Diabetic Family Members Research Articles

Exploring typologies of appraisals, involvement, and distress in type 2 diabetes family members.

The present study conducted a latent profile analysis from a US national sample of 446 family members to identify and predict unique clusters of family members' PWD illness appraisals, involvement, and psychological distress. Time since diagnosis, diabetes adherence, the relationship with the PWD, age, gender, race/ethnicity, income, and economic pressure were included as predictors. Class membership was used to predict the family members' own health behaviors (sleep quality, days of physical activity, and diet quality). Results revealed four distinct classes: Moderately Concerned, Involved, and Distressed (32.51%), Least Concerned, Distressed, and Involved (27.13%), Less Concerned and Distressed, Moderately Involved (23.77%), and Most Concerned, Involved, and Distressed (16.82%). The significant predictors and outcomes of class membership revealed interesting patterns in associations with class membership. Consequently, in addition to involving family members, health promotion and intervention efforts must consider the psychological health and illness appraisals of family members rather than a one-size-fits-all approach.

An Investigation into the Information-Seeking Behavior of Egyptian Adult Patients with Type 2 Diabetes Mellitus (T2DM)

ABSTRACT This study purposes to investigate the information-seeking behavior of Egyptian adult patients with T2DM. A survey in the form of a semi-structured questionnaire was used. The study included 311 Egyptian adult patients with T2DM. Demographically, slightly more than half of the patients were males, older, educated, with an average monthly income ranging from 3501 to 4000 EGP, and were mostly married, representing a diverse range of professions. The patients accessed Diabetes-related information from their own homes, followed by visits to hospitals. This information is used moderately on a daily basis. The majority stated that the most important needs they have are information about the causes of diabetes, diet, diabetic exercise, and diabetic complications. Diabetes-related booklets/brochures/bulletins were the most popular printed sources among patients, followed by magazines/newspapers. The Internet/Web and social media were the most popular non-printed sources. Discussions with diabetic family members, diabetic relatives, and other diabetic patients were also used as personal/interpersonal sources. Patients were more interested in laboratory reports, doctor’s notes, and nurse’s notes. Privacy violations, a lack of understanding of information due to scientific terms, psychological issues, a lack of basic infrastructure, and a lack of health care providers were identified as significant barriers. This study, the first of its kind, investigates DM from an informational standpoint, with a focus on Egypt. There is an urgent need to conduct research on such patients’ information behaviour toward diabetes in terms of their perceptions, concerns, needs, habits, methods, tools, and the challenges they face during their treatment journey with this chronic disease.

The Magnitude, Types, and Roles of Social Support in Diabetes Management among Diabetics' in Southern Ethiopia: a Multilevel, Multicenter Cross-Sectional Study.

IntroductionLifelong medical management is the main intervention to reduce diabetes-related morbidities and premature deaths; yet, social support can be a vital intervention to improve diabetics’ health. Therefore, this study aimed to determine the magnitude, types, and role of social support in diabetes management in southern Ethiopia.MethodsA multi-stage systematic sampling was applied to recruit 634 adult diabetics from the three-tiered healthcare system in the region. We proportionally distributed the sample size between randomly selected ten health-care facilities across the hierarchy. Pretested questionnaires and checklist; Epi-Info, and SPSS software used for data collection; entry, and analyses, respectively, and the statistical significance was determined at a P-value ≤0.05.ResultsA total of 240 females and 356 males completed the study, and the overall magnitude of the social support was 50.20% [95% CI: 46.19%, 54.21%], and it was categorized into non-material and material with 44.13% [95% CI: 40.14%, 48.12%] and 34.23% [95% CI: 30.42%, 38.04%] magnitudes, respectively, and social support was left to the patients’ families and friends whereas formal institutions and the public sectors were rarely offering when the patients needed it. Though sex, educational level, and health-care hierarchy were not significantly associated with the social support, residence, some occupations, presence of diabetic family members, acute medical conditions, blood glucose level, compliance to medical follow-ups, treatment adherence, and taking anti-diabetic drugs a day before the current visit to health-care facility were all statistically significantly associated with social support.ConclusionOne of every two adult diabetic patients in southern Ethiopia was receiving any social support, and social support for diabetic people reduces medical follow-ups absenteeism, improves treatment adherence, glycemic level controlling, and helps lifestyle modifications. Therefore, to keep diabetic people healthy and achieve diabetes management goals, the Ethiopian healthcare system, institutions, and concerned stakeholders should strengthen the social support for diabetic patients.

