Impact of technology use in type 2 diabetes distress:A systematic review

BACKGROUND Diabetes distress is an important factor in treatment outcomes and results in poor behavioral and biological consequences.Technology has been used in management programs of diabetes to improve communication between patients and health care providers and to promote education about the disease and its psychological aspects,which can impact the self-efficacy of the programs.However,the true impact of technological approaches on the management of type 2 diabetes distress remains controversial.AIM To investigate the effectiveness of technology interventions on the management of type 2 diabetes distress.METHODS Studies published from 2014 to 2019 were searched in five databases:MEDLINE,PubMed,Library and Information Science Source,Academic Search Ultimate and PsycINFO.The Boolean logic search terms were:(1)T2Diabetes;(2)diabetes distress;and(3)technology OR mobile OR phone OR application OR web.We also systematically searched the reference lists of the included studies and relevant reviews.Randomized controlled trials with technology interventions,type 2 diabetes patients and diabetes distress as the outcome were selected.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed.RESULTS Of the 88 studies selected,nine full articles met the inclusion criteria and were subjected to final careful review.On the JADAD scale,one article was classified as having poor quality and eight as having good quality.Six out of nine articles showed that technology interventions had a positive impact on diabetes distress scale scores when compared with the initial data.Among the six articles,five showed a greater reduction in the diabetes distress scores from control interventions.Web-based interventions had good results when users received personalized feedback and routine caregiver support and attention.CONCLUSION Technology interventions can contribute positively to the management of type 2 diabetes distress,especially with a tailored approach in conjunction with caregiver interaction with patients.

The Outpatient Clinic Visit: Expectations and Fulfilment of Perceived Needs in Adolescents with Type 1 Diabetes

Background: To make outpatient visits for adolescents with diabetes successful, it is important for health care professionals to meet the adolescents’ needs and wishes. Aims: The aim is to investigate adolescents’ expectations of an outpatient diabetes clinic visit in comparison to what was deemed to be delivered and contrast this outcome in adolescents with self-reported high- and low-diabetes distress respectively. Methods: All adolescents in Sweden with type 1 diabetes, aged 15 to 18 years, were identified via The National Pediatric Diabetes Registry (SWEDIABKIDS) and asked to complete an online questionnaire regarding their expectations and the support received during the outpatient diabetes clinic visit. Results: 453 adolescents completed the survey. Boys’ expectations of discussion topics were mainly met while girls, especially those with diabetes distress, felt their discussion needs were not met regarding quality-of-life aspects. Conclusions: Although adolescents’ expectations are in general met during the diabetes outpatient clinic visit, aspects related to living with diabetes are not being met especially among female adolescents who reported diabetes distress. This study shows a gender difference both regarding expected discussion topics and what was deemed covered. Practice Implications: A multi-professional, individual person-centred care approach is needed at the diabetes outpatient clinic. This paper proposes that agenda setting performed by the adolescent, and agreed by the physician, prior to the outpatient clinic visit could facilitate individualized care and better meet the adolescents’ needs in a shared decision-making process.