OBJECTIVETo study the changes in cognitive function of children with type 1 diabetes and explore the possible factors influencing cognitive function.

METHODSThirty-two children with type 1 diabetes (disease course equal to or more than one year) and aged from 6 to 16 years, were enrolled in this study. Cognitive function was evaluated by the Chinese Wechsler Intelligence Scale. Factors influencing cognitive function were investigated using multiple regression analysis. Thirty-two age- and gender-matched healthy children served as the control group.

RESULTSVerbal intelligence quotient in the diabetic group was significantly lower than in the control group (97±15 vs 118±13; P<0.01). Full intelligence quotient in the diabetic group was also lower than in the control group (99±15 vs 113±12; P<0.01). In the verbal scale test, a sub-test of the Wechsler Intelligence Scale, scores in knowledge, category, comprehension, arithmetics and vocabulary scale in the diabetic group were significantly lower than in the control group (P<0.01). Multiple regression analysis showed that glycosylated hemoglobin level was significantly negatively with full, verbal and operation intelligence quotients in diabetic children (r=-5.64, -7.29, -3.00 respectively; P<0.05).

CONCLUSIONSType 1 diabetes may affect adversely children's verbal intelligence quotient, resulting in a decreased full intelligence quotient. Glycosylated hemoglobin may be an independent risk factor for cognitive function in diabetic children.

Adolescent ; Child ; Cognition ; Diabetes Mellitus, Type 1 ; psychology ; Female ; Humans ; Intelligence ; Male ; Regression Analysis

INTRODUCTIONDiabetes mellitus (DM) is a serious chronic illness that has a major impact on the quality of life of the individuals. Our aim was to examine the determinants of health-related quality of life (HRQOL) in patients with DM.

MATERIALS AND METHODSAdult outpatients attending a Diabetes Centre were recruited on consecutive basis between August 2006 and February 2007. Clinical data were collected from interviews with the subjects and from medical records. Assessment of depressive symptoms was done using the Center for Epidemiologic Studies Depression Scale (CES-D) and HRQOL using the Short Form 36 Health Survey (SF-36). A two-step regression analysis was conducted for identifying factors affecting patients' quality of life.

RESULTSFive hundred and thirty-seven patients participated in the study. The mean (SD) age of the participants was 54.7 (13.3) years and 315 (58.7%) were males. The prevalence of depressive symptoms was 31.1% (n = 167). After adjusting for other variables, the effects of depressive symptoms persisted for all the 8 domains of SF-36 (P <0.001 for all). The medical factors that were negatively associated with HRQOL were a diagnosis of Type 1 DM, duration of the illness of more than 10 years, HbA1c levels of ≥7%, and comorbidity of stroke and retinopathy. Being male and a regular exerciser had a positive effect on HRQOL.

CONCLUSIONThese findings highlight the importance of detecting and treating comorbid depression in DM.

Adult ; Aged ; Depression ; epidemiology ; physiopathology ; psychology ; Diabetes Mellitus, Type 1 ; epidemiology ; physiopathology ; psychology ; Diabetes Mellitus, Type 2 ; epidemiology ; physiopathology ; psychology ; Female ; Health Status ; Health Surveys ; Humans ; Interviews as Topic ; Male ; Medical Records ; Middle Aged ; Quality of Life ; Singapore ; epidemiology

