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BackgroundThe self-management of adults with type 2 diabetes proves to be a continuous challenge. Within the South African context, socio-economic disparities, unequal access to healthcare and varying healthcare beliefs augment these challenges. CBT is a time-sensitive and structured intervention that has been effectively implemented for chronic diseases. CBT has been employed to improve psychological outcomes in adults with type 2 diabetes, but there is limited research on how this therapeutic intervention can enhance self-management outcomes of type 2 diabetes. Adaptable CBT-based interventions are needed to promote a holistic approach to type 2 diabetes self-management and empower a broader range of healthcare professionals to provide targeted interventions. Flexible interventions can promote patient engagement and be integrated into various healthcare settings where patients already access services.MethodThe study employed document analysis to develop CBT-informed guidelines. Data was analysed by means of content analysis. Two research studies formed the dataset, and categories and subcategories were identified. The categories were integrated and used to develop the CBT-informed guidelines.ResultsThese guidelines were based on core CBT components and divided into the introduction, working, and consolidation phases. The guidelines specified the roles of healthcare practitioners who would implement them and provided skills and techniques for healthcare professionals and patients within each phase.ConclusionThe CBT-based interventions aimed to provide a tool for healthcare practitioners and patients in terms of flexibility, accessibility, and personalisation.

AimThis study aimed to obtain an in-depth understanding of the experiences of adolescents with well-controlled type 1 diabetes who were adjusting to closed-loop technology.MethodInterpretative Phenomenological Analysis (IPA) was conducted. Five participants (aged 15–18) were recruited from the Centre for Diabetes and Endocrinology in Parktown, South Africa, to participate in semi-structured interviews about their experiences of adjusting to closed-loop technology.ResultsFive superordinate themes emerged (1): learning to trust the technology (2), making diabetes visible (3), building a relationship with diabetes (4), empowering support networks, and (5) transformative positive outcomes. The findings demonstrate that closed-loop technology positively impacts the adjustment to living with type 1 diabetes. However, as highlighted by all participants, the individual’s engagement and management are crucial. Based on the adolescents’ experiences, interventions should focus on psychological factors.

Background: The impact of a sedentary and unhealthy lifestyle on cardiovascular health is well-documented, however the current obesity and hypertension trends among children is concerning. The ExAMIN Youth SA study aims to investigate the impact of lifestyle behaviors (physical fitness/activity, dietary intake and psychosocial factors) involved in early vascular aging among South African children.Methods: This study is an analytical, multidisciplinary, observational cohort study in a school-based setting. We aim to phenotype a cohort of ~1,000 primary school children (black and white boys and girls between ages 5–9 years) based on current clinical childhood conditions including hypertension and obesity. The primary phenotype is large artery stiffness and retinal microvascular diameters, both biomarkers of early vascular aging. The risk factors and mediators of early vascular aging and also responsible for the clinical conditions include physical inactivity, unhealthy diet, and life stress. Additionally, urinalysis and salivary analyses will be performed to identify biomarkers related to the pathophysiology of early vascular aging.Discussion: In line with the growing prevalence of obesity and hypertension responsible for the development of early vascular aging from childhood to adulthood, this study will address the critical areas in which we observe unfavorable arterial modulation related to dietary behaviors, physical inactivity, and early life stress. Implementation of novel biological markers may further contribute to our understanding of early cardiovascular adaptations in childhood, and aid in the development of primary prevention programs.Trial registration: The study was retrospectively registered on ClinicalTrials.gov on 15 August 2019 (NCT04056377).

AimAdolescents have been identified as the group who struggle most with successful adjustment to closed loop technology. This study aims to identify the psychological constructs that should form part of a positive psychology intervention to assist with the adjustment to closed loop technology among adolescents living with type 1 diabetes.MethodQualitative document analysis was employed to integrate findings from two documents: a published ongoing intervention study and a recent phenomenological study by the authors. Reflexive thematic analysis was used to identify themes from the documents.FindingsThe following themes were identified as important psychological constructs that aid adjustment: the importance of knowledge and education; the process of positive adjustment to closed loop technology; a positive outlook; and building a relationship with diabetes.ConclusionInterventions are needed to assist adolescents in their adjustment to closed loop technology. The psychological constructs identified served as a starting point in designing an effective, evidence-based intervention grounded in data and theory. Knowledge and education, responsibility, identity, positive affect, gratitude, support, and trust are psychological constructs that need to be included in an intervention program.

BackgroundThe association between illness perception and diabetes management has been well established in adults but is not clearly understood for adolescents. This article reflects on qualitative findings on illness perception from the perspective of adolescents, and suggests future research to operationalize findings.MethodsQualitative document analysis was conducted on four research projects forming part of the Smile with Diabetes project, which aims to investigate psychosocial variables in diabetes management, including illness perception, within the adolescent and youth populations. Thematic analysis was used to derive four themes from the qualitative and review studies examined in the document analysis.ResultsThe voices of the adolescents were evident as four prominent themes: 1) living with diabetes leads to a sense of being different; 2) integration of diabetes into identity is critical, but difficult to achieve; 3) fear of potential negative consequences motivates adherence to treatment; 4) diabetes management is difficult, but possible.ConclusionThe findings not only confirmed the importance of illness perception in the management of diabetes by adolescents, but also indicate that illness perceptions should be investigated from a developmental perspective, specifically taking identity development into consideration in this group. Adolescents should be made aware of how their thinking about diabetes and its management affects their experience of living with diabetes and its future management. This study further contributes to the literature by focusing on the patient’s voice in understanding living with a chronic condition, and reassures that positive outcomes are possible when living with a chronic condition such as diabetes.

AimThis study aimed to assemble and critically reflect on previously acquired insights from investigations that have already been conducted into the role of self-compassion in diabetes and its management.MethodsThis study implemented a rapid review approach to assess the pre-existing knowledge in a time-sensitive manner. A rapid review involves the synthesis of existing knowledge using a simplified systematic review process.ResultsA total of 16 articles were identified for this rapid review. The main findings from these articles included that self-compassion is associated with improved outcomes (psychologically and medically), self-compassion can be improved through interventions, and that many extraneous factors influence levels of self-compassion.ConclusionIt is apparent that self-compassion plays a rather significant role in the management of diabetes, and that interventions aimed at developing self-compassion showed success in improving health-related outcomes. It is suggested that future research should build on the possibility of using positive psychology interventions to improve the quality of life of those living with diabetes, and work to better understand the influence of aspects such as gender and diabetes duration on self-compassion.

Type 1 diabetes mellitus (T1DM) is a chronic and lifelong condition that requires adequate behavior management in order to meet desired health outcomes. The effects of T1DM on the neurocognitive functioning of affected individuals raise concerns about how the disease may influence executive functioning. Inhibition is a core component of executive functioning, and plays a vital role in self-regulation and the restriction of impulsive behaviors. Inhibition may thus play a vital role in the behavior management of people with T1DM. The aim of this study was to identify current gaps in existing knowledge regarding the relationship between T1DM, inhibition, and behavior management. This study employed a critical review design to analyze and synthesize the current scientific literature. Twelve studies were identified through an appraisal process, and the data extracted were thematically analyzed and integrated. The findings of this study indicate that a possible cycle arises between these three constructs, in which T1DM affects inhibition, inhibition affects behavior management, and poor behavior management affects inhibition. It is recommended that future research should focus more specifically on this relationship.