Level of Knowledge and Awareness of Diabetic Emergencies Among Turkish Bus Drivers: Example of the Mediterranean Region

The objective of this research was to determine the level of knowledge and awareness of diabetic emergencies among Turkish bus drivers.
 Methods. The universe of this descriptive and cross-sectional study was all the individuals working as bus drivers in the Mediterranean Region between January-June 2019, and the study sample was 1292 drivers who met the inclusion criteria of the research. Data were collected by the Personal Information Form and the Diabetic Emergency Information and Awareness Survey Form. Descriptive statistics, the Mann-Whitney U test and the Kruskal-Wallis test were used in data evaluation.
 Results. The average age of bus drivers participating in the study was 38.29 ± 9.44 years, while their average work experience was 12.50 ± 8.92 years. Among them, 14.9% of bus drivers had a diabetic family member; 23.7% of bus drivers had a first aid certificate; 11.5% of bus drivers received diabetes-related training. The average score of drivers for the level of knowledge and awareness regarding diabetic emergencies was found to be 15.39 ± 4.72. There was a statistically significant difference between the drivers’ average scores for the level of knowledge and awareness and their age, education status, work experience, the presence of chronic disease, the presence of a diabetic family member, the presence of a first aid certificate, diabetes-related training, the place of receiving this training variables (p < 0.05).
 Conclusions. Bus drivers were found to have above average levels of knowledge and awareness of diabetic emergencies. Bus drivers are recommended to be trained on diabetic emergencies and raising awareness of diabetes mellitus to ensure a proper intervention in case of emergencies in individuals with diabetes mellitus during travels.

The barriers and facilitators of foot care practices in diabetic patients in Indonesia: A qualitative study.

AimTo investigate the barriers and facilitators of foot care practice in diabetic patients in Indonesia.DesignA qualitative content analysis with an inductive approach.MethodSemi‐structured interviews were conducted on 34 type 2 diabetes mellitus (T2DM) patients, health providers and family members in Purwokerto, Indonesia, between July 2020 and December 2020. The interview transcripts were coded using NVivo 12.ResultsFour themes emerged from data analysis, including personal barriers (low susceptibility of developing foot ulcer, limited knowledge about foot care, fatalistic practices, financial problems, glucose control taking priority over foot care, lack of motivation, lack of confidence, fear of being labelled), environmental barriers (lack of knowledge and time of health providers, lack of family support and climate conditions), perceived foot health benefits (intention to feel better and desire to stay socially active) and religious practices (foot washing as part of religious practice and intention to feel clean before praying).

Mapping T Cell Responses to Native and Neo-Islet Antigen Epitopes in at Risk and Type 1 Diabetes Subjects.

AimsRecent studies highlight the potentially important role of neoepitopes in breaking immune tolerance in type 1 diabetes. T cell reactivity to these neoepitopes has been reported, but how this response compares quantitatively and phenotypically with previous reports on native epitopes is not known. Thus, an understanding of the relationship between native and neoepitopes and their role as tolerance breakers or disease drivers in type 1 diabetes is required. We set out to compare T cell reactivity and phenotype against a panel of neo- and native islet autoantigenic epitopes to examine how this relates to stages of type 1 diabetes development.MethodsFifty-four subjects comprising patients with T1D, and autoantibody-positive unaffected family members were tested against a panel of neo- and native epitopes by ELISPOT (IFN-γ, IL-10, and IL-17). A further subset of two patients was analyzed by Single Cell Immune Profiling (RNAseq and TCR α/β) after stimulation with pools of native and neoepitope peptides.ResultsT cell responses to native and neoepitopes were present in patients with type 1 diabetes and at-risk subjects, and overall, there were no significant differences in the frequency, magnitude, or phenotype between the two sets of peptide stimuli. Single cell RNAseq on responder T cells revealed a similar profile in T1D patients stimulated with either neo- or native epitopes. A pro-inflammatory gene expression profile (TNF-α, IFN-γ) was dominant in both native and neoepitope stimulated T cells. TCRs with identical clonotypes were found in T cell responding to both native and neoepitopes.Conclusion/InterpretationThese data suggest that in peripheral blood, T cell responses to both native and neoepitopes are similar in terms of frequency and phenotype in patients with type 1 diabetes and high-risk unaffected family members. Furthermore, using a combination of transcriptomic and clonotypic analyses, albeit using a limited panel of peptides, we show that neoepitopes are comparable to native epitopes currently in use for immune-monitoring studies.

