**7. References**

150 Type 1 Diabetes – Complications, Pathogenesis, and Alternative Treatments

The fourth strategy in BFST that can be used therapeutically to improve adherence and glycemic control in families with youth with T1D is cognitive restructuring. Cognitive restructing can used to address cognitive distortions and irrational thinking that can impair problem solving ability within the family. Cognitive distortion can contribute to the maintenance of maladaptive communication patterns and conflict between parents and adolescents, and thereby adversely impacting regimen adherence. Helping parents and adolescents to restructure or "soften" their strong unproductive belief patterns can facilitate

Several studies conducted within the research program of Geffken and colleagues provide evidence for the effectiveness of telehealth family psychotherapy for youth with T1D. A case study[94] and case series[95] demonstrated decreased HbA1c in participants as well as improved family dynamics surrounding the diabetes regimen. An open trial of 27 adolescents[96] demonstrated a 0.7% reduction in HbA1c and no diabetes related hospitalizations in an at-risk sample of youth. Additionally, results from a controlled trial show improved metabolic control and family interactions.[97][98] Specifically, relative to those in the wait-list, families in immediate treatment had an average decrease in HbA1c of 1.32% and fewer disagreements around the diabetes regimen between parents and children (*p*<.05). Participants also showed improved adherence to their regimen at end of treatment (*p*<.05). After a one-month follow-up period, however, many participants did not maintain their treatment gains. Over one third had an increase of 0.6% or greater in HbA1c, suggesting that additional sessions would likely aid in maintaining treatment gains. Of the remaining youth, approximately one third maintained gains, while the remaining youth were unable to be reached for follow-up assessments. Although not systematically assessed, our non-study related interactions with these youth (i.e., consultations during their scheduled endocrinology visits) suggest that the overwhelming majority of these youth experienced partial or full relapses. Taken together, these studies demonstrate that intensive telehealth family psychological treatment using a BSFT model improves adherence to the

According to Azar and Gabbay[87], telemedicine interventions have a wide range of variability. Some systems are more basic and focus phone, email or short message services to faciliatate communication between patients and their providers. In contrast other systems use complex web interfaces that can include home meter information as well as logs for diet and activitiy levels.[99] For example, Carelink, an insulin-pump monitoring system accessed online, significantly improved glycemic control equally among children in both rural and urban areas even though children in rural areas visited clinics less frequently. The Carelink system allowed children and their parents to upload and access information about their glucose levels, amount of insulin required each day, and informed patients of where their blood sugar levels were in comparison to their goal daily sugar level. If dose adjustments were necessary, the diabetes care provider emailed or called their patient to alert them of the

This review of the literature demonstrates a wide variety of psychological variables may mediate the relationship between regimen adherence and glycemic control in the families of youth with T1D. These psychological variables range from parental warmth and support to coerciveness and conflict in the parent-child relationship. It was also demonstrated that a

more effective communication.[95][96]

medical regimen, glycemic control, and family dynamics.

change.[100]

**6. Conclusions** 


Contributing Factors to Poor Adherence and Glycemic

542. 1990.

610. 1994.

1997.

539, 2008.

pp. 908-914. 2009.

*Psychology,* Vol. 34(10), pp. 1097-1107. 2009.

diabetes care", *Diabetes,*Vol.38:28. 1989.

*Psychology*, Vol. 36, pp. 646-662, 1999.

Control in Pediatric Type 1 Diabetes: Facilitating a Move Toward Telehealth 153

[23] S. Miller-Johnson, R. E. Emery, R. S. Marvin, W. Clarke, R. Lovinger, & M. Martin,

[24] L. B. Williams, L. M. B. Laffel, & K. K. Hood," Diabetes-specific family conflict and

[25] M. A. Harris, K. A. Freeman, & M. Beers, "Family therapy for adolescents with poorly

[26] A. Lewandowski, & D. Drotar, "The relationship between parent-reported social

model of glycemic control", *Children's Health Care*, Vol. 39(4), 279-295. 2010. [28] F. J. Cameron, T. C. Skinner, C. E. de Beaufort, H. Hoey, P. G. F. Swift, H. Aanstoot, et

[30] K. K. Hood, D. A. Butler, B. J. Anderson, & L. Laffel, "Updated and revised diabetes

