Diabetic Medicine最新文献

{"title":"Analysis of attitudes towards and experiences with physician Associates in Diabetes and Endocrinology from a survey of Association of British Clinical Diabetologists members.","authors":"Saika Hussain, Oliver Hope, Ketan Dhatariya, Kate Fayers, Vijay Jayagopal, Hermione Price","doi":"10.1111/dme.15493","DOIUrl":"https://doi.org/10.1111/dme.15493","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15493"},"PeriodicalIF":3.2,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of liver function tests for resolution of metabolic dysfunction-associated steatotic liver disease after weight loss in the Diabetes Remission Clinical Trial.","authors":"S V Zhyzhneuskaya, A H Al-Mrabeh, C Peters, A C Barnes, K G Hollingsworth, P Welsh, N Sattar, M E J Lean, R Taylor","doi":"10.1111/dme.15462","DOIUrl":"https://doi.org/10.1111/dme.15462","url":null,"abstract":"<p><strong>Aims: </strong>Ectopic fat is reduced by effective weight management, but difficult to assess clinically.</p><p><strong>Methods: </strong>We evaluated paired data on 42 participants in the intervention group of the Diabetes Remission Clinical Trial (DiRECT) at baseline, 12 and 24 months after weight loss as indicators of liver fat content measured by 3-point Dixon MRI.</p><p><strong>Results: </strong>Baseline liver fat was elevated at 13.0 [7.8-23.3]% with fasting plasma glucose 7.9 [7.1-10.1] mmol/L. Prevalence of baseline MASLD was 86.4%. After weight loss of 11.9 ± 1.2 kg (0-37 kg) at 12 months, remission of MASLD occurred in 74% and liver fat normalised for many (1.8 [1.2-5.2]%; p < 0.0001) as did fasting glucose (5.9 [5.5-7.2] mmol/L; p < 0.0001). Alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) decreased at 12 months by 38 [19-60]% (p < 0·0001) and 38 [16-53]% (p < 0.0001) respectively. The positive predictive value for decrease in liver fat, with baseline values of >40 IU/L, was 100% for ALT and 87.5% for GGT. As expected, change in liver fat correlated with change in ALT (r = 0.64; p < 0.0001), GGT (r = 0.38; p = 0.013), AST (r = 0.36; p = 0.018), fatty liver index (r = 0.50; p < 0.0001) and hepatic steatosis index (r = 0.44; p < 0.0001).</p><p><strong>Conclusion: </strong>Metabolic dysfunction-associated steatotic liver disease, an important marker of ill-health is improved by intentional weight loss. If enzyme levels are raised at baseline, following weight loss, changes in ALT and GGT usefully reflect change in liver fat content, with high positive predictive value. Monitoring liver enzymes can provide a simple way to assess change in liver fat following weight loss in day-to-day clinical practice.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15462"},"PeriodicalIF":3.2,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the shadows: A qualitative study of fathers' perspectives and experiences of their partner's gestational diabetes mellitus and its implications.","authors":"Madeleine Benton, Nabiha Waheed, Khalida Ismail","doi":"10.1111/dme.15488","DOIUrl":"https://doi.org/10.1111/dme.15488","url":null,"abstract":"<p><strong>Aims: </strong>Gestational diabetes mellitus (GDM) affects an increasing number of women each year. Research involving partners of women with GDM, such as fathers is limited, however, understanding their perspectives and involvement in GDM management could enhance health outcomes for both women and their families. This study aims to explore the impact and experiences of GDM on fathers in the perinatal period.</p><p><strong>Methods: </strong>Qualitative, individual, semi-structured interviews were conducted with individuals whose partners either currently had GDM or had been diagnosed with GDM within the past 3 years. All participants identified as biological fathers. Data were transcribed and analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Nine fathers participated in the study. Analysis resulted in four themes that explored fathers' experiences of GDM during the perinatal period: 'navigating a GDM diagnosis', 'partnering in management and health', 'finding a place within the GDM journey' and 'the lasting impact of GDM'.</p><p><strong>Conclusion: </strong>Fathers encountered wide-ranging impacts of their partners' GDM. Fathers provided both practical and emotional support to their partners. Engaging fathers in discussions at diagnosis and in management could facilitate the maintenance of positive health behaviour changes postpartum, potentially reducing the risk of type 2 diabetes for both parents.