Promoting Resilience in Stress Management (PRISM) for Diabetes Mellitus

"Diabetes is a chronic disease that can cause significant problems. Approximately one percent of all adolescents were diagnosed with diabetes. Complications include diabetic ketoacidosis, hyperglycaemia, diabetic coma and long term complications such as eye, kidney and cardiovascular complications. The causes of diabetes may vary. Diabetes often has an autoimmune origin. Diabetes can be categorized as type 1 or type 2 based on autoimmune origins and the causes of diabetes. Type 1 diabetes results from abnormal autoimmune response against insulin, a hormone normally used to regulate blood sugar in the body. Type 2 diabetes results from the blood glucose remaining at high levels due to insulin resistance due to fatty substances in the body. Diabetes is more likely to occur in the obese." - Anonymous Online Contributor

"Diabetes and diabetes-related complications can present with a variety of symptoms, including unexplained weight loss, increased thirst and urination, blurry vision or loss of taste, frequent urination or no sensation to the feet, and brittle or crusted skin or rash. Diabetes may also present with fatigue or abnormal heart rhythms. It is not uncommon for diabetic patients to be asymptomatic by themselves, but to be found to have concurrent medical problems in the more advanced stages of disease.\n\nSigns of cancer are not limited to tumors on the skin, but include a wide range of signs and symptoms that are typically related to the type of cancer (e.g." - Anonymous Online Contributor

"The most common treatment is insulin, with or without oral medications. The treatment of diabetes is highly individualized based on the degree of diabetic control and the presence of comorbidities including atherogenic dyslipidemia; additionally, treatment is often tailored based on the medical priorities of the patient, as well as the general health of the patient. Oral medication is commonly prescribed in addition to insulin. There are also a wide variety of other common treatments including antihypertensives, anticoagulants and glucose-lowering agents." - Anonymous Online Contributor

"Autoimmunity seems to be the most important risk factor for both diabetes and autoimmune disorders in this study, and some diabetes cases were in a family with or without autoimmune disorders, while also some autoimmune cases were in a family without diabetes. It was more complicated for metabolic syndrome and/or overweight, where families without one or two of the risk factors or with both were also included. These cases did not have the family history for autoimmune or diabetes. Insulin resistance seems to be involved in the development of diabetes and autoimmune disorders, and this is due to a large number of single-nucleotide polymorphisms (SNPs) influencing insulin resistance and secretion." - Anonymous Online Contributor

"The most current estimates of diabetes prevalence in the United States are from the US Census Bureau's 1993-1994 American Community Surveys. That study estimated a prevalence of 8.7% – 13.4% (depending on time period), assuming a population of 55 million. This implies that approximately 675,000 U.S. residents are diagnosed with diabetes a year. This estimate is consistent with the prevalence of diabetes in the US as ascertained by data collection from more recent, large and nationally representative surveys. These new reports suggest that the average age of diagnosis with diabetes in the US continues to rise and may exceed the 75th mark some time by the end of the century." - Anonymous Online Contributor

"T1D can certainly be managed to improve its control and may be cured. This approach can be achieved in 1/2 patients through use of injections of auto-antibodies, anti-GM1 and anti-CD20, and in 1/2 of the patients with TID use of anti-GM1 only. T2-D can be better controlled with use of anti-TNFs, anti-IGF and more rarely, anti-insulin. T1D can be managed by an oral anti-GM1, with use of anti-CD20 and, more rarely, anti-CD20, anti-CD154 and/or anti-CD19 antibodies with the improvement of its control." - Anonymous Online Contributor

"Diabetes and its associated autoimmune disorders are more prevalent in women when compared to men. The mean age people suffer from autoimmune diabetes ranged between 23 and 42 for men, and 36 for women among the studies reviewed, with the greatest prevalence in the 50 to 60+ age range for both men and women.\n" - Anonymous Online Contributor

"There are several reasons why the studies cited in the table above and the ones suggested for practice are not suitable to be used as a basis for practice. Firstly, they are limited by sample size, which is insufficient or too small. Secondly, they lack an adequate methodology to investigate resilience with sufficient precision and certainty. Thirdly, they were not conducted in a clinical setting and the results may not be applicable for use in routine practice. Thus, we suggest to exclude them and we consider the studies that were already used as a basis for practice as sufficient for use in practice." - Anonymous Online Contributor

"Stress is associated with increased production of certain pro-inflammatory hormones. Diabetes affects this stress-hormone pattern through a number of mechanisms, which include impaired insulin signaling, oxidative stress, and reduced tissue integrity. Diabetes is associated with an increased risk of a variety of chronic diseases, all of which are associated with distress. We propose that stress can serve as a protective mechanism against both physical and mental health problems in people with diabetes through reduced release of stress hormones." - Anonymous Online Contributor

"A systematic review of current literature identified several potentially interesting studies; however, the body of evidence did not provide sufficient evidence for the conclusions that could be drawn. Further research into a wide range of topics is indicated to improve the quality of the evidence." - Anonymous Online Contributor

"In a recent study, findings provides preliminary evidence that facilitating resilience in stress management by providing tailored resilience training may improve stress management and may be more effective than offering general supportive counselling." - Anonymous Online Contributor

"Clinical trials are worthwhile to study the effects of the medications currently available for all of the three autoantibodies on life expectancy. They should also be conducted for those who are diagnosed before age 35, because, by this age, diabetes has already progressed to where it is associated with severe diabetic complications and increased mortality, which underscores the importance of preventive programs." - Anonymous Online Contributor