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Article ; Online: Peer interactions and health among youth with diabetes: An ecological momentary assessment.

Helgeson, Vicki S / Horner, Fiona S / Reis, Harry T / Niezink, Nynke M D / Libman, Ingrid

Health psychology : official journal of the Division of Health Psychology, American Psychological Association

2024

Abstract: Objective: We examined the links of supportive and conflictual peer interactions to mood and self-care via ecological momentary assessment.: Method: Adolescents with Type 1 diabetes (: Results: Cross-sectional analyses revealed between- and within- ...

Abstract	Objective: We examined the links of supportive and conflictual peer interactions to mood and self-care via ecological momentary assessment. Method: Adolescents with Type 1 diabetes ( Results: Cross-sectional analyses revealed between- and within-person (WP) links of peer support to positive mood and conflict to negative mood. Between-person peer support was linked to healthy self-care, but WP support was not. Lagged analyses showed conflictual interactions were associated with self-care decline. There was some evidence that females did not benefit as much from support and were more bothered by conflict than others. Conclusions: Results underscore differences in between- and WP links of social interactions to health. Individual differences in support were more influential than conflict, but conflictual interactions had more momentary effects than supportive interactions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Language	English
Publishing date	2024-04-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	226369-5
ISSN	1930-7810 ; 0278-6133
ISSN (online)	1930-7810
ISSN	0278-6133
DOI	10.1037/hea0001393
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Article ; Online: Support and Conflict Among Youth With Type 1 Diabetes: A Focus on Friends.

Helgeson, Vicki S / Horner, Fiona S / Reis, Harry T / Niezink, Nynke M D / Libman, Ingrid

Journal of pediatric psychology

2023 Volume 48, Issue 11, Page(s) 940–951

Abstract: ... as potential mediators.: Methods: Youth with type 1 diabetes (n = 167; M age 15.83 [SD = 0.78]; 50% female ...

Abstract	Objective: The goal of the study was to examine the relations of general and diabetes-specific friend support and conflict to psychological and diabetes health among youth with type 1 diabetes. We examined gender as a moderator of these relations, and friend responsiveness and information-sharing as potential mediators. Methods: Youth with type 1 diabetes (n = 167; M age 15.83 [SD = 0.78]; 50% female) were interviewed once in the Fall and once in the following Spring of the school year. Using multiple regression analysis, general friend support, general friend conflict, diabetes-specific support, and diabetes-specific conflict were investigated as simultaneous predictors of psychological and diabetes outcomes cross-sectionally and longitudinally over four months. Results: Cross-sectionally friend conflict, including both general and diabetes-specific, was more predictive of outcomes than friend support. In cross-sectional and longitudinal analyses, gender was a significant moderator, such that several relations of general friend conflict to outcomes were significant for females but not nonfemales. Friend support revealed mixed relations to outcomes across cross-sectional and longitudinal analyses. Although we found links of friend relationship variables to mediators (perceived responsiveness; information sharing), we found little evidence of mediation. Conclusions: These findings show stronger evidence that conflictual friend relationships than supportive friend relationships are linked to health. Findings suggest that problematic friend relationships may have a stronger impact on the health of females than nonfemales. These results underscore the need to better understand the conditions under which friend support is helpful versus harmful and the reasons underlying these links.
MeSH term(s)	Humans ; Female ; Adolescent ; Male ; Friends/psychology ; Diabetes Mellitus, Type 1/psychology ; Cross-Sectional Studies ; Schools ; Interpersonal Relations
Language	English
Publishing date	2023-10-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	625329-5
ISSN	1465-735X ; 0146-8693
ISSN (online)	1465-735X
ISSN	0146-8693
DOI	10.1093/jpepsy/jsad065
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Article ; Online: From Antiquity to Modern Times: A History of Diabetes Mellitus and Its Treatments.

March, Christine A / Libman, Ingrid M / Becker, Dorothy J / Levitsky, Lynne L

Hormone research in paediatrics

2022 Volume 95, Issue 6, Page(s) 593–607

Abstract: The past 200 years have brought an understanding of diabetes and its pathogenesis, as well as the development of treatments that could not have been predicted when the disorder was first clinically described 2000 years ago. Beginning in the late 19th ... ...

