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  1. Article ; Online: Understanding Hypoglycemia in the Real World.

    Dickinson, Jane K / Litchman, Michelle L

    The science of diabetes self-management and care

    2022  Volume 48, Issue 4, Page(s) 270–280

    Abstract: Purpose: The purpose of this study was to gain a better understanding of real-world hypoglycemia experiences from people living with diabetes.: Methods: An exploratory cross-sectional study of a convenience sample of 374 English-speaking adults ... ...

    Abstract Purpose: The purpose of this study was to gain a better understanding of real-world hypoglycemia experiences from people living with diabetes.
    Methods: An exploratory cross-sectional study of a convenience sample of 374 English-speaking adults affected by diabetes using an online survey was conducted.
    Results: Participant mean age was 37 years with an average diabetes duration of 21 years. On average, participants reported feeling hypoglycemia at 64 mg/dL (3.6 mmol/L), worrying about hypoglycemia at 63 mg/dL (3.5 mmol/L), and treating hypoglycemia at 72 mg/dL (4 mmol/L). Terminology used by study participants did not match the current classifications of hypoglycemia used in clinical research. Participants who have been told they have hypoglycemia unawareness treat at a significantly lower level compared to those without hypoglycemia unawareness. Only 58% always carry hypoglycemia treatment; there was a relationship with increasing age and always carrying hypoglycemia treatment. Thirty-eight percent of participants treat hypoglycemia with the recommended 15 g of carbohydrate (CHO). Survey respondents who wore continuous glucose monitors reported using significantly less CHO to treat hypoglycemia.
    Conclusions: In the real world, experiences related to feeling, worrying about, and treating hypoglycemia trend higher than what is noted in the standardized hypoglycemia classifications. Study findings have implications for teaching and supporting people with diabetes who experience hypoglycemia. Consuming less CHO to treat hypoglycemia could lead to fewer episodes of rebound hyperglycemia and less weight gain. Increased support for continuous glucose monitoring is warranted.
    MeSH term(s) Adult ; Blood Glucose ; Blood Glucose Self-Monitoring ; Cross-Sectional Studies ; Diabetes Mellitus ; Humans ; Hypoglycemia/diagnosis
    Chemical Substances Blood Glucose
    Language English
    Publishing date 2022-06-04
    Publishing country United States
    Document type Journal Article
    ISSN 2635-0114
    ISSN (online) 2635-0114
    DOI 10.1177/26350106221102855
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Diabetes Identity: A Mechanism of Social Change.

    Walker, Heather R / Litchman, Michelle L

    Qualitative health research

    2021  Volume 31, Issue 5, Page(s) 913–925

    Abstract: Historically, diabetes identity has been examined at the individual level as it relates to clinical outcomes and self-management practices. Yet, identity is not experienced as an individually isolated phenomenon. The purpose of this study is twofold: (a) ...

    Abstract Historically, diabetes identity has been examined at the individual level as it relates to clinical outcomes and self-management practices. Yet, identity is not experienced as an individually isolated phenomenon. The purpose of this study is twofold: (a) examine the social meaning of
    MeSH term(s) Adult ; Diabetes Mellitus ; Humans ; Qualitative Research ; Self-Management ; Social Change
    Language English
    Publishing date 2021-01-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1275716-0
    ISSN 1552-7557 ; 1049-7323
    ISSN (online) 1552-7557
    ISSN 1049-7323
    DOI 10.1177/1049732320984740
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Feasibility and Acceptability of a Community-Developed Health Insurance and Financial Toolkit for Emerging Adults With Type 1 Diabetes.

    Blanchette, Julia E / Allen, Nancy A / Litchman, Michelle L

    The science of diabetes self-management and care

    2022  Volume 48, Issue 3, Page(s) 174–183

    Abstract: Purpose: The purpose of the study was to assess the feasibility and acceptability of a financial stress and health insurance education toolkit developed by a community advisory board for emerging adults, ages 18 to 25, with type 1 diabetes.: Methods: ...