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15488"},"PeriodicalIF":3.2,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucocorticoid treatment and new-onset hyperglycaemia and diabetes in people living with chronic obstructive pulmonary disease: A systematic review and meta-analysis.","authors":"Rajna Golubic, Hudson Mumbole, Mouhamad Hussein Ismail, Alwyn Choo, Olivia Baker, Karyna Atha, Sarah Chew Sue Mei, Arjun Raj, Preethu Anand, Nwe Oo Aung, Niraj S Kumar, Tulika Nahar, Ruth L Coleman, Jeremy W Tomlinson, Najib Rahman, Rishi Caleyachetty, Amanda Adler","doi":"10.1111/dme.15475","DOIUrl":"https://doi.org/10.1111/dme.15475","url":null,"abstract":"<p><strong>Introduction: </strong>In people living with chronic obstructive pulmonary disease (COPD), we aimed to estimate: (1) the prevalence of glucocorticoid-induced hyperglycaemia (GIH); (2) whether the prevalence of GIH varies by age, baseline diabetes status, treatment duration, ascertainment of glycaemia, definition of hyperglycaemia, study design and year of publication; and (3) the relative risk (RR) of new-onset hyperglycaemia in exposed vs non-exposed to systemic glucocorticoids.</p><p><strong>Methods: </strong>We searched electronic databases until 9 November 2023 for randomised controlled trials and observational studies including adults diagnosed with COPD, with or without diabetes at baseline, using systemic glucocorticoids equivalent to prednisolone ≥5 mg/day for ≥3 days if exposed. Hyperglycaemia was defined as a blood glucose above a study-specific cut-off. We extracted data on study and participant characteristics, exposure and outcome. We performed random-effects meta-analysis to calculate pooled prevalence estimate of GIH. Prevalence was expressed as the proportion of people who developed hyperglycaemia among all exposed to systemic glucocorticoids during follow-up. We calculated RR of new-onset hyperglycaemia in exposed vs non-exposed to systemic glucocorticoids from eight studies.</p><p><strong>Results: </strong>Of 25,806 citations, we included 18 studies comprising 3642 people of whom 3125 received systemic glucocorticoids and 1189 developed hyperglycaemia. Pooled prevalence of GIH was 38.6% (95%CI 29.9%-47.9%) with significant heterogeneity, I² = 96% (p < 0.010), which was partially explained by differences in study design. Pooled RR = 2.39 (95%CI 1.51-3.78). Publication bias was present.</p><p><strong>Conclusion: </strong>The prevalence of GIH was 38.6%. Being treated with systemic glucocorticoids for COPD was associated with 2.4 times higher risk of new-onset hyperglycaemia versus no glucocorticoid treatment.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15475"},"PeriodicalIF":3.2,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for a feasibility and acceptability study for UK general population paediatric type 1 diabetes screening-the EarLy Surveillance for Autoimmune diabetes (ELSA) study.","authors":"Lauren M Quinn, Renuka P Dias, Sheila M Greenfield, Alex G Richter, Joanna Garstang, David Shukla, Animesh Acharjee, Georgios Gkoutos, Richard Oram, Sian Faustini, Olga Boiko, Ian Litchfield, Felicity Boardman, Fatima Zakia, Christine Burt, Clair Connop, Amanda Lepley, Christine Gardner, Colin Dayan, Tim Barrett, Parth Narendran","doi":"10.1111/dme.15490","DOIUrl":"https://doi.org/10.1111/dme.15490","url":null,"abstract":"<p><strong>Aim: </strong>The EarLy Surveillance for Autoimmune (ELSA) study aims to explore the feasibility and acceptability of UK paediatric general population screening for type 1 diabetes.</p><p><strong>Methods: </strong>We aim to screen 20,000 children aged 3-13 years for islet-specific autoantibodies through dried blood spot sample collection at home, hospital or community settings. Children with two or more autoantibodies are offered metabolic staging via oral glucose challenge testing. Feasibility assessments will compare recruitment modalities and uptake according to demographic factors (age, gender, ethnicity, level of deprivation and family history of diabetes) to determine optimal approaches for general population screening. The study is powered to identify 60 children (0.3%) with type 1 diabetes (stage 1-3). Parents are invited to qualitative interviews following ELSA completion (child screened negative or positive, single autoantibody or multiple, stage 1-3) to share their screening experience, strengths of the programme and any areas for improvement (acceptability assessments). Parents who decline screening or withdraw from participation are invited to interview to explore any concerns. Finally, we will interview professional stakeholders delivering the ELSA study to explore barriers and facilitators to implementation.