Carbohydrate intake is associated with time spent in the euglycemic range in patients with type 1 diabetes.

[Aims/Introduction]Greater glycemic variability and lack of predictability are important issues for patients with type 1 diabetes. Dietary factors are one of the contributors to this variability, but how closely diet is linked to glycemic fluctuation on a daily basis has not been investigated. We examined the association between carbohydrate intake and glycemic excursion in outpatients. [Materials and Methods]A total of 33 patients with type 1 diabetes were included in the analyses (age 44.5 ± 14.7 years, diabetes duration 15.1 ± 8.3 years, 64% female, 30% using insulin pump, glycated hemoglobin 8.1 ± 1.3%). Time spent in euglycemia (70–180 mg/dL), hyperglycemia (>180 mg/dL) and hypoglycemia (<70 mg/dL) of consecutive 48-h periods of continuous glucose monitoring data were collected together with simultaneous records of dietary intake, insulin dose and physical activity. Correlation analyses and multiple regression analyses were used to evaluate the contribution of carbohydrate intake to time spent in the target glycemic range. [Results]In multiple regression analyses, carbohydrate intake (β = 0.53, P = 0.001), basal insulin dose per kg per day (β = −0.31, P = 0.034) and diabetes duration (β = 0.30, P = 0.042) were independent predictors of time spent in euglycemia. Carbohydrate intake (β = −0.51, P = 0.001) and insulin pump use (β = −0.34, P = 0.024) were independent predictors of time spent in hyperglycemia. Insulin pump use (β = 0.52, P < 0.001) and bolus insulin dose per kg per day (β = 0.46, P = 0.001) were independent predictors of time spent in hypoglycemia. [Conclusions]Carbohydrate intake is associated with time spent in euglycemia in patients with type 1 diabetes

Social Orientation and Diabetes-Related Distress in Japanese and American Patients with Type 2 Diabetes

<div><p>Objective</p><p>Recent evidence in cultural and social psychology suggests Eastern cultures' emphasis on harmony and connection with others and Western cultures' emphasis on self-direction and autonomy. In Eastern society, relational harmony is closely linked to people's well-being. The impact of this cultural and social orientation on diabetes-related distress was investigated.</p><p>Research Design and Methods</p><p>Japanese and American patients with type 2 diabetes were surveyed by well-established questionnaire in Japan and in the United States, respectively. The association of personal values for interdependence, perceived emotional support, and the Problem Areas in Diabetes scale (PAID) were analyzed.</p><p>Results</p><p>A positive correlation between interdependence and PAID (<i>r</i> = 0.18; <i>P</i> = 0.025) and a negative correlation between perceived emotional support and PAID (<i>r</i> = − 0.24; <i>P</i> = 0.004) were observed after adjustments for other factors in Japanese data (<i>n</i> = 149), but not in American data (<i>r</i> = 0.00; <i>P</i> = 0.990, <i>r</i> = 0.02; <i>P</i> = 0.917, respectively, <i>n</i> = 50). In Japanese data, the three-factor structure of PAID (negative feelings about total life with diabetes, about living conditions with diabetes, and about treatment of diabetes) was identified, and interdependence showed significant positive correlations with the first and second factors and perceived emotional support showed significant negative correlations with all three factors of PAID.</p><p>Conclusions</p><p>These results suggest that personal values for interdependence may be linked to the level of diabetes-related distress and that the distress may be relieved by perception of emotional support, especially in an interdependent cultural context.</p></div

Characteristics of patients.

<p>Characteristics of patients.</p

Correlations between diabetes-related distress, interdependence and perceived emotional support.

<p>Correlations between diabetes-related distress, interdependence and perceived emotional support.</p

Distribution plots and Pearson's correlation coefficients to show the association between PAID and interdependence after adjusting for PES, self-esteem, sex, age and education level in Japanese (A) and Americans (B), between PAID and PES after adjusting for interdependence, self-esteem, sex, age and education level in Japanese (C) and Americans (D). PAID, the Problem Areas in Diabetes; PES, perceived emotional support.

<p>Distribution plots and Pearson's correlation coefficients to show the association between PAID and interdependence after adjusting for PES, self-esteem, sex, age and education level in Japanese (A) and Americans (B), between PAID and PES after adjusting for interdependence, self-esteem, sex, age and education level in Japanese (C) and Americans (D). PAID, the Problem Areas in Diabetes; PES, perceived emotional support.</p

Factor loadings of the 20 items of PAID for the three extracted factors after promax rotation in Japanese.

<p>Factor loadings of the 20 items of PAID for the three extracted factors after promax rotation in Japanese.</p