    Abstract Purpose: The purpose of the study was to assess the feasibility and acceptability of a financial stress and health insurance education toolkit developed by a community advisory board for emerging adults, ages 18 to 25, with type 1 diabetes.
    Methods: This study is a longitudinal, randomized controlled trial that enrolled 39 emerging adults with type 1 diabetes. Participants randomized to the intervention group were given access to the T1D Financial Toolkit, an online financial and health insurance education toolkit, over 30 days. For the present analysis, feasibility was assessed by enrollment and attrition. Optional, qualitative interviews were conducted upon the conclusion of the intervention to evaluate feasibility, acceptability, satisfaction, and key recommendations for improvement.
    Results: Of the 39 participants who enrolled, 36 completed the study. The intervention period had 100% completion in both the control and intervention groups. Eleven participants from the intervention group completed interviews. Participants described few challenges accessing the toolkit and were highly satisfied with the intervention aesthetics, display, and content. Key recommendations included integrating more applied problem-solving into the experience of watching the videos.
    Conclusions: The T1D Financial Toolkit is a financial and health insurance education intervention tailored to emerging adults with type 1 diabetes. This resource is feasible, acceptable, and satisfactory. Diabetes care and education specialists can utilize this tool in practice to provide relevant, developmentally tailored education to emerging adults with type 1 diabetes, prompt applied problem-solving, reduce barriers to self-management, and improve psychosocial outcomes.
    MeSH term(s) Adolescent ; Adult ; Community-Based Health Insurance ; Diabetes Mellitus, Type 1/therapy ; Feasibility Studies ; Health Education ; Humans ; Self-Management ; Young Adult
    Language English
    Publishing date 2022-03-15
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ISSN 2635-0114
    ISSN (online) 2635-0114
    DOI 10.1177/26350106221087474
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Understanding Hypoglycemia in the Real World

    Dickinson, Jane K. / Litchman, Michelle L.

    The science of diabetes self-management and care. 2022 Aug., v. 48, no. 4

    2022  

    Abstract: The purpose of this study was to gain a better understanding of real-world hypoglycemia experiences from people living with diabetes. An exploratory cross-sectional study of a convenience sample of 374 English-speaking adults affected by diabetes using ... ...

    Abstract The purpose of this study was to gain a better understanding of real-world hypoglycemia experiences from people living with diabetes. An exploratory cross-sectional study of a convenience sample of 374 English-speaking adults affected by diabetes using an online survey was conducted. Participant mean age was 37 years with an average diabetes duration of 21 years. On average, participants reported feeling hypoglycemia at 64 mg/dL (3.6 mmol/L), worrying about hypoglycemia at 63 mg/dL (3.5 mmol/L), and treating hypoglycemia at 72 mg/dL (4 mmol/L). Terminology used by study participants did not match the current classifications of hypoglycemia used in clinical research. Participants who have been told they have hypoglycemia unawareness treat at a significantly lower level compared to those without hypoglycemia unawareness. Only 58% always carry hypoglycemia treatment; there was a relationship with increasing age and always carrying hypoglycemia treatment. Thirty-eight percent of participants treat hypoglycemia with the recommended 15 g of carbohydrate (CHO). Survey respondents who wore continuous glucose monitors reported using significantly less CHO to treat hypoglycemia. In the real world, experiences related to feeling, worrying about, and treating hypoglycemia trend higher than what is noted in the standardized hypoglycemia classifications. Study findings have implications for teaching and supporting people with diabetes who experience hypoglycemia. Consuming less CHO to treat hypoglycemia could lead to fewer episodes of rebound hyperglycemia and less weight gain. Increased support for continuous glucose monitoring is warranted.
    Keywords biomedical research ; cross-sectional studies ; diabetes ; glucose ; hyperglycemia ; hypoglycemia ; people ; surveys ; terminology ; weight gain
    Language English
    Dates of publication 2022-08
    Size p. 270-280.
    Publishing place SAGE Publications
    Document type Article
    ISSN 2635-0114
    DOI 10.1177/26350106221102855
    Database NAL-Catalogue (AGRICOLA)

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  5. Article ; Online: Perceptions of the Diabetes Online Community's Credibility, Social Capital, and Help and Harm: Cross-Sectional Comparison Between Baby Boomers and Younger Adults.

    Litchman, Michelle L / Edelman, Linda S

    JMIR aging

    2019  Volume 2, Issue 2, Page(s) e10857

    Abstract: Background: The use of online health communities such as the diabetes online community (DOC) is growing. Individuals who engage in the DOC are able to interact with peers who have the same medical condition. It is not known if older adults are ... ...

