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4. The impact of hypoglycaemia in children and adolescents with type 1 diabetes on parental quality of life and related outcomes: A systematic review

Author

Jensen, M.V., Broadley, M., Speight, J., Chatwin, H., Scope, A., Cantrell, A., Heller, S., Galan, B.E., Hendrieckx, C., and Pouwer, F.

Subjects
Parents, Quality of life, YOUNG-CHILDREN, STRESS, Adolescent, Endocrinology, Diabetes and Metabolism, Hypoglycemia/psychology, FEAR, systematic review, Internal Medicine, Humans, Prospective Studies, Child, pediatric diabetes, MOTHERS, Metabolic Disorders Radboud Institute for Molecular Life Sciences [Radboudumc 6], ADULTS, Hypoglycemia, Diabetes Mellitus, Type 1, Pediatrics, Perinatology and Child Health, Quality of Life, Diabetes Mellitus, Type 1/complications, BURDEN, EMOTIONAL DISTRESS, FATHERS, Parents/psychology
Abstract

Contains fulltext : 286877.pdf (Publisher’s version ) (Closed access) This systematic review aims to summarize and critically evaluate the current evidence regarding the impact of hypoglycaemia in children and adolescents with type 1 diabetes on parental quality of life. MEDLINE, PsycINFO, CINAHL, and the Cochrane Library were searched. Inclusion criteria were: 1) quantitative design, 2) included parents of children or adolescents with type 1 diabetes, 3) assessment of hypoglycemia in children/adolescents with type 1 diabetes, 4) assessment of parent quality of life (or related domains of life), and 5) analysis of the relationship(s) between the child's hypoglycaemia and parents' quality of life. The data were summarised in accordance with Synthesis Without Meta-Analysis Guidelines. Twelve studies were included, reporting data from 1895 parents across six countries. Ten studies were cross-sectional; two included prospective data. Evidence suggested that greater frequency and severity of hypoglycemia was associated with greater parental fear of hypoglycemia, emotional distress and family burden. Children's hypoglycaemia has a negative impact on the well-being of parents, but there is an absence of evidence regarding the impact on their overall quality of life. Research into the hypoglycaemia-specific quality of life of parents is needed to explore the impact on various areas, such as social and physical dimensions.

Published
2022

12. Changes in quality of life following hypoglycaemia in adults with type 2 diabetes: A systematic review of longitudinal studies

Author

Matlock, K.A., Broadley, M., Hendrieckx, C., Clowes, M., Sutton, A., Heller, S.R., de Galan, B.E., Pouwer, F., Speight, J., and Hypo-RESOLVE consortium

Abstract

Aim\ud \ud To conduct a systematic review of published studies reporting on the longitudinal impacts of hypoglycaemia on quality of life (QoL) in adults with type 2 diabetes.\ud \ud \ud Method\ud \ud Database searches with no restrictions by language or date were conducted in MEDLINE, Cochrane Library, CINAHL and PsycINFO. Studies were included for review if they used a longitudinal design (e.g. cohort studies, randomised controlled trials) and reported on the association between hypoglycaemia and changes over time in patient-reported outcomes related to QoL.\ud \ud \ud Results\ud \ud In all, 20 longitudinal studies published between 1998 and 2020, representing 50,429 adults with type 2 diabetes, were selected for review. A descriptive synthesis following Synthesis Without Meta-analysis guidelines indicated that self-treated symptomatic hypoglycaemia was followed by impairments in daily functioning along with elevated symptoms of generalised anxiety, diabetes distress and fear of hypoglycaemia. Severe hypoglycaemic events were associated with reduced confidence in diabetes self-management and lower ratings of perceived health over time. Frequent hypoglycaemia was followed by reduced energy levels and diminished emotional well-being. There was insufficient evidence, however, to conclude that hypoglycaemia impacted sleep quality, depressive symptoms, general mood, social support or overall diabetes-specific QoL.\ud \ud \ud Conclusions\ud \ud Longitudinal evidence in this review suggests hypoglycaemia is a common occurrence among adults with type 2 diabetes that impacts key facets in the physical and psychological domains of QoL. Nonetheless, additional longitudinal research is needed—in particular, studies targeting diverse forms of hypoglycaemia, more varied facets of QoL and outcomes assessed using hypoglycaemia-specific measures.

Published
2021

39. How 25 years of psychosocial research has contributed to a better understanding of the links between depression and diabetes

Author

Pouwer, F. and Pouwer, F.

Abstract

This narrative review of the literature provides a summary and discussion of 25 years of research into the complex links between depression and diabetes. Systematic reviews have shown that depression occurs more frequently in people with type 1 or type 2 diabetes compared with people without diabetes. Currently, it remains unclear whether depression is also more common in people with impaired glucose metabolism or undiagnosed type 2 diabetes compared with people without diabetes. More prospective epidemiological research into the course of depression and an exploration of mechanisms in individuals with diabetes are needed. Depression in diabetes is associated with less optimal self-care behaviours, suboptimal glycaemic control, impaired quality of life, incident micro- and macrovascular diseases, and elevated mortality rates. Randomized controlled trails concluded that depression in diabetes can be treated with antidepressant medication, cognitive-behavioural therapy (individual, group-based or web-based), mindfulness-based cognitive therapy and stepped care. Although big strides forward have been made in the past 25 years, scientific evidence about depression in diabetes remains incomplete. Future studies should investigate mechanisms that link both conditions and test new diabetes-specific web- or app-based interventions for depression in diabetes. It is important to determine whether treatment or prevention of depression prevents future diabetes complications and lowers mortality rates.

Published
2020

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