Abstract	The past 200 years have brought an understanding of diabetes and its pathogenesis, as well as the development of treatments that could not have been predicted when the disorder was first clinically described 2000 years ago. Beginning in the late 19th century, the initial descriptions of the microscopic anatomy of the pancreatic islets by Langerhans led to recognition of pancreatic endocrine function. Many investigators attempted to isolate the hypoglycemic factor produced by the pancreas, but Banting, Best, Macleod, and Collip were able to extract and purify "isletin" to treat human diabetes in 1921. Rapid scientific progress over the next 100 years led to an understanding of insulin synthesis, structure and function, production of modified synthetic insulins, and the physiopathology that permitted classification of diabetes subtypes. Improvements in control of diabetes have reduced the risks of complications. In less than two hundred years, we have gone from being unable to measure glucose in blood to being able to offer people with diabetes continuous blood glucose monitoring, linked to continuous subcutaneous insulin infusion. We come ever closer with new drugs and treatments to repair the biochemical defects in type 2 diabetes and to biologically replace islets and their function in type 1 diabetes. This review addresses the history of continuing progress in diabetes care.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 2 ; Blood Glucose Self-Monitoring ; Blood Glucose ; Insulin ; Diabetes Mellitus, Type 1/therapy
Chemical Substances	Blood Glucose ; Insulin
Language	English
Publishing date	2022-11-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2537278-6
ISSN	1663-2826 ; 1663-2818
ISSN (online)	1663-2826
ISSN	1663-2818
DOI	10.1159/000526441
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Article: Nutrition and Obesity in the Pathogenesis of Youth-Onset Type 1 Diabetes and Its Complications.

March, Christine A / Becker, Dorothy J / Libman, Ingrid M

Frontiers in endocrinology

2021 Volume 12, Page(s) 622901

Abstract: Since the 1980s, there has been a dramatic rise in the prevalence of overweight and obesity in pediatric populations, in large part driven by sedentary lifestyles and changing dietary patterns with more processed foods. In parallel with the rise in ... ...

Abstract	Since the 1980s, there has been a dramatic rise in the prevalence of overweight and obesity in pediatric populations, in large part driven by sedentary lifestyles and changing dietary patterns with more processed foods. In parallel with the rise in pediatric obesity in the general population, the prevalence of overweight and obesity has increased among children and adolescents with type 1 diabetes. Adiposity has been implicated in a variety of mechanisms both potentiating the risk for type 1 diabetes as well as exacerbating long-term complications, particularly cardiovascular disease. Treatment options targeting the unique needs of obese pediatric patients, both before and after diagnosis of type 1 diabetes, are limited. In this review, we discuss the history of the epidemiology of the obesity epidemic in the context of pediatric type 1 diabetes, highlight the possible role of obesity in type 1 diabetes pathogenesis and review the concept of "double diabetes". The impact of obesity at and after diagnosis will be discussed, including noted differences in clinical and biochemical markers, lipid abnormalities, and long-term cardiovascular complications. Finally, we will review the existing literature on pharmacologic and nutritional interventions as potential treatment strategies for youth with coexisting type 1 diabetes and obesity.
MeSH term(s)	Adiposity/physiology ; Adolescent ; Child ; Child, Preschool ; Diabetes Mellitus, Type 1/complications ; Female ; Humans ; Male ; Nutritional Status ; Pediatric Obesity/complications ; Risk Factors ; Sedentary Behavior
Language	English
Publishing date	2021-03-22
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2021.622901
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Article ; Online: Baseline leptin predicts response to metformin in adolescents with type 1 diabetes and increased body mass index.

Ismail, Heba M / Barua, Souptik / Wang, Johnny / Sabharwal, Ashutosh / Libman, Ingrid / Bacha, Fida / Nadeau, Kristen J / Tosur, Mustafa / Redondo, Maria J

Diabetes, obesity & metabolism

2023 Volume 25, Issue 11, Page(s) 3420–3423

MeSH term(s)	Adolescent ; Humans ; Metformin/therapeutic use ; Body Mass Index ; Leptin ; Diabetes Mellitus, Type 1/drug therapy ; Hypoglycemic Agents/therapeutic use ; Hypoglycemic Agents/pharmacology ; Insulin ; Insulin Resistance
Chemical Substances	Metformin (9100L32L2N) ; Leptin ; Hypoglycemic Agents ; Insulin
Language	English
Publishing date	2023-07-24
Publishing country	England
Document type	Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Journal Article
ZDB-ID	1454944-x
ISSN	1463-1326 ; 1462-8902
ISSN (online)	1463-1326
ISSN	1462-8902
DOI	10.1111/dom.15218
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Article ; Online: Implications of the School Day on Health Behaviors for Children With Type 1 Diabetes: A Survey of Parent Perspectives During the COVID-19 Pandemic.