</p><p><strong>Conclusion: </strong>Early detection of type 1 diabetes allows insulin treatment to be started sooner, avoids diagnosis as an emergency, gives families time to prepare and the opportunity to benefit from future prevention trials and treatments. ELSA will provide essential feasibility and acceptability assessments for UK general population screening to inform a future national screening programme for paediatric type 1 diabetes.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15490"},"PeriodicalIF":3.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding inequities in access to diabetes technologies in children and young people with type 1 diabetes: Qualitative study of healthcare professionals' perspectives and views.","authors":"Rachel Dlugatch, David Rankin, Mark Evans, Nick Oliver, May Ng, Julia Lawton","doi":"10.1111/dme.15486","DOIUrl":"https://doi.org/10.1111/dme.15486","url":null,"abstract":"<p><strong>Aims: </strong>We explored healthcare professionals' perceptions and understandings of the factors and considerations underlying inequities in technology access in children and young people (CYP) with type 1 diabetes.</p><p><strong>Methods: </strong>We interviewed (n = 29) healthcare professionals working in paediatric diabetes in England recruited from (n = 15) purposively selected sites. We analysed data thematically.</p><p><strong>Results: </strong>Interviewees highlighted multiple, often overlapping barriers to accessing technology faced by CYP with type 1 diabetes from deprived and/or ethnic minority backgrounds. They described the impacts of deprivation on technology uptake, together with the complex social, ethnic and cultural factors that could also reinforce disparities in technology access. Interviewees further highlighted staffing shortfalls as a significant barrier to supporting CYP to use technology, especially those from under-represented groups who they perceived as requiring more staff time to be trained to use technology. While interviewees suggested that unconscious bias has become less prominent, they reported being less likely to recommend technology (especially pumps) to CYP/caregivers who they feared would not use it safely and effectively (e.g. those with low literacy levels). Interviewees also highlighted geographical variability in the technology commissioning process (a 'postcode lottery').</p><p><strong>Conclusions: </strong>Our findings suggest that without targeted interventions, technology inequities may continue to persist amongst CYP from the most and least deprived areas and from white and ethnic minority groups in the United Kingdom. Additionally, our findings suggest that closing the technology gap will require large-scale governmental and health policies aimed at fostering socioeconomic, ethnic and cultural equality alongside targeted measures to improve technology accessibility.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15486"},"PeriodicalIF":3.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the lived experience of women with gestational diabetes: A cross-sectional Irish national survey.","authors":"Pauline Dunne, Louise O'Mahony, Linda Culliney, Molly Byrne, Andrew W Murphy, Sharleen O'Reilly","doi":"10.1111/dme.15489","DOIUrl":"https://doi.org/10.1111/dme.15489","url":null,"abstract":"<p><strong>Aim: </strong>Gestational diabetes (GDM) poses risks of short- and long-term complications for mother and infant, emphasising the importance of antenatal and postpartum education and support. We aimed to understand the experiences and views of women with GDM in the Republic of Ireland.