    Abstract Background: The use of online health communities such as the diabetes online community (DOC) is growing. Individuals who engage in the DOC are able to interact with peers who have the same medical condition. It is not known if older adults are perceiving the DOC differently compared with younger adults.
    Objective: The purpose of this study was to explore and understand how the DOC is perceived in terms of social capital, source credibility, and help and harm. The findings from this study will shed light on how users of different age groups (baby boomers and younger adult counterparts) perceive DOC use.
    Methods: This study represents a subset of participants from a larger study of DOC users. Baby boomers and younger adults with diabetes were recruited from the DOC to participate in a cross-sectional survey. Demographics, electronic health use (reasons to join the DOC, DOC intensity, DOC engagement, internet social capital, and help or harm from the DOC), source credibility, health-related quality of life, and diabetes self-care data were collected. We examined the differences between baby boomer and younger adult responses.
    Results: The participants included baby boomers (N=76) and younger adult counterparts (N=102). Participants scored their diabetes health care team (mean 33.5 [SD 8]) significantly higher than the DOC (mean 32 [SD 6.4]) with regard to competence (P<.05) and trustworthiness (diabetes health care team mean 36.3 [SD 7.1]; DOC mean 33.6 [SD 6.2]; P<.001). High bonding and bridging social capital correlated with high DOC intensity (r=.629; P<.001 and r=.676; P<.001, respectively) and high DOC engagement (r=.474; P<.01 and r=.507; P≤.01, respectively). The greater majority (69.8%) reported the DOC as being helpful, and 1.8% reported that the DOC had caused minor harm. Baby boomers perceived DOC credibility, social capital, help, and harm similarly to their younger adult counterparts.
    Conclusions: Baby boomers are using and perceiving the DOC similarly to younger adults. DOC users find the DOC to be credible; however, they scored their health care team higher with regard to competence and trustworthiness. The DOC is beneficial with low risk and may augment current diabetes care.
    Language English
    Publishing date 2019-09-26
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-7605
    ISSN (online) 2561-7605
    DOI 10.2196/10857
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Navigating Diabetes Online Communities in Clinical Practice.

    McLarney, Meghan / Litchman, Michelle L / Greenwood, Deborah / Drincic, Andjela

    Journal of diabetes science and technology

    2022  Volume 16, Issue 4, Page(s) 874–886

    Abstract: Objective: This purpose of this study was to conduct a rapid review and environmental scan of diabetes online communities (DOCs) to highlight the clinical impact of DOC engagement and provide guidance to health care providers for navigating and ... ...

    Abstract Objective: This purpose of this study was to conduct a rapid review and environmental scan of diabetes online communities (DOCs) to highlight the clinical impact of DOC engagement and provide guidance to health care providers for navigating and prescribing DOCs.
    Methods: This two-phase review included a rapid review of clinical outcomes and an assessment of DOC content. We conducted a literature search for studies evaluating DOC use and glucometric (glycated hemoglobin [A1C], time-in-range, hypoglycemia), behavioral, and psychosocial outcomes. The environmental scan of current DOC sites established key features, including available platforms, target population, content areas, and reach.
    Results: Twelve papers were included-eight reported DOC use within a context of do-it-yourself (DIY) noncommercial, opensource hybrid closed loop systems community and four were non-DYI related. In latter, all studies were cross-sectional, describing patient-reported outcomes. Two studies reported A1C lowering with DOC use, two DOC use was associated with high self-efficacy, one showed association with higher self-care levels, and one showed higher quality of life scores when compared with population norms. All DIY studies showed improvement in glucometrics after initiation of sensor augmented pump technology with DOC support. Of 54 DOC sites reviewed in the environmental scan, 29 were included. Diabetes online community sites were heterogenous in social media platform and type of diabetes targeted.
    Conclusion: Diabetes online communities have the potential to improve clinical, behavioral, and psychosocial outcomes. Randomized control trials and/or longitudinal prospective studies evaluating outcomes are needed to further examine the potential benefits of DOC use. Diabetes online communities are diverse and span a variety of social media platforms, providing clinicians opportunities to individualize recommendations for DOC use.
    MeSH term(s) Diabetes Mellitus/psychology ; Glycated Hemoglobin ; Humans ; Prospective Studies ; Quality of Life ; Self Care
    Chemical Substances Glycated Hemoglobin A
    Language English
    Publishing date 2022-02-05
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ISSN 1932-2968
    ISSN (online) 1932-2968
    DOI 10.1177/19322968211069409
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Equity in the Provision of Diabetes Self-Management Education and Support.

    Blanchette, Julia E / Aaron, Siobhan P / Allen, Nancy A / Litchman, Michelle L

    Diabetes spectrum : a publication of the American Diabetes Association

    2022  Volume 35, Issue 3, Page(s) 284–294

    Abstract: Diabetes self-management education and support (DSMES) interventions must be accessible to all people with diabetes. To address equity in the delivery of DSMES, interventions should consider the unique needs of various populations. This article outlines ... ...

    Abstract Diabetes self-management education and support (DSMES) interventions must be accessible to all people with diabetes. To address equity in the delivery of DSMES, interventions should consider the unique needs of various populations. This article outlines the needs of a wide range of populations, including people with diabetes who are racially or ethnically diverse; have limited English proficiency or literacy; are deaf or hard of hearing; are blind or have low vision; are neurodiverse; live with learning disabilities or intellectual or developmental disabilities; have dementia or cognitive impairment; or are of sexual and/or gender minority. The authors discuss how best to tailor DSMES to meet the needs of these diverse groups.
    Language English
    Publishing date 2022-08-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2211544-4
    ISSN 1040-9165
    ISSN 1040-9165
    DOI 10.2337/dsi22-0005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Limited Diabetes Education and Resources in American Sign Language.

