Psychological Factors in Evaluation and Treatment of Diabetes

Both type 1 and type 2 diabetes are increasing in incidence world-wide and being diagnosed at earlier ages. Despite advances in medical treatments and technologies, most patients do not attain optimal glycemic control, many are not on intensified insulin regimens, regimen adherence problems are common, and significant diabetes-related morbidity contributes to reduced quality of life, early mortality, and substantial heath care costs to society. This presentation summarizes research on psychological problems among adults with diabetes. Studies indicate that depression, anxiety, and eating disorders are common and associated with increased risk for metabolic control problems. Research also indicates that neurocognitive problems may develop in older adults with chronic poor glycemic control. Cognitive behavior therapy has been shown to improve outcomes for patients with psychological problems, and intervention research to increase patient empowerment has also demonstrated improved patient outcomes in terms of both quality of life and glycemic control. Future research needs and recommendations for clinical care are discussed. The patient-centered chronic care model is described as a skillful approach to increase the probability of successful management of psychological problems in adults with diabetes.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Bottle Size and Weight Gain in Formula-Fed Infants

Formula-fed infants may be at greater risk for overfeeding and rapid weight gain. Different size bottles are used for feeding infants, although little is known about whether bottle size is related to weight gain in bottle-fed infants

Psychometric Findings for a Spanish Translation of the Diabetes Self-Management Profile (DSMP-Parent-Sp)

OBJECTIVE: Few validated measures exist to evaluate self-management of diabetes in families with limited English proficiency. The present study evaluated the psychometric properties and the factorial equivalence of a Spanish translation of the parent report version of the Diabetes Self-Management Profile (DSMP-Parent-Sp). RESEARCH DESIGN AND METHODS: Hispanic families of youth (mean 13.7 years old) with type 1 diabetes were recruited from three clinics in South Florida and represented a wide range of nationalities and acculturation levels. A total of 127 parents reported on their child\u27s self-management behaviors using either the original DSMP-Parent (59.8%) or the DSMP-Parent-Sp (40.2%). In addition, youth reported their self-management using the original DSMP in English, and physicians rated their perceptions of the youth\u27s self-management. Glycemic control was indexed by A1C in the past 3 months and collected from medical chart review. RESULTS: Item analysis confirmed that the DSMP-Parent-Sp items related to the overall composite score in expected ways, and internal consistency estimates were adequate. Paired correlations demonstrated strong parent-child concordance and a significant relationship with physician perceptions of self-management. Evidence of concurrent and convergent validity, as well as strict factorial invariance, was demonstrated. CONCLUSIONS: These preliminary findings indicate that the DSMP-Parent-Sp is a reliable and valid parent report measure of the diabetes self-management behaviors of Hispanic youths. In addition, there is preliminary evidence that the translated measure may be considered equivalent to the original English measure when used to measure self-management in Hispanic youth with diabetes

Sex Differences in Associations of Adiposity Measures and Insulin Resistance in US Hispanic/Latino Youth: The Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth)