</p><p><strong>Methods: </strong>Women with current or previous GDM were invited to complete an online cross-sectional survey (April-June 2022). Recruitment utilised social media, local media and personal networks. The survey addressed demographics, GDM knowledge and experiences, breastfeeding and weight management during pregnancy and post-pregnancy GDM support needs. Descriptive statistics were conducted, and between-group comparisons were undertaken using the chi-square test. Content analysis was applied to free text data.</p><p><strong>Results: </strong>Amongst 231 respondents, most were aged 35-39 (42%); 70% experienced a single GDM pregnancy. Only 6% correctly identified their increased level of risk for developing type 2 diabetes. Under half (44.5%) of respondents reported sufficient time with health professionals to address GDM-related questions. Just over half (54.3%) reported attending for diabetes screening at 6-12 weeks postpartum. The majority (66%) expressed a desire for postpartum information, particularly on healthy eating and physical activity. Having a more recent GDM experience was associated with a stronger preference for weaning (p ≤ 0.001) and weight management information (p = 0.025). Qualitative analysis identified inconsistencies in healthcare messaging, significant concerns about a GDM diagnosis' impact on the pregnancy experience, and financial costs of diagnosis.</p><p><strong>Conclusions: </strong>The findings underscore women's desire for appropriate information and support during and after pregnancy with GDM. Future interventions should address these needs to effectively promote chronic disease prevention after GDM.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15489"},"PeriodicalIF":3.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental perspectives following the implementation of advanced hybrid closed-loop therapy in children and adolescents with type 1 diabetes and elevated glycaemia.","authors":"Sin-Ting Tiffany Lai, Sara E Styles, Alisa Boucsein, Yongwen Zhou, Venus Michaels, Craig Jefferies, Esko Wilshire, Martin I De Bock, Benjamin J Wheeler","doi":"10.1111/dme.15448","DOIUrl":"https://doi.org/10.1111/dme.15448","url":null,"abstract":"<p><strong>Aims: </strong>To identify from a parental perspective facilitators and barriers of effective implementation of advanced hybrid closed-loop (AHCL) therapy in children and adolescents with type 1 diabetes (T1D) with elevated glycaemia.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with parents of participants while in a post-trial extension phase of the CO-PILOT randomized controlled trial. The Capability, Opportunity, Motivation, Behaviour Model and Theoretical Domain Framework informed the interviews and framework analysis.</p><p><strong>Results: </strong>Eleven parents of 9 children and adolescents were interviewed. The median age of their children and adolescents was 14.2 years (IQR 13.3-14.7) with median HbA1c 78 mmol/mol (IQR 75-86) (9.3% IQR 9-10) before starting AHCL. Facilitators of implementing AHCL therapy included the following: (1) knowledge acquired from training, (2) establishing routines and action plans, (3) remote glucose monitoring, (4) achievement of glycaemic goals through automation, (5) children/adolescents' capability to use AHCL independently, (6) improved outcomes incentivized continued AHCL, (7) optimism about sustained improvements and (8) social support from healthcare providers, school staff, peers and parents. Barriers to AHCL implementation included the following: (1) challenges with device usability, (2) need for technical support, (3) forgotten knowledge and skills, (4) non-adherence to best practices, (5) negative social influences, (6) physical and psychosocial burden and (7) negative emotions.</p><p><strong>Conclusions: </strong>This study provides comprehensive insights into parental perspectives of influences on implementing AHCL therapy in children and adolescents with elevated glycaemia. As parents remain key partners in diabetes care, these findings inform successful implementation of AHCL and development of future diabetes technology.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15448"},"PeriodicalIF":3.