PURPOSE: The purpose of this study was to describe the subjective happiness and satisfaction with life of children with type 1 diabetes and explore related factors. METHODS: A descriptive cross-sectional study design was used and the study was conducted with children at a diabetes camp. Data were collected using a self-report questionnaire to explore positive and negative psychological factors. The questionnaire included Subjective Happiness Scale, Satisfaction with Life Scale, Perceived Stress Scale and the Center for Epidemiological Studies Depression Scale for Children (CES-DC), Multidimensional Scale of Perceived Social Support, and General Self-Efficacy Scale. RESULTS: Data from 15 children were used for data analysis. The correlational analysis results showed that subjective happiness was positively correlated satisfaction with life, social support, and self-efficacy, and was negatively correlated with perceived stress. Satisfaction with life was positively correlated social support, and was negatively correlated with perceived stress. CONCLUSION: Results indicate that the positive psychology factors were closely related with social support and self-efficacy and may alleviate perceived stress and depressive feelings. Therefore, researchers and clinicians should include positive psychological factors in their health management model for children with chronic illness.
Child* ; Chronic Disease ; Cross-Sectional Studies ; Depression ; Diabetes Mellitus, Type 1 ; Happiness* ; Humans ; Psychology* ; Self Efficacy ; Statistics as Topic ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to describe the subjective happiness and satisfaction with life of children with type 1 diabetes and explore related factors. METHODS: A descriptive cross-sectional study design was used and the study was conducted with children at a diabetes camp. Data were collected using a self-report questionnaire to explore positive and negative psychological factors. The questionnaire included Subjective Happiness Scale, Satisfaction with Life Scale, Perceived Stress Scale and the Center for Epidemiological Studies Depression Scale for Children (CES-DC), Multidimensional Scale of Perceived Social Support, and General Self-Efficacy Scale. RESULTS: Data from 15 children were used for data analysis. The correlational analysis results showed that subjective happiness was positively correlated satisfaction with life, social support, and self-efficacy, and was negatively correlated with perceived stress. Satisfaction with life was positively correlated social support, and was negatively correlated with perceived stress. CONCLUSION: Results indicate that the positive psychology factors were closely related with social support and self-efficacy and may alleviate perceived stress and depressive feelings. Therefore, researchers and clinicians should include positive psychological factors in their health management model for children with chronic illness.
Child* ; Chronic Disease ; Cross-Sectional Studies ; Depression ; Diabetes Mellitus, Type 1 ; Happiness* ; Humans ; Psychology* ; Self Efficacy ; Statistics as Topic ; Surveys and Questionnaires

PURPOSE: The current study was aimed to investigate the transformational experience of a female student nurse living with type 1 diabetes. METHODS: A case study of a 24-year-old diabetes patient was conducted, with interviews concerning the evolving process she had lived through during the period from her later high school years to her graduation from nursing college. RESULTS: Followings were identified as 5-transformation process: With her diabetes-related limitation, the participant experienced 'conflict involving choosing a college and major'. The participant tried to be in charge of managing her diabetes and stepped forward to 'adaptation to college life as a new environment', and she learned more about the process of 'evolving awareness of caring' and developed herself further through the process of 'integration of the nurse identity into self-identity', and finally through the process of 'progression and preparation for getting a job' she achieved her goals, being positive about the future. CONCLUSIONS: The results of the study can provide individuals with diabetes a way of self-management and help the patients and their families in diabetes education. Further research will be needed to refine the results of this study and to learn more about the experiences of patients with type I diabetes in college years.
*Adaptation, Psychological ; Adult ; Career Choice ; Conflict (Psychology) ; Diabetes Mellitus, Type 1/*psychology ; Empathy ; Female ; Humans ; Job Application ; Korea ; Social Identification ; Students, Nursing/*psychology

This article reviews the clinical and experimental researches on cognitive impairment related to diabetes in the recent decade. Most clinical studies indicate that the cognitive impairment in patients with type 1 diabetes mellitus is related to recurrent hypoglycemia closely. There is little research about whether or not hyperglycemia is related to cognitive impairment in patients with type 1 diabetes mellitus. Most studies indicate that the cognitive impairment in type 2 diabetes involves multiple factors through multiple mechanisms, including blood glucose, blood lipid, blood pressure, level of insulin, medication, chronic complication, etc. But, there has been no large-scale, multi-center, randomized controlled clinical trial in China recently. And what is more, some problems exist in this field of research, such as the lack of golden criterion of cognitive function measurement, different population of studied objects, and incomprehensive handling of confounding factors. Experimental studies found that hippocampal long-term potentiation (LTP) was impaired, which were manifested by impairment of spatial memory and decreased expression of LTP, but it's relation to hyperglycemia, the duration of diabetes, learning and memory has always been differently reported by different researches. Thus, there are a lot of unknown things to be explored and studied in order to clarify its mechanism. TCM has abundant clinical experience in treating cerebral disease with medicine that enforces the kidney and promotes wit. However, there has been no research on treating diabetic cognitive impairment, which requires work to be done actively and TCM to be put into full play, in order to improve the treatment of diabetes and enhance living quality of patients.
Animals ; Cognition Disorders ; etiology ; pathology ; physiopathology ; Diabetes Mellitus, Experimental ; pathology ; physiopathology ; psychology ; Diabetes Mellitus, Type 1 ; pathology ; physiopathology ; psychology ; Diabetes Mellitus, Type 2 ; pathology ; physiopathology ; psychology ; Drugs, Chinese Herbal ; therapeutic use ; Hippocampus ; pathology ; physiopathology ; Humans ; Hyperglycemia ; complications ; Hypoglycemia ; complications ; Long-Term Potentiation ; Neuronal Plasticity