[31] D. Arnold, "Co-occurrence of externalizing behavior problems and emergent academic

[32] D. Schwartz, K.A. Dodge, G.S. Pettit, J.E. Bates, & The Conduct Problems Prevention

[33] C.R. Petty, J.F. Rosenbaum, D.R. Hirshfeld-Becker, A. Henin, S. Hubley, S., LaCasse, et

[34] T.M. Achenbach, "Integrative guide for the 1991 CBCL/4-18,YSR, and TRF profiles," Burlington: University of Vermont, Department of Psychiatry, 1991. [35] D. M. Cohen, M. A., Lumley, S. Naar-King, T. Partridge, & N. Cakan, "Child behavior

[36] L. Greening, L. Stoppelbein, C. Konishi, S.S. Jordan, & G. Moll, "Child routines and youths' adherence to treatment for type 1 diabetes," Vol. 32, pp. 437-447, 2007.

study," *Journal of Pediatric Psychology*, Vol. 29, pp. 171–284, 2008.

diabetes", *Journal of Pediatric Psychology*, Vol. 32(4), pp. 427-436. 2007. [27] K. M. Grabill, G. R. Geffken, D. Duke, A. Lewin, L. Williams, E. Storch, & J. Silverstein,

with Type 1 diabetes?", *Diabetic Medicine*, Vol. 25(4), pp. 463-468. 2008. [29] D. Rubin Young-Hyman, & M. Peyrot "Parent-child responsibility and conflict in

family conflict scale", *Diabetes Care,* Vol. 30(7), pp.1764-1769. 2007.

mellitus over a four-year longitudinal follow-up: II. immediate and long-term linkages with the family milieu", *Journal of Pediatric Psychology*, Vol. 15(4), pp. 527-

"Parent-child relationships and the management of insulin-dependent diabetes mellitus", *Journal of Consulting and Clinical Psychology*, (1994). Vol. 62(3), pp. 603-

psychological distress in paediatric type 1 diabetes", *Diabetic Medicine*, Vol. 26(9),

controlled diabetes: Initial test of clinical significance", *Journal of Pediatric* 

support and adherence to medical treatment in families of adolescents with type 1

"Family functioning and adherence in youth with type 1 diabetes: A latent growth

al., "Are family factors universally related to metabolic outcomes in adolescents

difficulties in young high-risk boys: A preliminary evaluation of patterns and mechanisms," *Journal of Applied Developmental Psychology,* Vol. 18, pp. 317-330,

Research Group, "Friendship as a moderating factor in the pathway between early harsh home environment and later victimization in the peer group," *Developmental* 

al., "The Child Behavior Checklist broad-band scales predict subsequent psychopathology: a 5-year follow-up," *Journal of Anxiety Disorders*, Vol. 22, pp. 532–

problems and family functioning as predictors of adherence and glycemic control in economically disadvantaged children with type 1 diabetes: A prospective


[9] A. J. Rovner, S. N. Mehta, D. L. Haynie, E. M. Robinson, H. J. Pound, D. A.Butler et al.,

[10] J. R. Wood, E. C. Moreland, L. K. Volkening, B. M. Svoren, D. A. Butler, & L. M. B.

[11] I. Rabbone, A. Bobbio, K. Berger, M. Trada, C. Sacchetti, & F. Cerutti, "Age-related

[12] D. J. Wiebe, A. Croom, K. T. Fortenberry, J. Butner, J. Butler, M. T. Swinyard, et al.,

[13] L. C. Schafer, K. D. McCaul, & R. E. Glasgow, "Supportive and nonsupportive family

[14] A. B. Lewin, E. A. Storch, J. H. Silverstein, A. L. Baumeister, M. S. Strawser, & G. R.

psychopathology", *Families, Systems, & Health,* Vol., 23(1), pp. 56-65. 2005. [15] M. S., Greene, B., Mandleco, S. O. Roper, E. S. Marshall, & T. Dyches, "Metabolic

correlational study", *The Diabetes Educator*, Vol. 36(2), pp. 326-336. (2010). [16] S. M. Lloyd, M. Cantell, D. Pacaud, S. Crawford, & D. Dewey, "Brief report: Hope,

[17] A. B. Lewin, G. R. Geffken, A. D. Heidgerken, D. Duke, W. Novoa, L. B. Williams, &

*Journal of Clinical Psychology in Medical Settings*, Vol. 12(4), pp. 315-322. 2005. [18] M. E. Hilliard, M. Monaghan, F. R. Cogen, & R. Streisand, "Parent stress and child

[19] R. Streisand, E. R. Mackey, B. M. Elliot, L. Mednick, I. M. Slaughter, J. Turek, & A.