A family harboring an MLKL loss of function variant implicates impaired necroptosis in diabetes

Maturity-onset diabetes of the young, MODY, is an autosomal dominant disease with incomplete penetrance. In a family with multiple generations of diabetes and several early onset diabetic siblings, we found the previously reported P33T PDX1 damaging mutation. Interestingly, this substitution was also present in a healthy sibling. In contrast, a second very rare heterozygous damaging mutation in the necroptosis terminal effector, MLKL, was found exclusively in the diabetic family members. Aberrant cell death by necroptosis is a cause of inflammatory diseases and has been widely implicated in human pathologies, but has not yet been attributed functions in diabetes. Here, we report that the MLKL substitution observed in diabetic patients, G316D, results in diminished phosphorylation by its upstream activator, the RIPK3 kinase, and no capacity to reconstitute necroptosis in two distinct MLKL−/− human cell lines. This MLKL mutation may act as a modifier to the P33T PDX1 mutation, and points to a potential role of impairment of necroptosis in diabetes. Our findings highlight the importance of family studies in unraveling MODY’s incomplete penetrance, and provide further support for the involvement of dysregulated necroptosis in human disease.

Mitochondrial Diabetes: More Than Just Hyperglycemia.

Juvenile-onset diabetes is often branded as type 1 diabetes when a clear family history is absent. A high degree of suspicion regarding other forms of diabetes should be kept in mind when systems not known to be affected by hyperglycemia or associated with type 1 diabetes are involved. Such a scenario is often complicated by the slow evolution of symptomatology and the absence of diabetes in family members. Here, we report on a genetically proven mitochondrial A3243G mutation–related syndromic diabetes in a young patient whose mitochondrial disease–related multisystem symptomatology slowly evolved over the course of a decade. Our association with the patient started from his childhood (Figure 1). His first visit to our hospital was for short stature at the age of 9 years. Systemic work-up and growth hormone studies were normal. Familial factors were thought to be responsible. He was noted to have an IQ of 75, with poor performance in school. FIGURE 1. Chronology of symptoms in the patient. At the age of 16 years, he presented to us with diabetes without ketosis or a family history of diabetes. Tests for GAD65 and IA2 antibodies were negative at this stage. Although a trial of oral hypoglycemic agents was instituted, he was soon shifted to insulin therapy because of his poor response. Two years later, he presented with gastrointestinal symptoms in the form of intermittent diarrhea. Work-up for celiac disease and pancreatic insufficiency, including upper and lower endoscopies with biopsies, was normal. Fortunately, the diarrhea subsided, which was attributed by the family to dietary manipulation, especially restriction of wheat products. At around this time, sensorineural hearing loss was documented. The combination of these symptoms led to a consideration of mitochondrial diabetes. However, fundus evaluation for characteristic pigmentary changes was normal. Also around this …

Depression is associated with diabetes status of family members: NHANES (1999–2016)

BackgroundThe majority of the studies in this area focus on the psychological impact of having diabetic children or adolescents on parents, while a limited number of studies have investigated the effect of diabetes on the mental health status of family members in the general population. Thus, the aim of the current study is to explore the possible association between mental health disorders (depression, anxiety and panic) and diabetes status of family members among a national sample of adults in the United States. MethodsOur analysis included 1,787 and 25,574 participants in the National Health and Nutrition Examination Survey (NHANES) 1999–2004 and 2005–2016, respectively. Diabetes status of family members was self-reported by the participants, and depression was assessed using the Composite International Diagnostic Interview (CIDI) and the Patient Health Questionnaire-9 (PHQ-9) in NHANES (1999–2004) and NHANES (2005–2016), respectively. ResultsWith NHANES (1999–2004) participants, logistic regression indicated a marginally significant association between depression and diabetes status of family members after multivariable adjustment (P = 0.07), and trend analysis suggested that participants who had more diabetic family members were at a higher risk of depression (Ptrend < 0.01). We further validated these results using data from NHANES (2005–2016), which indicated diabetes status of family members was associated with both clinically relevant depression (PHQ-9 ≥ 10) and clinically significant depression (PHQ-9 ≥ 15) (P < 0.01). LimitationsThe information about the mental health status of family members and the exact role of participants in caring for diabetic patients was inadequate. ConclusionsA positive association between depression and diabetes status of family members was observed in the general population, suggesting that psychological interventions targeting the family members of diabetic patients are worthy of attention.

