Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Department of Biostatistics and School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Pediatr Diabetes. 2022 Jun;23(4):516-526. doi: 10.1111/pedi.13334. Epub 2022 Apr 3.
To assess the relationship between mindfulness and glycemia among adolescents with type 1 diabetes (T1D) with suboptimal glycemia, and evaluate the potential mediation by ingestive behaviors, including disordered eating, and impulsivity.
We used linear mixed models for hemoglobin A1c (HbA1c) and linear regression for continuous glucose monitoring (CGM) to study the relationship of mindfulness [Child and Adolescent Mindfulness Measure (CAMM)] and glycemia in adolescents with T1D from the 18-month Flexible Lifestyles Empowering Change (FLEX) trial. We tested for mediation of the mindfulness-glycemia relationship by ingestive behaviors, including disordered eating (Diabetes Eating Problem Survey-Revised), restrained eating, and emotional eating (Dutch Eating Behavior Questionnaire); and impulsivity (total, attentional, and motor, Barrett Impulsiveness Scale).
At baseline, participants (n = 152) had a mean age of 14.9 ± 1.1 years and HbA1c of 9.4 ± 1.2% [79 ± 13 mmol/mol]. The majority of adolescents were non-Hispanic white (83.6%), 50.7% were female, and 73.0% used insulin pumps. From adjusted mixed models, a 5-point increase in mindfulness scores was associated with a -0.19% (95%CI -0.29, -0.08, p = 0.0006) reduction in HbA1c. We did not find statistically significant associations between mindfulness and CGM metrics. Mediation of the relationship between mindfulness and HbA1c by ingestive behaviors and impulsivity was not found to be statistically significant.
Among adolescents with T1D and suboptimal glycemia, increased mindfulness was associated with lower HbA1c levels. Future studies may consider mindfulness-based interventions as a component of treatment for improving glycemia among adolescents with T1D, though more data are needed to assess feasibility and efficacy.
评估正念与血糖水平之间的关系，研究对象为血糖控制不佳的 1 型糖尿病（T1D）青少年，并评估摄食行为（包括饮食障碍和冲动性）的潜在中介作用。
我们使用线性混合模型研究血红蛋白 A1c（HbA1c），使用线性回归研究连续血糖监测（CGM），以研究来自 18 个月灵活生活方式改变（FLEX）试验的 T1D 青少年的正念（儿童和青少年正念量表（CAMM））和血糖之间的关系。我们通过摄食行为（包括饮食障碍（修订后的糖尿病饮食问题调查）、限制饮食和情绪性饮食（荷兰饮食行为问卷））和冲动性（总体、注意力和运动，巴雷特冲动量表）来测试正念与血糖关系的中介作用。
在基线时，参与者（n=152）的平均年龄为 14.9±1.1 岁，HbA1c 为 9.4±1.2%[79±13mmol/mol]。大多数青少年为非西班牙裔白人（83.6%），50.7%为女性，73.0%使用胰岛素泵。从调整后的混合模型中可以看出，正念评分增加 5 分与 HbA1c 降低 0.19%（95%CI-0.29，-0.08，p=0.0006）相关。我们没有发现正念与 CGM 指标之间存在统计学上的显著关联。正念与 HbA1c 之间的关系没有通过摄食行为和冲动性的中介作用来证明具有统计学意义。
在血糖控制不佳的 T1D 青少年中，正念程度的增加与 HbA1c 水平的降低相关。未来的研究可能会考虑将正念为基础的干预措施作为改善 T1D 青少年血糖控制的治疗手段之一，尽管需要更多的数据来评估其可行性和疗效。
