ED is a failure to obtain/maintain penile erection sufficient for intercourse is more prevalent in men with diabetes and increases with age. It is important to distinguish erectile failure from premature ejaculation, decreased libido and other problems as these have different causes and treatment. ED in diabetes is largely due to failure of vascular smooth muscle relaxation secondary to endothelial dysfunction and/or autonomic neuropathy.
The reasons underpinning the considerable increase in incidence over the study period are unclear. This may reflect an actual change in the type 1 diabetes incidence in patients <15 yr. Alternatively, it may reflect an earlier age of onset without change in incidence over all ages, so that greater numbers of people are being diagnosed with type 1 diabetes in adolescence rather than in young adulthood. This would be consistent with the ‘accelerator hypothesis’, which suggests that an increasing rate of obesity is a primary driver for an earlier age of diabetes onset . Studies have shown an association between higher BMI and younger age at diagnosis , , , indicating greater adiposity in childhood may hasten the onset of diabetes mellitus. The ‘accelerator hypothesis’ predicts an early onset rather than increased risk , and a Swedish study examining type 1 diabetes incidence on a nation-wide cohort 0–34 yr showed a shift in age of onset towards younger ages, rather than an increase in incidence per se across the whole population . Although we cannot rule out a similar phenomenon in Auckland, we did not observe an increase in BMI SDS among children recently diagnosed with type 1 diabetes, or an association between BMI SDS and age at diagnosis. In fact, we observed an actual increase in age at diagnosis which is inconsistent with the ‘accelerator hypothesis’. Thus, our data suggest a true increase in the incidence of type 1 diabetes in the Auckland region, and not changes driven by increasing adiposity.
Patients were involved in all stages of the study, including the initial conceptualisation and formative work leading to the development of SMS4BG (for more information, see the development paper28). Patient feedback informed the intervention modality, purpose, and structure, and patients reviewed intervention content before it was finalised. Patient feedback on the acceptability of SMS4BG through the pilot study28 led to improvements to the intervention including additional modules, the option for feedback graphs to be posted, additional tailoring variables, and a longer duration of intervention. Patient feedback also informed the design of this trial—specifically its duration, the inclusion criteria, and recruitment methods. Additionally, patients contributed to workshops of key stakeholders held to discuss interpretation, dissemination of the findings, and potential implementation. We have thanked all participants for their involvement and they will be given access to all published results when these are made publicly available.
Clinical psychologists have studied psychology at University, usually for at least seven years. They have specialised in learning about how the feelings, actions, beliefs, experiences and culture of people affect the way they live. They have learned how to listen to and understand people’s emotional and psychological problems and how to help people make changes in their lives.
Sexual problems are common in the general population but people with diabetes are at an increased risk. The biological effects of diabetes can affect both men and women although the correlation between diabetes and sexual function in women is poorly understood. It is important to ask both male and female patients if they are experiencing any issues regarding their sexual functioning.
There are a variety of mobile apps for people with diabetes. They can be a useful way to learn about and take control of your diabetes. Many apps have features that enable you to record your blood glucose levels, food, medication and physical activity. By looking for patterns or trends in your results and discussing them with your healthcare team, you can learn how to make changes to your diabetes management plan and better manage your diabetes. The Health Navigator team have reviewed some diabetes apps that you might to consider.
Data were imported into SPSS version 24 (IBM). Incomplete responses were included in the analysis. In the patient survey, independent sample t tests were conducted to compare mean clinical variables (age, BP, C:HDL, LDL, HbA1c) by type of diabetes, method of recruitment, and whether the responder used a diabetes mobile phone app. Adjustment was made for unequal variances. Normal distribution was assumed for all variables, apart from urinary microalbumin to creatinine for which a Wilcoxin test was used. No statistically significant differences in these variables or in mobile phone app use were found between patients with recorded email addresses and patients phoned for their email address. Therefore, all 189 responses were combined for further analysis. Chi-square tests were used to compare medications and survey responses by type of diabetes. Statistical significance was determined by exact 2-sided P values less than .05. In the HP survey, mean values on the usefulness and confidence Likert scales were calculated to compare app features.
-Learn to eat well-balanced meals that include healthful food choices (vegetables, fruits, whole grains, etc.) and watch your portion sizes. Even foods that are good for you can add pounds to your waistline, if you consume too much of them. Losing those extra pounds will help you manage not only your diabetes, but also other health problems you may have.
Almost two-thirds of HPs responding had recommended a diabetes app to patients. Dieticians were more likely to recommend an app than others. Blood glucose and carbohydrate diaries were considered the most useful feature and HPs were most confident to recommend blood glucose diaries. HPs are the least confident recommending insulin dose calculation functions. Over one-third of HPs desire guidance with app recommendations.
We’ll also teach you what to do with everything you’re learning. Using the latest research and stories from people with diabetes, we’ll help you make small changes through short videos and simple action items. Soon, you’ll be seeing results, feeling better and having more energy. Many people with diabetes say that they’re healthier NOW than they were before they were diagnosed– you can be one of them!