Volume 26, Issue 4 (Avicenna Journal of Clinical Medicine-Winter 2020)                   Avicenna J Clin Med 2020, 26(4): 227-233 | Back to browse issues page

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Abstract:   (3259 Views)
Background and Objective: Type 1 diabetes is the most common metabolic and chronic disease in children and adolescents. This study aimed to evaluate the factors influencing diabetic control among adolescents with Type 1 diabetes.
Materials and Methods: This cross-sectional descriptive study was conducted on 205 patients aged 11-19 years with type 1 diabetes who referred to Endocrine Clinic of Besat Hospital, Hamadan, Iran, in 2019. The participants were selected based on a census sampling method and investigated in terms of factors affecting diabetic control. The data were analyzed in SPSS software (version 16). A p-value less than 0.05 was considered statistically significant.
Results: The mean age of the patients was 13.96±3.17 years, and 58% of the participants were female. Moreover, the mean values of diabetes duration and Hemoglobin A1c (HbA1c) were estimated at 5.71±3.16 years and 8.89±1.84%, respectively. Regarding treatment adherence, 35.2% of the patients had poor adherence. The prevalence rate of depression, anxiety, and stress were 51.2%, 72.2%, and 13.2% in patients, respectively. Poorly controlled diabetes based on HbA1c correlated significantly with father's unemployment status and poor family support. Furthermore, the status of diabetes control based on HbA1c level had a significant correlation with the scores of stress, anxiety, and depression. However, there was a negative and significant relationship between the status of diabetes control and the number of annual referrals to the clinic.
Conclusion: This study showed that anxiety, depression, and stress led to poor control in patients with type 1 diabetes. On the other hand, increased income and family support, as well as frequent visits to the clinic improved diabetic control.
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Type of Study: Original | Subject: Endocrine & Metabolism

1. Barnard KD, Lloyd CE, Holt RI. Psychological burden of diabetes and what it means to people with diabetes. Psychol Diabetes Care. 2012;2:1-22. DOI.org/: 10.1007/978-0-85729-573-6_1
2. Klein HA, Lippa KD. Assuming control after system failure: type II diabetes self-management. Cog Tech Work. 2012;14(3):243-51. DOI: 10.1007/s10111-011-0206-3
3. Michael V, Richard E, Hal B, Kligman H, Behrman A. Nelson text book of pediatrics. 18th ed. Philadelphia: Saundres Publishing; 2011. P. 2404-25.
4. Kermansaravi F, Navidian A, Ansarymoghadam A. Quality of life in type 1 diabetic adolescents in Zahedan. Iran J Endocrin Metab. 2011;13(6):651-7.
5. Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison’s principles of internal medicine. New York: McGraw-Hill; 2018. P. 2851-2.
6. d'Annunzio G, Accogli A, Tallone R, Bolloli S, Lorini R. Environmental factors and type 1 diabetes mellitus in pediatric age group. In: Stanilova S, editors. Genes and autoimmunity - intracellular signaling and microbiome contribution. Norderstedt, Germany: BoD–Books on Demand; 2013.
7. Morisky DE, Ang A, Krousel‐Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens. 2008;10(5):348-54. PMID: 18453793 DOI: 10.1111/j.1751-7176.2008.07572.x
8. Kooshyar H, Shoorvazi M, Dalir Z, Hosseini M. Health literacy and its relationship with medical adherence and health-related quality of life in diabetic community-residing elderly. J Mazandaran Univ Med Sci. 2014;23(1):134-43. [Persian]
9. Afzali A, Delavar A, Borjali A, Mirzamani M. Psychometric properties of DASS-42 as assessed in a sample of Kermanshah high school students. J Res Behav Sci. 2007;5(2):81-92.
10. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.
11. Mann DM, Ponieman D, Leventhal H, Halm EA. Predictors of adherence to diabetes medications: the role of disease and medication beliefs. J Behav Med. 2009;32(3):278-84. PMID: 19184390 DOI: 10.1007/s10865-009-9202-y
12. Liu YT, Lin LY, Tuan CW, Yang CY, Tang PL. Analyzing the association hba1c control by depression, social participation and utilizing self-management questionnaire. Diabetes Res Clin Pract. 2019;153:103-10. PMID: 31175913 DOI: 10.1016/j.diabres.2019.05.037
13. Schmitt A, Reimer A, Kulzer B, Haak T, Gahr A, Hermanns N. Negative association between depression and diabetes control only when accompanied by diabetes-specific distress. J Behav Med. 2015;38(3):556-64. PMID: 25326733 DOI: 10.1007/s10865-014-9604-3
14. Krass I, Schieback P, Dhippayom T. Adherence to diabetes medication: a systematic review. Diabetic Med. 2015;32(6):725-37. DOI: 10.1111/dme.12651
15. Razavi Z, Kaviani E, Fredmal J. Glycosylated hemoglobin and related factors in children with type 1 diabetes mellitus under 20 years of age. Acta Med Iran. 2018;56(8):516-21.
16. Nielsen NF, Gaulke A, Eriksen TM, Svensson J, Skipper N. Socioeconomic inequality in metabolic control among children with type 1 diabetes: a nationwide longitudinal study of 4,079 Danish children. Diabetes Care. 2019;42(8):1398-405. PMID: 31123155 DOI: 10.2337/dc19-0184
17. Travis K, Jones A, Lyons S, Desalvo DJ. Association between glycemic control and visits with diabetes care team in youth with type 1 diabetes. Am Diabetes Assoc. 2018;67(Suppl 1):159. DOI: 10.2337/db18-159-LB
18. Shulman R, Palmert MR, Daneman D. Glycemic control in Brazilian youth with type 1 diabetes. J Pediatr. 2009;85(6):467-8. PMID: 20016874 DOI: 10.2223/JPED.1954
19. Sargazi Shad T, Kermansaravi F, Navidian A. Effect of the family-centered empowerment model on quality of life and self-efficacy in adolescents with type 1 diabetes referring to the Ali Asghar’s clinic in Zahedan, 2016. Iran J Endocrin Metab. 2018;19(5):330-9.
20. Cutfield SW, Derraik JGB, Reed PL, Hofman CJ, Cutfield WS. Early markers of glycaemic control in children with type1 diabetes mellitus. PLoS One. 2011;6(9):e25251. PMID: 21966469 DOI: 10.1371/journal.pone.0025251

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