March, Christine A / Siminerio, Linda M / Muzumdar, Radhika H / Libman, Ingrid M

The science of diabetes self-management and care

2021 Volume 47, Issue 6, Page(s) 447–456

Abstract: Purpose: The purpose of this study is to survey parents of youth with type 1 diabetes during the COVID-19 pandemic with school closures to better understand the implications of the school day on health care behaviors.: Methods: A cross-sectional, ... ...

Abstract	Purpose: The purpose of this study is to survey parents of youth with type 1 diabetes during the COVID-19 pandemic with school closures to better understand the implications of the school day on health care behaviors. Methods: A cross-sectional, online survey was distributed to parents of youth with type 1 diabetes ≤19 years of age in a large, academic diabetes center. Questions encompassed perceived changes in management behaviors and plans for return to school. Subgroup analysis compared parent responses by child's age, reported stressors, and socioeconomic markers. Results: Parents reported a worsening in their child's diabetes health behaviors during school closures compared to what they perceived during a regular school day before the pandemic. More than half of parents reported feeling that their child was unable to maintain a normal routine, with particular implications for snacking between meals, daily physical activity, and sleep habits. Families with adolescents or those experiencing multiple pandemic-related stressors reported greater challenges. In open-ended responses, families highlighted difficulty in balancing school, work, and diabetes care and expressed concerns about the mental health repercussions of school closures for their children. Nearly half of parents reported being at least moderately worried about return to school, whereas only a minority reported seeking guidance from their diabetes provider. Conclusions: Parent-reported disruptions of school-day routines frequently had adverse consequences for diabetes management in this population. These findings highlight the importance of a school-day routine for children with type 1 diabetes; during closures, families may benefit from mitigating strategies to maintain effective habits.
MeSH term(s)	Adolescent ; COVID-19 ; Child ; Cross-Sectional Studies ; Diabetes Mellitus, Type 1/epidemiology ; Health Behavior ; Humans ; Pandemics ; Parents ; SARS-CoV-2 ; Schools
Language	English
Publishing date	2021-12-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2635-0114
ISSN (online)	2635-0114
DOI	10.1177/26350106211051298
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Article ; Online: Comparisons of school-day glycemia in different settings for children with type 1 diabetes using continuous glucose monitoring.

March, Christine A / Nanni, Michelle / Lutz, James / Kavanaugh, Madison / Jeong, Kwonho / Siminerio, Linda M / Rothenberger, Scott / Miller, Elizabeth / Libman, Ingrid M

Pediatric diabetes

2023 Volume 2023

Abstract: Objective: Using continuous glucose monitoring (CGM), we examined patterns in glycemia during school hours for children with type 1 diabetes, exploring differences between school and non-school time.: Methods: We conducted a retrospective analysis of ...

Abstract	Objective: Using continuous glucose monitoring (CGM), we examined patterns in glycemia during school hours for children with type 1 diabetes, exploring differences between school and non-school time. Methods: We conducted a retrospective analysis of CGM metrics in children 7-12 years (n=217, diabetes duration 3.5±2.5 years, hemoglobin A1c 7.5±0.8%). Metrics were obtained for weekday school hours (8 AM to 3 PM) during four weeks in fall 2019. Two comparison settings included weekend (fall 2019) and weekday (spring 2020) data when children had transitioned to virtual school due to COVID-19. We used multilevel mixed models to examine factors associated with time in range (TIR) and compare glycemia between in-school, weekends, and virtual school. Results: Though CGM metrics were clinically similar across settings, TIR was statistically higher, and time above range (TAR), mean glucose, and standard deviation (SD) lower, for weekends and virtual school (p<0.001). Hour and setting exhibited a significant interaction for several metrics (p<0.001). TIR in-school improved from a mean of 40.9% at the start of the school day to 58.0% later in school, with a corresponding decrease in TAR. TIR decreased on weekends (60.8 to 50.7%) and virtual school (62.2 to 47.8%) during the same interval. Mean glucose exhibited a similar pattern, though there was little change in SD. Younger age (p=0.006), lower hemoglobin A1c (p<0.001), and insulin pump use (p=0.02) were associated with higher TIR in-school. Conclusion: Although TIR was higher for weekends and virtual school, glycemic metrics improve while in-school, possibly related to beneficial school day routines.
MeSH term(s)	Humans ; Child ; Diabetes Mellitus, Type 1/drug therapy ; Glycated Hemoglobin ; Blood Glucose/analysis ; Blood Glucose Self-Monitoring ; Retrospective Studies
Chemical Substances	Glycated Hemoglobin ; Blood Glucose
Language	English
Publishing date	2023-03-09
Publishing country	Denmark
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1502504-4
ISSN	1399-5448 ; 1745-1426 ; 1399-543X
ISSN (online)	1399-5448
ISSN	1745-1426 ; 1399-543X
DOI	10.1155/2023/8176606
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Article ; Online: School-based diabetes care: A national survey of U.S. pediatric diabetes providers.