The Ahmedabad Declaration, 2018: the family and diabetes

The family is the basic social unit and should be taken as the basic unit of engagement and intervention in diabetes care as well. Family members not only contribute to diabetes care and support but are also prone to all effects arising from this. Shared genetic and environmental factors lead to a higher prevalence of diabetes in family members, and open a window of opportunity for diabetes prevention as well. The Ahmedabad Declaration of 2018, titled “The Family and Diabetes” has been released during the Annual Conference of the Research Society for Study of Diabetes India (RSSDI). It supports the theme of World Diabetes Day 2018–2019 and lends its voice towards strengthening the family in our quest for optimal diabetes control.

Barriers to diabetes awareness and self-help are influenced by people's demographics: perspectives of South Asians with type 2 diabetes

ABSTRACT Aim: To determine whether barriers to diabetes awareness and self-help differ in South Asian participants of different demographic characteristics (age, gender, and literacy) with type 2 diabetes living in the United Kingdom. Methods: Six focus group discussions (FGDs) were carried out in patients who were categorized according to age (30–60 years, ≥60 years), gender (male, female) and literacy status (literate, illiterate). Data were analysed following the iterative process of thematic analysis techniques. Results: Barriers were demographic-specific. The illiterate groups reported language as the major barrier to improved diabetes awareness and self-help. The literate groups reported that information provided by healthcare providers was general, and not specific to their diet/culture. Major barriers to adherence to the recommended diet for diabetes included: insufficient knowledge/awareness about nutritional content of food (all groups); lack of self-will to resist eating sweets, especially during weddings/festivals (literate older groups/literate younger females/illiterate older males); difficulty cooking separate meals for diabetic and non-diabetic family members (illiterate/literate older females). Other barriers to seeking advice/help ranged from not wanting to disclose their diabetes as it may affect employment/work (literate groups) to fear of being singled out at social gatherings (illiterate groups). General lack of motivation to exercise was reported by all groups. Time constraints and not knowing what/how to exercise was reported by literate younger groups whilst the illiterate older groups reported to not having suitable exercising facilities at local communities. Different barriers were also reported when accessing healthcare; language barriers (illiterate groups), restricted access to doctors’ appointments/difficulty attending specific appointment slots offered by General Practitioners (literate females). Conclusion: Different barriers exist to improved awareness about diabetes and self-help in different patient demographics. Lack of culturally appropriate diabetes educational/awareness programs in the community appeared to be a major barrier in most older and illiterate participants while younger participants reported time constraint.

Automated Insulin Delivery Systems: Hopes and Expectations of Family Members.

This study examines the hopes and expectations that children, adolescents, and adults with type 1 diabetes and their families have for new automated insulin delivery systems. The study also aims to examine how the automated insulin delivery system may impact family functioning and individual members' psychosocial adjustment. Forty-eight semistructured focus groups (n = 195) and 89 individual interviews were conducted with children, adolescents, and adults with type 1 diabetes and parents and partners. Coders reviewed results in key themes most likely to contain references to the family system. Clusters were analyzed using thematic analysis to identify participants' salient hopes and expectations of how new technology may impact family relationships and individual psychosocial functioning. Three main themes emerged for participants' hopes and expectations for implementation of the automated insulin delivery system. First, there is an expectation that this diabetes technology will alleviate diabetes-specific worry and burden for the people with diabetes and other family members. Second, there is also hope that this system may reduce day-to-day stress and, third, improve family relationships. The unique perspective of a broad age group provides insight into how individuals and families creatively address the multiple tasks required in daily diabetes management. Study findings elucidate the very high hopes and expectations held by those managing type 1 diabetes and the impact this new technology may have on family relationships. Awareness of these hopes and expectations is important for developers and clinicians in addressing potential challenges to uptake and to ensure that expectations are set appropriately.

