering information to people (even in a troubled context) and its infrequent incorporation in practice really contradicts resource efficiency.
Diabetes Nutr Metab
PMID:Closing the gap between literature and practice: evaluation of a teaching programme (in the absence of a structured treatment) on both type 1 and type 2 diabetes. 1500 Apr 41

The work situation and fatigue-related complaints of employees with diabetes (N = 141) were compared with "healthy" employees (N = 8946) and employees with other chronic diseases (N = 1883). Baseline data from a Dutch Cohort Study on Fatigue at Work were used to test differences in background variables, work characteristics, lifestyle factors, and fatigue-related complaints. Odds ratios were calculated for prolonged fatigue, the need for recovery, burnout, and psychological distress. Results showed that employees with diabetes work more daytime hours and work less overtime than the other groups. If they have no comorbidity, they are no more likely to report fatigue-related complaints than "healthy" employees, except for a depressed mood. Comorbidity (the presence of one or more additional chronic diseases) is associated with increased fatigue-related complaints. Therefore, this group will need special attention from professionals.
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PMID:Diabetes, employment and fatigue-related complaints: a comparison between diabetic employees, "healthy" employees, and employees with other chronic diseases. 1530 Jan 35

In this study, the authors examined the relation between glycemic control and sense of coherence (SOC) and the mediating role of psychological distress and of adherence to self-care behaviors in 67 people with type 1 and type 2 diabetes. In addition, 29 individuals without any chronic disease composed a control group. The authors determined glycemic control by glycosylated hemoglobin (HbA1c) measures. The participants answered a questionnaire that included questions about medical data, an adherence to self-care behaviors inventory, Derogatis' Brief Symptoms Inventory, and Antonovsky's SOC scale. People with diabetes showed higher levels of psychological distress than matched controls, but similar SOC scores. A path analysis revealed that SOC was indirectly related to glycemic control, through adherence to self-care behaviors and psychological distress. Adherence did not mediate the effect of psychological distress on glycemic control In addition, the type of diabetes of the subject was directly related to glycemic control. The model explained 38% of the variance of glycemic control. The results suggest a possible role of SOC in the psychological and physical wellbeing of people with diabetes. SOC should constitute a focus of further research, particularly studies of possible psychological intervention to enhance SOC in people with diabetes.
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PMID:Relation between sense of coherence and glycemic control in type 1 and type 2 diabetes. 1536 98

"Depression, anxiety, and other disorders causing serious psychological distress (SPD) frequently complicate the health care of persons with diabetes." To assess the prevalence and effects of SPD among adults with diabetes, the New York City Department of Health and Mental Hygiene (DOHMH) analyzed data from approximately 10,000 adults who participated in the 2003 New York City Community Health Survey (CHS). The results indicated that 1) adults with diabetes were twice as likely to have SPD as those without diabetes, and 2) adults with both SPD and diabetes were more likely than those with only diabetes to live in poverty, report poor health, lack access to health care, and to have lost a spouse or partner to separation, divorce, or death. An integrated program of physical and mental health care that addresses socioeconomic barriers and improves access to treatment might improve the overall health of persons with diabetes and SPD.
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PMID:Serious psychological distress among persons with diabetes--New York City, 2003. 1556 19

Type 1 diabetes mellitus is a chronic disease that may have an impact on children's psychosocial adjustment. This study aimed to investigate the psychosocial characteristics of Kuwaiti children with type 1 diabetes as compared to healthy children without diabetes, and assess the impact of glycaemic control on psychosocial variables. A total of 349 school children aged 6-18 years with type 1 diabetes, and 409 children without diabetes having comparable age, gender, and social class were included in the study. Data were obtained by interviewing children and parents using a questionnaire. Psychological distress was measured by the Hopkins symptoms checklist-25 scale including anxiety and depression. Glycaemic control was assessed by glycosylated haemoglobin, HbA(IC) level. Glycaemic control was considered 'good to excellent' at HbA(IC)<8.0%, 'fair' at HbA(IC) 8.1 to 10.0%, and 'poor' at HbA(IC)>10.0%. Median scores of anxiety, depression, and total distress were significantly higher in children with diabetes indicating worse psychological adjustment. There was also significant difference between children with diabetes and those without diabetes in social aspects and school absence days. There was significant positive correlation between HbA(IC) concentration and scores of the psychological functioning indices. Children with poor glycaemic control had worse psychological adjustment. After controlling the variance accounted by gender and age, stepwise multiple regression analysis showed that girls, older children, children in need of emotional support, and those with higher HbA(IC) were at higher risk for psychological maladjustment. These variables explained 47.9% of the variation in total distress. In conclusion, the study supported our hypotheses. Children with diabetes had worse psychological adjustment, and distress was related to glycaemic control. Since psychological distress increases the risk for future complications due to its relation with glycaemic control, longitudinal studies are recommended to identify children with diabetes having distress at an early stage when preventive interventions are effective.
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PMID:Social and psychological characteristics of Kuwaiti children and adolescents with type 1 diabetes. 1568 13

