Department of Pediatric Endocrinology, Stanford University, Stanford, California.
Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina.
Pediatr Diabetes. 2019 Nov;20(7):974-985. doi: 10.1111/pedi.12903. Epub 2019 Aug 15.
The impact of weight management in persons with type 1 diabetes (T1D) from childhood into adulthood has not been well described. The purpose of the study was to explore qualitative themes presented by young adults with T1D with respect to the dual management of weight and T1D.
We analyzed focus group data from 17 young adults with T1D (65% female, age 21.7 ± 2.1 years, HbA1c 8.1% ± 1.5) via inductive qualitative analysis methods. Major themes were compared to themes presented by youth with T1D ages 13-16 years in previously published study in order to categorize thematic progression from early adolescence through adulthood.
Themes from young adults with T1D, when compared to those from youth were categorized as: (a) persistent and unchanged themes, (b) evolving themes, and (c) newly reported themes. Hypoglycemia and a sense of futility around exercise was an unchanged theme. Importance of insulin usage and a healthy relationship with T1D evolved to gather greater conviction. Newly reported themes are unique to integration of adulthood into T1D, such as family planning and managing T1D with work obligations. Young adults also reported negative experiences with providers in their younger years and desire for more supportive provider relationships.
Issues identified by youth regarding the dual management of T1D and weight rarely resolve, but rather, persist or evolve to integrate other aspects of young adulthood. Individualized and age-appropriate clinical support and practice guidelines are warranted to facilitate the dual management of weight and T1D in persons with T1D.
从儿童期到成年期，1 型糖尿病（T1D）患者的体重管理的影响尚未得到很好的描述。本研究的目的是探讨 T1D 青年患者在兼顾体重和 T1D 双重管理方面呈现的定性主题。
我们通过归纳定性分析方法，对 17 名 T1D 青年患者（65%为女性，年龄 21.7±2.1 岁，HbA1c 8.1%±1.5）的焦点小组数据进行了分析。主要主题与之前发表的 13-16 岁 T1D 青少年研究中的主题进行了比较，以便将主题从青少年期到成年期进行分类。
与青少年相比，T1D 青年患者的主题可分为：（a）持续不变的主题；（b）不断发展的主题；（c）新报告的主题。低血糖和运动带来的无力感是不变的主题。胰岛素使用的重要性和与 T1D 的健康关系不断发展，以获得更大的信念。新报告的主题是成年期融入 T1D 所特有的，例如计划生育和管理 T1D 与工作义务。年轻人还报告了年轻时与提供者的负面经历，并希望与提供者建立更支持性的关系。
年轻人提出的关于 T1D 和体重双重管理的问题很少得到解决，但会持续存在或发展，以整合年轻成年期的其他方面。需要个体化和适合年龄的临床支持和实践指南，以促进 T1D 患者的体重和 T1D 双重管理。