The role of hypoglycemia in the burden of living with diabetes among adults with diabetes and family members: results from the DAWN2 study in The Netherlands

BackgroundTo examine the relation between self-reported hypoglycemic events, worries about these episodes, and the burden of diabetes in adults with diabetes and family members from The Netherlands.MethodsAs part of the second multinational Diabetes Attitudes, Wishes and Needs (DAWN2) study, 412 Dutch adults with type 1 or type 2 diabetes and 86 family members completed questions about the burden of living with diabetes, the frequency of hypoglycemia, worries about these events, and several demographic and clinical factors. Analyses included hierarchical logistic regression.ResultsIn total, 41% of people with diabetes and 56% of family members considered diabetes at least somewhat of a burden. In people with diabetes, diabetes burden was independently associated with self-reported current insulin use (fully adjusted OR = 2.75, 95% CI 1.49–5.10), self-reported frequent non-severe hypoglycemia in the past year (OR = 2.45, 1.25–4.83), self-reported severe hypoglycemia in the past year (OR = 1.91, 1.02–3.58), and being very worried about hypoglycemia at least occasionally (OR = 3.64, 2.18–6.10). For family members, the odds of experiencing living with diabetes as a burden was increased only for participants who were at least occasionally very worried about hypoglycemia (adjusted OR = 5.07, 1.12–23.00).ConclusionsApproximately half of adults with diabetes and adult family members experienced at least some diabetes burden. In both groups, diabetes burden appeared to be associated with being very worried about hypoglycemia at least occasionally. If these results are replicated, new intervention studies could test new ways of decreasing the traumatic consequences of previous or anticipated hypoglycemic events for people with diabetes and family members.

Epidemiologic study of familial Type 2 Diabetes in Tehran.

Type 2 diabetes is the most common cause of hyperglycemia. It has different prevalence in various populations. It has been found out that type 2 diabetes is a genetic disorder; however, its inheritance and its type have not been well defined. In studying the genes involved in the development of diabetes, several genes have been introduced as candidates; however, the gene or genes involved in diabetes cannot be identified yet. As family diabetes has not been studied in Iran so far, this study was conducted on a population aged over 20 years in east of Tehran. In a population of 14,687 people living in east of Tehran, 180 families with type 2 diabetes were identified. In this research, 802 subjects were female and 792 were male. After oral glucose tolerance test, 40.7% of females and 32.3% of males had diabetes. The incidence of diabetes in females was significantly higher than that in males (P < 0.001). It was found that 656 diabetic patients had age over 20 years, which most of them had age between 41 and 70 years. The highest number of diabetic patients was in the age group of 51–60 years. The percentage of offspring and siblings involvement in this sample was 44% and 53%, respectively. The highest level of involvement among the first-degree family members belonged to sister-brother, followed by father-daughter. This study shows the relationship between family diabetes in Iranian families in a demographic study. By recognizing the family relations, effective measures can be taken to prevent this disease. In the case of type 2 diabetes development in one member of family, the incidence of diabetes in other family members would increase by up to 50%. Thus, screening is suggested for all type 2 diabetic family members continuously so that the disease to be immediately diagnosed and treated to prevent major complications of diabetes.

Illness experiences of diabetes in the context of malaria in settings experiencing double burden of disease in southeastern Tanzania.

BackgroundTanzania is doubly burdened with both non-communicable and infectious diseases, but information on how Tanzanians experience the co-existence of these conditions is limited. Using Kleinman’s eight prompting questions the study synthesizes explanatory models from patients to describe common illness experiences of diabetes in a rural setting where malaria is the predominant health threat.MethodsWe conducted 17 focus group discussions with adult members of the general community, diabetes patients, neighbours and relatives of diabetes patients to gain insight into shared experiences. To gain in-depth understanding of the individual illness experiences, we conducted 41 in-depth interviews with malaria or diabetes patients and family members of diabetes patients. The analysis followed grounded theory principles and the illness experiences were derived from the emerging themes.ResultsThe illness experiences showed that malaria and diabetes are both perceived to be severe and fatal conditions, but over the years people have learned to live with malaria and the condition is relatively manageable compared with diabetes. In contrast, diabetes was perceived as a relatively new disease, with serious life-long consequences. Uncertainty, fear of those consequences, and the increased risk for severe malaria and other illnesses impacted diabetes patients and their families’ illness experiences. Unpredictable ailments and loss of consciousness, memory, libido, and functional incapability were common problems reported by diabetes patients. These problems had an effect on their psychological and emotional health and limited their social life. Direct and indirect costs of illness pushed individuals and their families further into poverty and were more pronounced for diabetes patients.ConclusionThe illness experiences revealed both malaria and diabetes as distressing conditions, however, diabetes showed a higher level of stress because of its chronicity. Strategies for supporting social, emotional, and psychological well-being that build on the patient accounts are likely to improve illness experiences and quality of life for the chronically ill patient.