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing a regional clinical service for people with early-onset type 2 diabetes in England.","authors":"Jonathan Goldney, Victoria Alabraba, Priscilla Sarkar, Harriet Morgan, Malak Hamza, Michael Skarlatos, Tommy Slater, Jack A Sargeant, Rhys O'Callaghan, Michelle Hadjiconstantinou, Julia Burdon, Azhar Farooqi, Samuel Seidu, Claire Meek, Melanie J Davies","doi":"10.1111/dme.15479","DOIUrl":"https://doi.org/10.1111/dme.15479","url":null,"abstract":"<p><strong>Aims: </strong>To design a regional clinical service for people with early-onset type 2 diabetes (EOT2D) in Leicester, Leicestershire and Rutland (England).</p><p><strong>Methods: </strong>A literature search was undertaken to identify important considerations. A working group of key stakeholders was formed to design a triage system and service pathway. Electronic medical records (EMRs) were searched (15th November 2023) to assess feasibility of the pathway and adapt accordingly.</p><p><strong>Results: </strong>A literature search identified important considerations: High risk of complications; large proportion from minority ethnic and socioeconomically deprived backgrounds; significant psychological burden; stigma and other social challenges; and misclassification and miscoding. Novel clinical risk criteria were developed, implementable in EMRs, to match intervention-intensity to clinical need. Specialist clinics were planned, one for people at the highest-clinical risk, another for women with adverse perinatal risk factors. A healthcare professional training package was developed to increase awareness of the unmet clinical needs of people with EOT2D and to upskill in provision of holistic care. Subsequent EMR searches supported the need for our service. Due to the large numbers with HbA1c ≥86mmol/mol (10.0%; n=299; 10.8% of total), these people were prioritised for clinic access. We opted for specialist nurse/educator support to practices with clustering of patients and to financially incentivise referrals from primary care into services.</p><p><strong>Conclusions: </strong>We showcase a service specifically for people with EOT2D based on the literature, a broad range of stakeholder involvement and utilising a locally-sourced data-driven approach. We further discuss areas for development and recommendations based on the challenges we encountered.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15479"},"PeriodicalIF":3.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explanatory variables of objectively measured physical activity, sedentary behaviour and sleep in adults with type 1 diabetes: A systematic review.","authors":"Lotte Bogaert, Eveline Dirinck, Patrick Calders, Simon Helleputte, Bruno Lapauw, Joke Marlier, Vera Verbestel, Marieke De Craemer","doi":"10.1111/dme.15473","DOIUrl":"https://doi.org/10.1111/dme.15473","url":null,"abstract":"<p><strong>Aims: </strong>This systematic review aimed to summarize knowledge on explanatory variables of PA, SB and sleep in adults with T1D to support the development of healthy lifestyle interventions.</p><p><strong>Methods: </strong>A systematic search of four databases (PubMed, Web of Science, Scopus and Embase) was performed. Only objective measurements of PA, SB and sleep were included and all explanatory variables were classified according to the socio-ecological model (i.e. intrapersonal, interpersonal, environmental and policy level). Risk of bias (ROB) (Joanna Briggs Institute appraisal checklists) and level of evidence (Evidence-Based Guideline Development) were assessed.</p><p><strong>Results: </strong>Twenty-one studies were included (66.7% low ROB). Most explanatory variables were situated at the intrapersonal level. A favourable body composition was associated with more time spent in total PA and moderate-to-vigorous PA (MVPA). Men with T1D spent more time in MVPA than women and a younger age was associated with increased MVPA. Barriers to PA were indeterminately associated with MVPA and HbA1c showed an indeterminate association with sleep. Explanatory variables of SB and light PA were not studied in at least two independent studies.</p><p><strong>Conclusion: </strong>This review underscores the focus on the individual level to identify explanatory variables of movement behaviours in adults with T1D, despite the necessity for a socio-ecological approach to develop effective interventions. More evidence on psychological, interpersonal and environmental variables is needed as these are modifiable.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15473"},"PeriodicalIF":3.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}