TY - JOUR
T1 - Barriers and Facilitators of Self-Management in Older People with Type 1 Diabetes
T2 - A Narrative Review Focusing on Cognitive Impairment
AU - Fonseca, Luciana Mascarenhas
AU - Schmidt, Juliana Janeiro
AU - Snoek, Frank J.
AU - Weinstock, Ruth S.
AU - Chaytor, Naomi
AU - Stuckey, Heather
AU - Ryan, Christopher M.
AU - van Duinkerken, Eelco
N1 - Publisher Copyright:
© 2024 Fonseca et al.
PY - 2024
Y1 - 2024
N2 - Over the past decades, life expectancy of people with type 1 diabetes has increased considerably, which brings potential challenges due to the process of aging. Cognitive aging and dementia, as well as reductions in visual acuity, hearing and dexterity, can influence the frequency and quality of daily self-management activities, including medication taking and insulin dosing, glucose self-monitoring, and healthy eating. This can increase the risk for hypo-and hyperglycemic events, which, in turn, may contribute to cognitive decline. Because there is a gap in understanding the barriers and facilitators of self-management in older adults with type 1 diabetes and the relationship to cognitive functioning, the authors 1) review the available literature on cognitive aging and type 1 diabetes, 2) describe what self-management in later adulthood entails and the cognitive functions required for effective self-management behaviors, 3) analyze the interaction between type 1 diabetes, cognition, aging, and self-management behaviors, and 4) describe the barriers and facilitators for self-management throughout the life span and how they may differ for older people. Potential evidence-based practices that could be developed for older adults with type 1 diabetes are discussed. There is need for further studies that clarify the impact of aging on T1D self-management, ultimately to improve diabetes care and quality of life.
AB - Over the past decades, life expectancy of people with type 1 diabetes has increased considerably, which brings potential challenges due to the process of aging. Cognitive aging and dementia, as well as reductions in visual acuity, hearing and dexterity, can influence the frequency and quality of daily self-management activities, including medication taking and insulin dosing, glucose self-monitoring, and healthy eating. This can increase the risk for hypo-and hyperglycemic events, which, in turn, may contribute to cognitive decline. Because there is a gap in understanding the barriers and facilitators of self-management in older adults with type 1 diabetes and the relationship to cognitive functioning, the authors 1) review the available literature on cognitive aging and type 1 diabetes, 2) describe what self-management in later adulthood entails and the cognitive functions required for effective self-management behaviors, 3) analyze the interaction between type 1 diabetes, cognition, aging, and self-management behaviors, and 4) describe the barriers and facilitators for self-management throughout the life span and how they may differ for older people. Potential evidence-based practices that could be developed for older adults with type 1 diabetes are discussed. There is need for further studies that clarify the impact of aging on T1D self-management, ultimately to improve diabetes care and quality of life.
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U2 - 10.2147/DMSO.S410363
DO - 10.2147/DMSO.S410363
M3 - Review article
C2 - 38872713
AN - SCOPUS:85196836278
SN - 1178-7007
VL - 17
SP - 2403
EP - 2417
JO - Diabetes, Metabolic Syndrome and Obesity
JF - Diabetes, Metabolic Syndrome and Obesity
ER -