Context: US Hispanic/Latino youth are disproportionally affected by the obesity and diabetes. Objective: We examined associations of adiposity measures with insulin resistance (IR) and hyperglycemia and the influences of sex and pubertal development on these associations. Design, Setting, and Participants: We performed a cross-sectional analysis of 1223 8- to 16-year-old Hispanic/Latino youth from a community-based study in the United States (SOL Youth). Main Outcome Measures: We measured IR (≥75th percentile of sex-specific Homeostatic Model Assessment of Insulin Resistance) and hyperglycemia (fasting glucose ≥100 mg/dL or hemoglobin a1c ≥5.7%). Results: In boys, body mass index (BMI) showed the strongest association with IR [prevalence ratio (PR), 2.10; 95% confidence interval (CI), 1.87 to 2.36 per standard deviation], which was not statistically different compared with body fat percentage (%BF) (PR, 2.03; 95% CI, 1.81 to 2.29) and waist circumference (WC) (PR, 1.89; 95% CI, 1.67 to 2.13) but was significantly stronger compared with fat mass index (FMI) (PR, 1.79; 95% CI, 1.63 to 1.96), waist-to-hip ratio (WHR) (PR, 1.32; 95% CI, 1.21 to 1.44), and waist-to-height ratio (WHtR) (PR, 1.76; 95% CI, 1.54 to 2.01) (P for difference, <0.05). In girls, %BF (PR, 2.73; 95% CI, 2.34 to 3.20) showed a significantly stronger association with IR compared with BMI (PR, 1.48; 95% CI, 1.29 to 1.70), FMI (PR, 1.71; 95% CI, 1.49 to 1.95), WC (PR, 1.96; 95% CI, 1.70 to 2.27), WHR (PR, 1.95; 95% CI, 1.70 to 2.23), and WHtR (PR, 1.79; 95% CI, 1.53 to 2.09) (P for difference, <0.003). Associations between adiposity measures and IR were generally stronger among children in puberty versus those who had completed puberty, with significant interactions for WC and WHtR in boys and for BMI in girls (P for interaction, <0.01). Adiposity measures were modestly associated with hyperglycemia (PR, 1.14 to 1.25), with no interactions with sex or pubertal status. Conclusions: Sex and puberty may influence associations between adiposity measures and IR in US Hispanic/Latino youth. Multiple adiposity measures are needed to better assess IR risk between boys and girls according to pubertal status

Confirmatory factor analysis of the Infant Feeding Styles Questionnaire in Latino families

Parent feeding practices affect risk of obesity in children. Latino children are at higher risk of obesity than the general population, yet valid measure of feeding practices, one of which is the Infant Feeding Styles Questionnaire (IFSQ), have not been formally validated in Spanish

Sex Differences in Cardiometabolic Risk Factors among Hispanic/Latino Youth

To determine the prevalence of obesity and cardiometabolic risk in US Hispanic/Latino youth and examine whether there are disparities by sex in cardiometabolic risk factors

Patterns of Sedentary Time in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Youth

Accepted author manuscript version reprinted, by permission, from Journal of Physical Activity and Health, 2020, 18(1), 61-69, https://doi.org/10.1123/jpah.2020-0135. © Human Kinetics, Inc.Background: Total sedentary time and prolonged sedentary patterns can negatively impact health. This study investigated rates of various sedentary pattern variables in Hispanic/Latino youth. Methods: Participants were 956 youths (50.9% female) in the Hispanic Community Health Study/Study of Latinos Youth, a population-based cohort study of Hispanic/Latino 8- to 16-year-olds from 4 geographic regions in the United States (2012–2014). Total sedentary time and 10 sedentary pattern variables were measured through 1 week of accelerometer wear. Differences were examined by sociodemographic characteristics, geographic location, weekdays versus weekends, and season. Results: On average, youth were sedentary during 67.3% of their accelerometer wear time, spent 24.2% engaged in 10- to 29-minute sedentary bouts, and 7.2% in ≥60-minute bouts. 8- to 12-year-olds had more favorable sedentary patterns (less time in extended bouts and more breaks) than 13- to 16-year-olds across all sedentary variables. Sedentary patterns also differed by Hispanic/Latino background, with few differences across sex, household income, season, and place of birth, and none between weekdays versus weekends. Conclusions: Variables representing prolonged sedentary time were high among Hispanic/Latino youth. Adolescents in this group appear to be at especially high risk for unhealthy sedentary patterns. Population-based efforts are needed to prevent youth from engaging in increasingly prolonged sedentary patterns

Youth and Caregiver Physical Activity and Sedentary Time: HCHS/SOL Youth

We examined associations between youth and caregiver moderate/vigorous physical activity (MVPA) and sedentary (SED) time, using accelerometery, in the Hispanic Community Health Study/Study of Latino Youth (HCHS/SOL) Youth

Parental Perceptions of Weight During the First Year of Life

More than half of parents underestimate their overweight child’s weight; however, prior research focuses on children greater than 2 years of age. The objective of this study was to assess whether parents of 2–12month-old infants are able to accurately perceive their children’s weight status