Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Białystok, Białystok 15-274 Waszyngtona 24, Poland.
Students' Scientific Section of the Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Białystok, Białystok 15-274 Waszyngtona 24, Poland.
Biomed Res Int. 2019 Apr 30;2019:5184682. doi: 10.1155/2019/5184682. eCollection 2019.
Adolescence is a difficult period for young people with type 1 diabetes mellitus (T1DM), both in psychological and clinical terms. Empowerment therapy may support these patients, provided they are ready to change and have adequate executive functions to facilitate this change. Therefore, we hypothesise that the readiness of adolescents with T1DM to change is related to clinical features and/or their executive functions.
Using the Diabetes Empowerment Scale and the Behavioural Rating Inventory of Executive Function, we evaluated patients with T1DM duration of more than one year from three Polish diabetes centres of the PolPeDiab study group (N = 146). We related the data to features associated with disease and treatment and compared the results to those of adolescents without diabetes (N = 110).
We observed that adolescents with T1DM had a higher rate of abnormal results in executive function tests than their peers without diabetes (p > 0.05). Diabetes empowerment in this group of patients decreased with disease duration (r = -0.25, p = 0.006) and increased with deteriorating metabolic control (HbA1c; r = 0.25, p = 0.006). The greater the deficiencies in executive functions among adolescents with T1DM, the greater their readiness to change. The relationship between executive functions and diabetes empowerment is partially gender-differentiated.
To conclude, we propose individualized diabetes education in this group of patients based on the assessment of readiness to change and executive functions.
对于患有 1 型糖尿病(T1DM)的青少年来说,无论是在心理方面还是临床方面,青春期都是一个艰难的时期。赋能疗法可以为这些患者提供支持,前提是他们已经准备好做出改变,并且具备足够的执行功能来促进这种改变。因此,我们假设 T1DM 青少年改变的意愿与临床特征和/或他们的执行功能有关。
我们使用糖尿病赋能量表和行为评定量表对来自波兰 PolPeDiab 研究小组的三个波兰糖尿病中心的超过一年病程的 T1DM 患者(N=146)进行了评估。我们将这些数据与与疾病和治疗相关的特征相关联,并将结果与无糖尿病的青少年(N=110)进行了比较。
我们观察到,患有 T1DM 的青少年在执行功能测试中的异常结果发生率高于无糖尿病的同龄人(p>0.05)。在这组患者中,糖尿病赋能随着疾病持续时间的增加而降低(r=-0.25,p=0.006),随着代谢控制恶化(HbA1c;r=0.25,p=0.006)而增加。T1DM 青少年的执行功能缺陷越大,他们改变的意愿就越大。执行功能与糖尿病赋能之间的关系部分存在性别差异。
总之,我们建议根据改变的意愿和执行功能评估,为这组患者提供个性化的糖尿病教育。