PURPOSE: To examine the psychometric properties of a Turkish version of the Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ). METHODS: Forward-backward translation of the D-FISQ from English into Turkish was conducted. Original English and translated forms were examined by a panel group. Validity was investigated using content, confirmatory factor analysis, and divergent validity. Reliability was assessed using Cronbach α values, item-total correlations, and intraclass correlations. The sample comprised 350 patients with diabetes. Data were analyzed using SPSS 15.0 for Windows and LISREL 8. RESULTS: The content validity index for the panel members was .90, which indicated perfect content validity; items in D-FISQ were clear, concise, readable, and distinct. Confirmatory factor analysis confirmed the original construct of the D-FISQ. All items had factor loadings higher than the recommended level of .40. The D-FISQ scores were discriminated by the level of anxiety. Reliability results were also satisfactory. Cronbach α values were within ideal limits. Item-total correlation coefficient ranged from .72 to .86. In terms of test-retest reliability, intraclass correlation coefficient was found to be over .90. CONCLUSIONS: D-FISQ is a valid and reliable questionnaire in assessing needle-prick fear among Turkish patients with diabetes. We recommend performing the Turkish D-FISQ in determining and screening patients with diabetes who have fear related to self-insulin injection and finger-prick test. Thus, health care professionals should be aware of the potential consequences of injection fear such as insulin misuse and poor self-monitoring of blood glucose, which may have unfavorable effects on optimal diabetes management.
Anxiety/etiology ; Blood Glucose Self-Monitoring/psychology ; Diabetes Mellitus, Type 1/drug therapy/*psychology ; Diabetes Mellitus, Type 2/drug therapy/*psychology ; *Fear ; Female ; Humans ; Hypoglycemic Agents/administration & dosage ; Injections/psychology ; Insulin/administration & dosage ; Male ; Middle Aged ; Psychometrics ; Reproducibility of Results ; Self Care/psychology ; Surveys and Questionnaires/standards ; Translations ; Turkey

INTRODUCTIONThe Diabetes Health Profile-18 (DHP-18) measures diabetes-related psychological well-being in patients with type 2 diabetes mellitus (T2DM). It includes 3 subscales: psychological distress (PD), barriers to activity and disinhibited eating. The psychometric properties of the DHP have not been evaluated in Asia. The aim of this study was to determine the psychometric properties of the DHP in multiethnic Singapore.

MATERIALS AND METHODSPatients between the ages of 18 to 65 diagnosed with diabetes (either type 1 or type 2) for at least 1 year were recruited from a diabetes outpatient clinic in a tertiary hospital. They completed a set of self-administered questionnaires including sociodemographic information and the DHP. Validity of the DHP was evaluated using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Reliability was assessed with internal consistency and sensitivity was determined by effect size, associated with detecting a statistically significant and clinically important difference between various patient subgroups.

RESULTSA total of 204 patients with mean age 45.4 (11.9) years, comprising 64% males and 50% Chinese, 27% Indian and 12% Malay were studied. In CFA, model fit was poor. Forced 3-factor EFA supported the original 3-factor structure of the DHP. Convergent and discriminant validity was demonstrated (100% scaling success). DHP was sensitive across majority of social demographic, clinical and social-functioning determinants (i.e., effect size >0.3). Cronbach's alpha exceeded 0.70 for all subscales. Ceiling effects were negligible but large floor effects were seen for the PD subscale (23%).

CONCLUSIONThe DHP is valid, reliable and sensitive for measuring well-being in Asian patients with T2DM.

Adolescent ; Adult ; Aged ; Diabetes Mellitus, Type 1 ; psychology ; Diabetes Mellitus, Type 2 ; psychology ; Emotional Adjustment ; Ethnic Groups ; psychology ; statistics & numerical data ; Factor Analysis, Statistical ; Feeding Behavior ; psychology ; Female ; Humans ; Male ; Middle Aged ; Psychological Tests ; Psychometrics ; Reproducibility of Results ; Sensitivity and Specificity ; Singapore ; Stress, Psychological ; diagnosis ; etiology ; psychology ; Surveys and Questionnaires ; Young Adult