How's Your Sugar? Evaluation of a Website for Aboriginal People With Diabetes.

BackgroundAustralia’s Aboriginal and Torres Strait Islander peoples (hereafter referred to as “Aboriginal people”) have the longest continuing culture in the world, living sustainably for at least 65,000 years on the Australian continent. In relatively recent times, colonization processes have resulted in Aboriginal people experiencing unacceptable health inequalities compared with other Australians. One disease introduced due to colonization is diabetes, the second leading cause of death for Aboriginal peoples.ObjectivesThe objective of this study was to describe the construction and utilization of the website “How’s Your Sugar, ” a website for Aboriginal people with type 2 diabetes (herein after referred to as diabetes). The questions for the evaluation were as follows: how was the website constructed; did target groups utilize the website; and did engagement with the website improve diabetes management.MethodsA mixed-method study design was employed. A content analysis of project documents provided information about the website construction. Data from Google analytics provided information about website utilization. To describe patterns of website sessions, percentages and numbers were calculated. A voluntary survey provided more information on website utilization and diabetes self-management. Percentage, numbers, and 95% CIs were calculated for each variable. A chi-square test was performed for Aboriginal status, age, gender, and Aboriginal diabetic status using Australian population estimates and Aboriginal diabetes rates.ResultsThe website development drew on Aboriginal health, social marketing, interactive health promotion frameworks, as well as evidence for diabetes self-management. The website build involved a multidisciplinary team and participation of Aboriginal diabetics, Aboriginal diabetic family members, and Aboriginal health workers. This participation allowed for inclusion of Aboriginal ways of knowing and being. The highest number of website sessions came from Australia, 98.15% (47,717/48,617) and within Australia, Victoria 50.97% (24,323/47,717). There were 129 survey respondents, and the distribution had more female, 82.9% (107/129, 95% CI 76-88), Aboriginal, 21.7% (28/129, 95% CI 16-30), and Aboriginal diabetic, 48% (13/27, 95% CI 31-66) respondents than expected with P<.001 for these three groups. Most common reasons for visits were university assignment research, 40.6% (41/101), and health workers looking for information, 20.8% (21/101). The sample size was too small to calculate diabetes self-management change.ConclusionsInclusion of Aboriginal ways of knowing and being alongside other theoretical and evidence models in Web design is possible. Aboriginal people do utilize Web-based health promotion, and further understanding about reaching to this population would be of use. Provision of an education resource would likely have enhanced educational engagement. Web-based technologies are rapidly evolving, and these can potentially measure behavior change in engaging ways that also have benefits for the participant. A challenge for designers is inclusivity of cultural diversity for self-determination.

A three-step programmed method for the identification of causative gene mutations of maturity onset diabetes of the young (MODY)

To establish a three-step programmed method to find gene mutations related to maturity onset diabetes of the young (MODY). Target region capture and next-generation sequencing (NGS) were performed using customized oligonucleotide probes designed to capture suspected genes for MODY in 11 probands with clinically diagnosed MODY. The suspected associations of certain genes with MODY were then confirmed by Sanger sequencing in the probands and their family members. Finally, to validate variants of one of the genes of interest (glucokinase, GCK) as pathogenic mutations, protein function editing by the variant genes was assessed. In the target region capture and NGS phase, a total of nine variants of seven genes (GCK, WFS1, SLC19A2, SH2B1, SERPINB4, RFX6, and GATA6) were identified in eight probands. Two heterozygous GCK mutations located on the same allele (p.Leu77Arg and p.Val101Met) were identified in a MODY family. Sanger sequencing was used to confirm the variants identified by NGS to be present in probands and their diabetic family members, but not in non-diabetic family members. Finally, enzyme kinetic and thermal stability analyses revealed that the p.Leu77Arg mutation or the p.Leu77Arg mutation in combination with the p.Val101Met mutation inactivates GCK function and stability, while mutation of p.Val101Met alone does not. The p.Leu77Arg but not p.Val101Met GCK mutation is therefore considered a pathogenic mutation associated with MODY. Genetic screening coupled with gene-editing protein function testing is an effective and reliable method by which causative gene mutations of MODY can be identified.