Approximately a quarter of adults with type 1 diabetes do not succeed in achieving satisfactory glycaemic control, partly due to problems with the demanding self-management regimen. To improve glycaemic control, interventions with a cognitive behavioural approach, aimed at modifying dysfunctional beliefs, reducing negative emotions and enhancing self-care practices are a potentially successful tool. Little is known about the reach of such an approach. This article describes characteristics of participants in a randomized, controlled trial of cognitive behavioural group training for patients with type 1 diabetes in poor glycaemic control. Results show that outpatients from seven hospitals in the area of Amsterdam, selected on long-standing high HbA1c and volunteering to participate, report high levels of psychological distress and depressive symptoms. Furthermore, self-care behaviours were perceived as important, but burdensome. Diabetes-specific self-efficacy was relatively low. It is concluded that this selected group of adults with type 1 diabetes would potentially benefit from a cognitive-behavioural intervention in order to reduce negative emotions, enhance diabetes self-efficacy, self-care behaviour and glycaemic outcomes.
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PMID:Cognitive behavioural group training (CBGT) for patients with type 1 diabetes in persistent poor glycaemic control: who do we reach? 1572 74

In a previous study, a subgroup of asymptomatic insulin-dependent diabetic individuals (termed IDDM-2) were identified on the basis of diminished parasympathetic cardiac input and elevated heart rate at rest. When compared to another group of asymptomatic IDDM participants (termed IDDM-1), and a nondiabetic healthy control group, the IDDM-2 group displayed elevated blood pressure, supported by elevated total peripheral resistance. Measures of psychological regulation were also taken in this study, and form the basis of this article, which examined whether these IDDM-2 patients differed from the other two groups on these measures. The possible role of glycemic control, IDDM duration, and number of somatic complaints among group differences in psychological regulation was also examined. The IDDM-2 group reported increased psychological distress, as reflected by increased dysphoric or depressive symptoms, trait anxiety, perceived stress, and cynical hostility, as well as decreased optimism and interpersonal, but not family, social support. Glycemic control did not account for any of the group differences in psychological regulation. However, group differences in dysphoria and anxiety were accounted for by differences in somatic complaints, whereas differences in interpersonal social support were accounted for by IDDM duration. Moreover, none of the variables investigated accounted for the diminished optimism of the IDDM-2 group. Therefore, in individuals with IDDM, who would otherwise be considered, after medical examination, as no different from other asymptomatic IDDM individuals, the combination of diminished parasympathetic cardiac input and elevated heart rate was associated with aberrant alterations of both hemodynamic and psychological functioning; the increased psychological distress in these individuals may be influenced, in part, by increased diabetes duration and number of somatic symptoms.
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PMID:Aberrant parasympathetic and hemodynamic function distinguishes a subgroup of psychologically distressed individuals with asymptomatic type-I diabetes mellitus. 1625 Jun 93

Psychological stress has been implicated as a cause of several psychosomatic disorders, but also as a factor that can unfavourably influence many diseases including diabetes mellitus. Measure of psychological stress in diabetes was performed by Psychological Stress Measure (PSM), a validated instrument, designed using 49 items drawn from descriptors generated by focus groups on stress. Clinical and psychological framework was assessed in a cohort of 100 type 2 diabetic patients (30 m, 70 f), aged 66.99 +/- 13.68 years considering disease grade, complications and level of instruction. Three other questionnaires were administered concurrently to all patients: Sickness Impact Profile (SIP), Functional Living Index (FLI) and SF-36 QOL. ANOVA statistical testing and Spearman correlation matrix were used also vs socio-cultural and clinical profile. Gender, obesity, diet compliance, smoking do not affect PSM response. Hypertensive patients and those with family history of diabetes show lower PSM scores, according to a sort of moderator effect on stress of concurrent and/or previous experience with chronic disease. Neuromuscular ailments are more prevalent in women; men vs women experience severe limitations of their working capacities and relational possibilities, with severe discomfort. In the whole, higher scores of PSM (greater stress p < 0.01) and lower scores of FLI (fair well-being perception; p < 0.01) are reciprocally related inside any school instruction level. Despite the great reciprocal association of the PSM vs FLI and SIP, no significant correlation is found between PSM vs SF-36 QOL. Socio-cultural elements interfere, and particularly instruction level quantified as school grades achieved, with the manner of living their disease. Interventions on psychological distress of type 2 diabetes mellitus patients is warranted, specially in the groups with lower levels of instruction which may need an attentive strategy for achieving a satisfactory coping with this disease.
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PMID:Psychological stress measure in type 2 diabetes. 1670 51

In a retrospective study from the Dutch Mononitrate Quality of Life (DUMQOL) Study Group, the authors found that patients with angina with concomitant diabetes or hypercholesterolemia derived more benefit from changing over to a once-daily nitrate treatment regimen than did patients without angina. The aim of this study was to assess this issue prospectively. In an open-label study, patients with stable angina pectoris from facilities in Germany, Portugal, and me Czech Republic were treated for 3 months with multiple daily doses and subsequently for 3 more months with once-daily isosorbide mononitrate/dinitrate. After the first and second 3-month periods, they were assessed by a validated QOL battery including domains for mobility, side effects, life satisfaction, anginal pain, and psychological distress. In the 1045 patients who participated in the study, the mean summary domain scores varied from 5 to 16 points and score improvements from 1.6 to 4.3 points. In the patients without concomitant hypertension and smokers, domain scores improved less than they did in the patients without, with differences in domain score improvements up to 1.0 points (P<0.001), which is substantial considering the range of improvement was between 1.6 and 4.3 points. In the patients with diabetes mellitus or hypercholesterolemia, a reverse pattern was observed with differences in domain score improvements up to 0.4 points (P<0.05). Patients with angina with diabetes or hypercholesterolemia derived more benefit from an asymmetric regimen of isosorbide mononitrate/dinitrate than did patients without. Patients with angina with hypertension and smokers benefited less. Differences in endothelial function may be involved.
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PMID:Chronic nitrate therapy in patients with angina with comorbidity. 1677 58


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