March, Christine A / Siminerio, Linda M / Kazmerski, Traci M / Albanese-O'Neill, Anastasia / Miller, Elizabeth / Libman, Ingrid

Pediatric diabetes

2023 Volume 2023

Abstract: Objectives: To understand the practices, attitudes, and beliefs of type 1 diabetes (T1D) providers towards school-based diabetes care (SBDC), including counseling families and communicating with schools, and explore the barriers and facilitators which ... ...

Abstract	Objectives: To understand the practices, attitudes, and beliefs of type 1 diabetes (T1D) providers towards school-based diabetes care (SBDC), including counseling families and communicating with schools, and explore the barriers and facilitators which affect their support of SBDC. Research design and methods: We conducted a national survey of pediatric T1D providers about their perceived support of SBDC, including family counseling and school communication. We used descriptive statistics to analyze results and explored differences by practice size (<500, 500-999, and ≥1000 patients) and environment (academic vs non-academic). Results: A total of 149 providers completed the survey. Nearly all (95%) indicated SBDC was very important. Though most (63%) reported counseling families about SBDC multiple times per year, few (19%) spoke with school staff routinely, reporting that was a shared responsibility among different providers. Close to 90% agreed school feedback on T1D management plans would be helpful, yet only 31% routinely requested this input. Moderate to extremely significant barriers to SBDC communication included internal factors, such as staff resources (67%) and time (82%), and external factors, such as school nurse education needs (62%) and differing school district policies (70%). Individuals from large or academic practices reported more barriers in their knowledge of SBDC, including federal/state laws. Desired facilitators for SBDC included a designated school liaison (84%), electronic transmission for school forms (90%), and accessible school staff education (95%). Conclusions: Though providers universally agree that SBDC is important, there are multilevel internal (practice) and external (policy) barriers to facilitating a bidirectional relationship between schools and health teams.
MeSH term(s)	Child ; Humans ; Diabetes Mellitus, Type 1/epidemiology ; Diabetes Mellitus, Type 1/therapy ; Surveys and Questionnaires ; Schools
Language	English
Publishing date	2023-04-11
Publishing country	Denmark
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1502504-4
ISSN	1399-5448 ; 1745-1426 ; 1399-543X
ISSN (online)	1399-5448
ISSN	1745-1426 ; 1399-543X
DOI	10.1155/2023/4313875
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Article ; Online: HOMA-IR and the Matsuda Index as predictors of progression to type 1 diabetes in autoantibody-positive relatives.

Petrelli, Alessandra / Cugnata, Federica / Carnovale, Debora / Bosi, Emanuele / Libman, Ingrid M / Piemonti, Lorenzo / Cuthbertson, David / Sosenko, Jay M

Diabetologia

2023 Volume 67, Issue 2, Page(s) 290–300

Abstract: Aim/hypothesis: We assessed whether HOMA-IR and the Matsuda Index are associated with transitions through stages of type 1 diabetes.: Methods: Autoantibody (AAb)-positive relatives of individuals with type 1 diabetes (n=6256) from the TrialNet ... ...