Educación terapéutica y autocuidado: resultados del estudio observacional transversal Diabetes Attitudes, Wishes and Needs 2 (DAWN2) en España

IntroductionTherapeutic education (TE) has been gradually introduced progressively into diabetes mellitus care programs with the aim of providing patients and their families or caregivers with the necessary skills for the self-management of the disease. The Diabetes Attitudes, Wishes and Needs 2 (DAWN2) study helps to clarify what are the unmet needs with regards to self-management and the TE offer available to patients and their families. The objective of this paper is to analyse the results of the DAWN2 study regarding self-care habits and participation in TE activities in Spain. MethodsThe DAWN2 is an observational, cross-national study. In this paper, an analysis was performed on the Spanish sample of diabetic patients (502) and family members (123). ResultsPatients report taking their medications as recommended by their doctor an average of 6.4 days/week, and self-monitor their blood glucose an average of 3.4 days/week. The large majority (86%) of patients with diabetes mellitus type 1, 59% of patients with diabetes mellitus type 2, and 21% of family members state to have participated in education activities. ConclusionsDiabetes educators should reinforce the messages about the benefits of self-care, particularly for patients who are in the early stages of the disease. Likewise, access for family members and people with diabetes mellitus type 2 to TE programs should be improved, and these programs for diabetic patients and their families should be included in the services portfolio of health centres.

Therapeutic education and self-care: Results from the cross-sectional study Diabetes, Attitudes, Wishes and Needs 2 (DAWN2) in Spain

Abstract Introduction Therapeutic education (TE) has been gradually introduced progressively into diabetes mellitus care programs with the aim of providing patients and their families or caregivers with the necessary skills for the self-management of the disease. The Diabetes Attitudes, Wishes and Needs 2 (DAWN2) study helps to clarify what are the unmet needs with regards to self-management and the TE offer available to patients and their families. The objective of this paper is to analyze the results of the DAWN2 study regarding self-care habits and participation in TE activities in Spain. Methods The DAWN2 is an observational, cross-national study. In this paper, an analysis was performed on the Spanish sample of diabetic patients (502) and family members (123). Results Patients report taking their medications as recommended by their doctor an average of 6.4 days/week, and self-monitor their blood glucose an average of 3.4 days/week. The large majority (86%) of patients with diabetes mellitus type 1, 59% of patients with diabetes mellitus type 2, and 21% of family members state to have participated in education activities. Conclusions Diabetes educators should reinforce the messages about the benefits of self-care, particularly for patients who are in the early stages of the disease. Likewise, access for family members and people with diabetes mellitus type 2 to TE programs should be improved, and these programs for diabetic patients and their families should be included in the services portfolio of health centers.

Health Beliefs Related to Diabetes Mellitus Prevention among Adolescents in Saudi Arabia.

The incidence of type 2 diabetes mellitus (T2DM) is growing rapidly in the Saudi population. The purpose of this study was to assess the constructs of the health belief model (HBM) as they relate to T2DM lifestyle and prevention behaviours among adolescents. A cross-sectional study was conducted between May and October 2013 among 426 non-diabetic secondary school students from randomly selected schools in Riyadh, Saudi Arabia. An Arabic version of an adapted English language questionnaire was used to assess knowledge and attitudes related to the severity and prevention of T2DM. A preventative behaviour assessment was also conducted to assess physical activity and dietary habits. The majority of the students (63.4%) had at least one diabetic family member. Obesity was more frequent in males compared to females (P = 0.013). Awareness about the importance of maintaining a healthy body weight to prevent T2DM was lower in males than females (P = 0.037), although males engaged in routine exercise more often (P = 0.001). Males were less likely than females to recognise the risks for T2DM, including obesity (P = 0.030), heredity (P = 0.013) and high fat intake (P = 0.001). An alarmingly high number of Saudi students were unaware of T2DM severity and associated risk factors. Female students were more aware of the benefits of T2DM preventative lifestyle behaviours than males, although males engaged in routine exercise more often. Raising adolescents' awareness about the primary prevention strategies for T2DM should be a public health priority in Saudi Arabia. The HBM could inform further research on diabetes prevention among Saudi adolescents.