    Litchman, Michelle L / Moreland, Christopher / Fagerlin, Angela / Kushalnagar, Poorna

    Diabetes spectrum : a publication of the American Diabetes Association

    2022  Volume 35, Issue 2, Page(s) 134–135

    Language English
    Publishing date 2022-05-13
    Publishing country United States
    Document type Editorial
    ZDB-ID 2211544-4
    ISSN 1040-9165
    ISSN 1040-9165
    DOI 10.2337/ds21-0091
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Continuous glucose monitoring with data sharing in older adults: A qualitative study.

    Allen, Nancy A / Grigorian, Ernest G / Mansfield, Kelly / Berg, Cynthia A / Litchman, Michelle L

    Journal of clinical nursing

    2023  Volume 32, Issue 19-20, Page(s) 7483–7494

    Abstract: Aims: This study examined the perceptions of the SHARE plus intervention and its effects on communication, collaboration, and involvement in day-to-day diabetes management in older adults with Type 1 diabetes (T1D) and their care partners.: Background! ...

    Abstract Aims: This study examined the perceptions of the SHARE plus intervention and its effects on communication, collaboration, and involvement in day-to-day diabetes management in older adults with Type 1 diabetes (T1D) and their care partners.
    Background: The SHARE plus intervention includes continuous glucose monitoring with a data sharing app that allows care partners to view glucose data on a smartphone and receive alerts. People with T1D and their care partners are educated about communication strategies, problem-solving strategies, and action planning when using glucose data sharing.
    Design: Qualitative descriptive design.
    Methods: Older adults with T1D wore a continuous glucose monitor for 3 months (n = 10). Care partners (n = 10) used a data-sharing app. The SHARE plus intervention consisted of one 90-min education session. Semi-structured interviews were conducted across 10 dyads (person with diabetes and care partner) following the 12-week study. A qualitative description and a constant comparison approach were used to examine similarities and differences in experiences. Interviews were transcribed, coded, and analysed for common themes. The manuscript adheres to COREQ EQUATOR checklist.
    Results: The SHARE plus intervention increased diabetes knowledge across the dyads, improving confidence and helping partners understand how to navigate symptoms and behaviours and when to intervene. Dyads worked together to optimise diabetes management through improved communication, collaboration, and management of disagreements. Although the majority of persons with diabetes and their care partners reported no conflictual communication, disagreements about diabetes management remained in some dyads. The SHARE plus intervention impacted care partners in various ways from a psychological perspective. While live-in-care partners felt peace of mind, care partners living away from persons with diabetes had some increased worry and concern.
    Conclusion: The SHARE plus intervention results can help guide future development of diabetes dyadic care and education interventions using diabetes technology.
    Relevance to clinical practice: The SHARE plus intervention is a brief, practical intervention that can help diabetes clinicians improve communication and collaboration among spouses living with older adults with T1D who use continuous glucose monitoring with data sharing.
    Patient contribution: A person with diabetes was part of the research team and assisted with design of the intervention and subsequent interviews and analysis.
    MeSH term(s) Humans ; Aged ; Blood Glucose ; Diabetes Mellitus, Type 1/psychology ; Blood Glucose Self-Monitoring/psychology ; Qualitative Research ; Information Dissemination ; Glucose
    Chemical Substances Blood Glucose ; Glucose (IY9XDZ35W2)
    Language English
    Publishing date 2023-06-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 1159483-4
    ISSN 1365-2702 ; 0962-1067 ; 1752-9816
    ISSN (online) 1365-2702
    ISSN 0962-1067 ; 1752-9816
    DOI 10.1111/jocn.16808
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Hispanic Diabetes Peer Facilitator Training Needs and Connections to Hispanics With Type 2 Diabetes.

    Allen, Nancy A / Litchman, Michelle L / Greenwood, Deborah A / Ng, Ashley / Sanchez-Birkhead, Ana

    Hispanic health care international : the official journal of the National Association of Hispanic Nurses

    2023  Volume 21, Issue 4, Page(s) 221–227

    Abstract: Introduction: ...

    Abstract Introduction:
    MeSH term(s) Humans ; Diabetes Mellitus, Type 2/therapy ; Diabetes Mellitus, Type 2/psychology ; Blood Glucose Self-Monitoring ; Qualitative Research ; Blood Glucose ; Peer Group ; Hispanic or Latino
    Chemical Substances Blood Glucose
    Language English
    Publishing date 2023-05-23
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ISSN 1938-8993
    ISSN (online) 1938-8993
    DOI 10.1177/15404153231175998
    Database MEDical Literature Analysis and Retrieval System OnLINE

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