The purpose of this study was to examine the feasibility and acceptability of training peers to function as lifestyle coaches and to deliver a church-based lifestyle modification program.

Methods:

We recruited 6 African-American adults to participate in an 8-hour peer lifestyle coach (PLC) training program followed by a subsequent 2-hour booster session. The PLC training program addressed several key areas, including: (1) developing empowerment-based facilitation, active listening, and behavior change skills; (2) learning self-management strategies (eg, reading food labels, counting calories); (3) practicing session delivery; and (4) interpreting clinical lab results. Training evaluation was conducted retrospectively (immediately following the delivery of the diabetes prevention intervention rather than after the 8-hour training session) and measured program satisfaction and efficacy from the perspective of participants.

Results:

Peer lifestyle coaches’ confidence levels for performing core skills (eg, asking open-ended questions, 5-step behavioral goal-setting process) and advanced skills (eg, addressing resistance, discussing sensitive topics) were uniformly high. Similarly, PLCs were very satisfied with the length of training, balance between content and skills development, and preparation for leading group- and individual-based support activities.

Conclusions:

Findings suggest that it is feasible to customize a PLC training program that is acceptable to participants and that equips participants with the knowledge and skills to facilitate a church-based diabetes prevention intervention.

The purpose of the study was to explore a parent’s sense of meaning in relation to the parenting of a child with type 1diabetes.

Methods

A qualitative collective case study design was used and 10 interviews conducted with parents of children with type 1 diabetes. Recruitment took place through the Winnipeg Diabetes Education and Resource for Children and Adolescents and Juvenile Diabetes Research Foundation. Categories were identified using qualitative content analysis.

Findings

Two major categories identified include being like everyone else and protecting the children.

Implications

Findings indicate that there is a need for greater diabetes education in schools. Diabetes educators can play a more proactive role in leading school based discussions with children, parents, and school staff.

The purpose of this study was to estimate the benefit of using a cultural characteristics scale to help diabetes educators understand how African Americans cope with diabetes. Illness representations are influenced by culture. Race and ethnicity as a proxy for culture provides an incomplete understanding of the mechanism by which cultural values influence representations of diabetes.

Methods

A descriptive correlational design was employed by recruiting hospitalized adults with type 2 diabetes at 3 metropolitan northeast coast sites. The TRIOS Afrocentric cultural characteristics measure and the Illness Perception Questionnaire were administered by paper-and-pencil to a diverse sample. Black race and African American ethnicity was used as a proxy for culture and compared to levels of agreement on an Afrocentric cultural scale to determine the relative ability to explain variance in illness representations of diabetes.

Conclusion

The TRIOS measure adapted to diabetes care explained variance in illness representations of diabetes, while African American ethnicity/black race was not able to explain variance in illness representations. Clinicians would benefit from considering the degree to which a patient identifies with particular cultural characteristics when tailoring interventions to manipulate illness representations that are not concordant with biomedical representations.

We identified three probands with a phenotype consistent with maturity-onset diabetes of the young (MODY) subtype GCK-MODY, in whom two potential pathogenic mutations were identified: [R43H/G68D], [E248 K/I225M], or [G261R/D217N]. Allele-specific PCR and cosegregation were used to determine phase. Single and double mutations were kinetically characterized.

The mutations occurred in cis (double mutants) in two probands and in trans in one proband. Functional studies of all double mutants revealed inactivating kinetics. The previously reported GCK-MODY mutations R43H and G68D were inherited from an affected father and unaffected mother, respectively. Both our functional and genetic studies support R43H as the cause of GCK-MODY and G68D as a neutral rare variant.

These data highlight the need for family/functional studies, even for previously reported pathogenic mutations.

Adults with type 1 diabetes (n = 37) underwent continuous glucose monitoring via a subcutaneous sensor as well as recording of R-R interval or electrocardiogram for 3 nights. Heart rate (HR) variability was analyzed during periods of hypoglycemia (glucose<3.5 mmol/L) (minimum length of 20 min) and a control nonhypoglycemic period (glucose >3.9 mmol/L) of equal duration and at the same time of night.

The duration of hypoglycemic and control episodes (n = 18) ranged from 20 to 190 min (mean 71 min). HR (62 ]]> http://diabetesresearchnews.net/autonomic-cardiac-regulation-during-spontaneous-nocturnal-hypoglycemia-in-patients-with-type-1-diabetes/feed/ 0 http://diabetesresearchnews.net/diabetes-differentially-affects-depression-and-self-rated-health-by-age-in-the-u-s/ http://diabetesresearchnews.net/diabetes-differentially-affects-depression-and-self-rated-health-by-age-in-the-u-s/#comments Fri, 18 May 2012 19:20:09 +0000 Wexler, D. J.; Porneala, B.; Chang, Y.; Huang, E. S.; Huffman, J. C.; Grant, R. W. http://diabetesresearchnews.net/?guid=5a1bba904ae8594dcf92c60038e8bb6e here.]]> To determine whether the relationship between age and physical and mental health varies by diabetes status in older U.S. adults.

Using data from the National Social Life, Health, and Aging Project, a national sample of 3,005 adults aged 57–85 years, we tested the significance of the interaction between age and diabetes in association with health states.

Respondents with diabetes in the youngest age cohort had more medical conditions than those without diabetes, a difference that narrowed with age (P for interaction <0.01). The youngest cohort with diabetes had a higher rate of depression compared to those without diabetes (14 vs. 8%). Depression declined with age and did not differ by diabetes status in the oldest respondents (P = 0.01 for age-diabetes interaction).

Diabetes differentially affects self-rated overall health and depression by age, with convergence in the oldest age-group with and without diabetes.

A total of 629 subjects aged 11 to 17 years, with a type 1 diabetes onset occurring from age 0 to 4 years during the years 1993–1999, and their parents, completed questionnaires, including the generic KINDL-R Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, revised version, to assess QoL. The comparison group (n = 6,813) was a representative sample from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study. Regression analyses were conducted using sociodemographic and health-related covariates.

Intensified insulin therapy was used to treat 93% of children and adolescents with type 1 diabetes. They reported "excellent" general health as often as peers (adjusted OR 0.83 [95% CI 0.66–1.04] for an "excellent" rating), but the parent-rated general health was worse than that in the general population (OR 0.60 [0.48–0.74]). The patients reported increased self-esteem (adjusted difference β = 4.39 [SE 0.82]; P < 0.001) and well-being at school (β = 3.41 [0.77]; P < 0.001) but lower well-being within their families (β = –2.42 [0.80]; P = 0.002). The self- and parent-reported total QoL did not differ between the patient group and the general population. The adjusted difference (SE) between the two samples in total QoL was β = 0.89 (0.52; P = 0.087) in the self-reports and β = –0.98 (0.53; P = 0.066) in the parent-reports.

Compared with the general population, the QoL and general health status were not impaired among those aged 11–17 years with early-onset type 1 diabetes, despite the challenges of modern therapy.

In 988 participants from North America and Europe uncontrolled on metformin ]]> http://diabetesresearchnews.net/sequential-intensification-of-metformin-treatment-in-type-2-diabetes-with-liraglutide-followed-by-randomized-addition-of-basal-insulin-prompted-by-a1c-targets/feed/ 0