Characterization of youth goal setting in the self-management of type 1 diabetes and associations with HbA1c: The Flexible Lifestyle Empowering Change trial.
Characterization of youth goal setting in the self-management of type 1 diabetes and associations with HbA1c: The Flexible Lifestyle Empowering Change trial.
复制标题
青年 1 型糖尿病自我管理目标设定的特征及其与 HbA1c 的关联：灵活的生活方式赋权变革试验。
DOI：
10.1111/pedi.13099
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发表时间：
2020-11
影响因子：
3.4
通讯作者：
Mayer-Davis E
中科院分区：
文献类型：
--
作者：
Cristello Sarteau A;Crandell J;Seid M;Kichler JC;Maahs DM;Wang J;Mayer-Davis E
1型糖尿病（T1 D）青少年通常无法达到HbA 1c目标。以青年为导向的目标设定作为改善HbA 1c的策略尚未得到很好的表征，特定目标重点领域与血糖控制之间的关联仍未得到探索。为了为未来的试验提供信息，这项分析描述了青少年自我导向目标的预期重点领域，并检查了18个月内HbA 1c变化的相关性。我们对来自灵活生活方式授权改变干预中的青年（n = 122，13-16岁，T1 D持续时间>1年，HbA 1c 8-13%）的咨询会议数据进行了归纳编码，以分类预期的目标重点领域，并检查青年选择的目标重点领域的频率与第一次和最后一次研究访视之间HbA 1c变化之间的关联。我们确定了13个重点领域，对青年目标意图进行了分类。在青少年目标设定同时纳入血糖监测（BGM）、动态血糖监测（CGM）和胰岛素给药的每次会议中，干预结束时的HbA 1c降低了0.4%（95%CI：-0.77，-0.01; P = 0.03）参与。未观察到HbA 1c与目标意图仅关注BG（未涉及胰岛素或CGM）（β：0.07; 95% CI：−0.07，0.21; P = .33）或仅关注胰岛素给药（未涉及BGM或CGM）（β：0.00; 95% CI：−0.11，0.10; P = .95）的治疗频率之间存在关联。研究结果表明，如何指导青少年目标的发展，并结合多种行为密切相关的血糖控制到目标设定可能有利于青少年T1 D的HbA 1c。需要更多的研究来表征T1 D青年的最佳目标设定实践。
Youth with type 1 diabetes (T1D) commonly do not meet HbA1c targets. Youth-directed goal setting as a strategy to improve HbA1c has not been well characterized and associations between specific goal focus areas and glycemic control remain unexplored. To inform future trials, this analysis characterized intended focus areas of youth self-directed goals and examined associations with change in HbA1c over a 18 months. We inductively coded counseling session data from youth in the Flexible Lifestyle Empowering Change Intervention (n = 122, 13–16 years, T1D duration >1 year, HbA1c 8–13%) to categorize intended goal focus areas and examine associations between frequency of goal focus areas selected by youth and change in HbA1c between first and last study visit. We identified 13 focus areas that categorized youth goal intentions. Each session where youth goal setting concurrently incorporated blood glucose monitoring (BGM), continuous glucose monitoring (CGM), and insulin dosing was associated with a 0.4% (95% CI: −0.77, −0.01; P = .03) lower HbA1c at the end of intervention participation. No association was observed between HbA1c and frequency of sessions where goal intentions focused on BG only (without addressing insulin or CGM) (β:0.07; 95% CI: −0.07, 0.21; P = .33) nor insulin dosing only (without addressing BGM or CGM) (β: 0.00; 95% CI: −0.11, 0.10; P = .95). Findings exemplify how guiding youth goal development and combining multiple behaviors proximally related to glycemic control into goal setting may benefit HbA1c among youth with T1D. More research characterizing optimal goal setting practices in youth with T1D is needed.
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影响因子：
16.2
作者：
Chiang JL;Maahs DM;Garvey KC;Hood KK;Laffel LM;Weinzimer SA;Wolfsdorf JI;Schatz D
通讯作者：
Schatz D
影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
3.9
作者：
Beck, Joni;Greenwood, Deborah A.;Wang, Jing
通讯作者：
Wang, Jing
影响因子：
3.4
作者：
DiMeglio, Linda A.;Acerini, Carlo L.;Maahs, David M.
通讯作者：
Maahs, David M.
影响因子：
7.7
作者：
Moran, A;Jacobs, DR;Sinaiko, AR
通讯作者：
Sinaiko, AR