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Understanding antagonism and synergism: A qualitative assessment of weight management in youth with Type 1 diabetes mellitus.

ABSTRACT: Aims:No current clinical guidelines focus on weight management in youth with type 1 diabetes mellitus (T1DM). Our aim was to characterize the patient-perceived experience and barriers to weight management in youth with T1DM. Methods:Participants were recruited from the University of North Carolina (n = 16, 56% female, 60% White, 50% insulin pump users, mean age 14.8 years, mean HbA1c 8.5% (69 mmol/mol)) and the University of Colorado (n = 18, 50% female, 80% white, 53% pump users, mean age 15.3 years, mean HbA1c 9.3% (78 mmol/mol)). Focus groups were stratified by sex and weight status (BMI cutoff = 25). Discussions were guided by a standardized set of questions, audio-taped, transcribed, and analyzed thematically using inductive qualitative methods. Results:Youth with T1DM expressed four interrelated themes of antagonism between type 1 diabetes and weight management: dysregulated appetite, disruption of blood glucose levels associated with changing diet/exercise, hypoglycemia as a barrier to weight loss, and the overwhelming nature of dual management of weight and glycemic control, and two interrelated themes of synergism: improvement in shared, underlying heath behaviors and exercise as a tool for weight and glycemic control. Variation in emphasis of specific thematic elements was greatest across sex. Youth identified five major components of a weight management program for T1DM: intensified glucose management, healthy diet with known carbohydrate content, exercise, individualization and flexibility, and psychosocial and peer support. Conclusions:There is critical need for personalized, T1DM-specific weight recommendations to overcome disease-specific barriers to weight management in the context of T1DM.

SUBMITTER: Kahkoska AR

PROVIDER: S-EPMC6034698 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Understanding antagonism and synergism: A qualitative assessment of weight management in youth with Type 1 diabetes mellitus.

Kahkoska Anna R AR Watts Madison E ME Driscoll Kimberly A KA Bishop Franziska K FK Mihas Paul P Thomas Joan J Law Jennifer R JR Jain Nina N Mayer-Davis Elizabeth J EJ

Obesity medicine 20180222

<h4>Aims</h4>No current clinical guidelines focus on weight management in youth with type 1 diabetes mellitus (T1DM). Our aim was to characterize the patient-perceived experience and barriers to weight management in youth with T1DM.<h4>Methods</h4>Participants were recruited from the University of North Carolina (n = 16, 56% female, 60% White, 50% insulin pump users, mean age 14.8 years, mean HbA1c 8.5% (69 mmol/mol)) and the University of Colorado (n = 18, 50% female, 80% white, 53% pump users, ...[more]

PMID: 29984330

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Understanding antagonism and synergism: A qualitative assessment of weight management in youth with Type 1 diabetes mellitus.

Publications

Understanding antagonism and synergism: A qualitative assessment of weight management in youth with Type 1 diabetes mellitus.

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