Abstract	Aim/hypothesis: We assessed whether HOMA-IR and the Matsuda Index are associated with transitions through stages of type 1 diabetes. Methods: Autoantibody (AAb)-positive relatives of individuals with type 1 diabetes (n=6256) from the TrialNet Pathway to Prevention were studied. Associations of indicators of insulin resistance (HOMA-IR) and insulin sensitivity (Matsuda Index) with BMI percentile (BMIp) and age were assessed with adjustments for measures of insulin secretion, Index60 and insulinogenic index (IGI). Cox regression was used to determine if tertiles of HOMA-IR and Matsuda Index predicted transitions from Not Staged (<2 AAbs) to Stage 1 (≥2 AAbs and normoglycaemia), from Stage 1 to Stage 2 (≥2 AAbs with dysglycaemia), and progression to Stage 3 (diabetes as defined by WHO/ADA criteria). Results: There were strong associations of HOMA-IR (positive) and Matsuda Index (inverse) with baseline age and BMIp (p<0.0001). After adjustments for Index60, transitioning from Stage 1 to Stage 2 was associated with higher HOMA-IR and lower Matsuda Index (HOMA-IR: HR=1.71, p<0.0001; Matsuda Index, HR=0.40, p<0.0001), as with progressing from Stages 1 or 2 to Stage 3 (HOMA-IR: HR=1.98, p<0.0001; Matsuda Index: HR=0.46, p<0.0001). Without adjustments, associations of progression to Stage 3 were inverse for HOMA-IR and positive for Matsuda Index, opposite in directionality with adjustments. When IGI was used in place of Index60, the findings were similar. Conclusions/interpretation: Progression to Stages 2 and 3 of type 1 diabetes increases with HOMA-IR and decreases with the Matsuda Index after adjustments for insulin secretion. Indicators of insulin secretion appear helpful for interpreting associations of progression to type 1 diabetes with HOMA-IR or the Matsuda Index in AAb-positive relatives.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 1 ; Insulin/metabolism ; Autoantibodies/metabolism ; Insulin Resistance ; Insulin Secretion ; Blood Glucose
Chemical Substances	Insulin ; Autoantibodies ; Blood Glucose
Language	English
Publishing date	2023-11-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1694-9
ISSN	1432-0428 ; 0012-186X
ISSN (online)	1432-0428
ISSN	0012-186X
DOI	10.1007/s00125-023-06034-y
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Article ; Online: School Nurse Confidence with Diabetes Devices in Relation to Diabetes Knowledge and Prior Training: A Study of Convergent Validity.

March, Christine A / Hill, Amber / Kazmerski, Traci M / Siminerio, Linda / Switzer, Galen / Miller, Elizabeth / Libman, Ingrid

Pediatric diabetes

2023 Volume 2023

Abstract: Objective: The Diabetes Device Confidence Scale (DDCS) is a new scale designed to evaluate school nurse confidence with diabetes devices. We hypothesized that DDCS score would be associated with related constructs of school nurse diabetes knowledge, ... ...

Abstract	Objective: The Diabetes Device Confidence Scale (DDCS) is a new scale designed to evaluate school nurse confidence with diabetes devices. We hypothesized that DDCS score would be associated with related constructs of school nurse diabetes knowledge, experience, and training. Research design and methods: In a cross-sectional study, we co-administered the DDCS and Diabetes Knowledge Test 2 (DKT2) questionnaires to school nurses in Pennsylvania. We summarized DDCS scores (range 1-5) descriptively. We evaluated the relationship between DKT2 percent score and DDCS mean score with the Spearman correlation coefficient. Simple linear regression examined school nurse characteristics as predictors of DDCS score. Results: A total of 271 completed surveys were received. Mean DDCS score was 3.16±0.94, indicating moderate confidence with devices overall. School nurses frequently reported low confidence in items representing specific skills, including suspending insulin delivery (40%), giving a manual bolus (42%), knowing when to calibrate a continuous glucose monitor (48%), changing an insulin pump site (54%), and setting a temporary basal rate (58%). Mean DKT2 score was 89.5±0.1%, which was weakly but not significantly correlated with DDCS score (r=0.12, p=0.06). Formal device training (p<0.001), assisting ≥5 students with diabetes devices in the past 5 years (p<0.01), and a student caseload between 1000-1500 students (p<0.001) were associated with higher mean DDCS score. Conclusions: DDCS score is related to prior training and experience, providing evidence for the scale's convergent validity. The DDCS may be a useful tool for assessing school nurse readiness to use devices and identify areas to enhance knowledge and practical skills.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Diabetes Mellitus/therapy ; Insulin ; Surveys and Questionnaires ; Students
Chemical Substances	Insulin
Language	English
Publishing date	2023-02-24
Publishing country	Denmark
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1502504-4
ISSN	1399-5448 ; 1745-1426 ; 1399-543X
ISSN (online)	1399-5448
ISSN	1745-1426 ; 1399-543X
DOI	10.1155/2023/2162900
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