[20] S. Bowes, L. Lowes, J. Warner, & J. W. Gregory, "Chronic sorrow in parents of children with type 1 diabetes", *Journal of Advanced Nursing*,Vol. 65(5), 992-1000. 2009. [21] M. Monaghan, M. E. Hilliard, F. R. Cogen, & R. Streisand, "Supporting parents of very

[22] S. T. Hauser, A. M. Jacobson, P. Lavori, J. I. Wolfsdorf, R. D. Herskowitz, J. E. Milley, et

*Patient Education & Counseling,* Vol. 73(2), pp. 333-338. 2008.

*American Dietetic Association*, Vol. 110(9), pp. 1302-1306. 2010.

*Endocrinological Investigation*, Vol. 30(6), pp. 477-483. 2007.

diabetes", *Diabetes Care,* Vol. 9(2), pp. 179-185. 1986.

*Development,* Vol. 37(2), pp. 224-232. 2011.

*& Counseling*, Vol. 82(2), pp. 271-274. 2011.

*Diabetes Care,* Vol. 29(11), pp. 2355-2360. 2006.

35(10), pp.1152-1160. 2010.

1029. 2009.

"Perceived benefits, barriers, and strategies of family meals among children with type 1 diabetes mellitus and their parents: Focus-group findings", *Journal of the* 

Laffel, "Durability of insulin pump use in pediatric patients with type 1 diabetes",

differences in metabolic response to continuous subcutaneous insulin infusion in pre-pubertal and pubertal children with type 1 diabetes mellitus", *Journal of* 

"Parental involvement buffers associations between pump duration and metabolic control among adolescents with type 1 diabetes", *Journal of Pediatric Psychology,* Vol.

behaviors: Relationships to adherence and metabolic control in persons with type I

Geffken, "Validation of the pediatric inventory for parents in mothers of children with type 1 diabetes: An examination of parenting stress, anxiety, and childhood

control, self-care behaviors, and parenting in adolescents with type 1 diabetes: A

perceived maternal empathy, medical regimen adherence, and glycemic control in adolescents with type 1 diabetes", *Journal of Pediatric Psychology*, Vol.34(9), pp. 1025-

E.A. Storch, "The diabetes family behavior checklist: A psychometric evaluation",

behaviour among young children with type 1 diabetes", *Child: Care, Health &* 

Austin, "Parental anxiety and depression associated with caring for a child newly diagnosed with type 1 diabetes: Opportunities for education and counseling",

young children with type 1 diabetes: Results from a pilot study", *Patient Education* 

al., "Adherence among children and adolescents with insulin-dependent diabetes

mellitus over a four-year longitudinal follow-up: II. immediate and long-term linkages with the family milieu", *Journal of Pediatric Psychology*, Vol. 15(4), pp. 527- 542. 1990.


Contributing Factors to Poor Adherence and Glycemic

337–347, 1998.

Vol. 40, pp. 1-15, 2011.

pp. 7–15, 1994.

2008.

Control in Pediatric Type 1 Diabetes: Facilitating a Move Toward Telehealth 155

[51] Channon, S. J., Huws-Thomas, M. V., Rollnick, S., Hood, K., Cannings-John, R. L.,

[53] A. Baumeister, E.A. Storch, & G.R. Geffken, "Peer victimization in children with

[54] C.S. Lim, P.A. Graziano, D.M. Janicke, W.N. Gray, L.M. Ingerski, & J.H.

[55] E.A. Storch, A. Lewin, J.H. Silverstein, A.D. Heidgerken, M.S. Strawser, A. Baumeister,

endocrine disorders*," The Journal of Pediatrics,* Vol. 145, pp. 784-789, 2004. [56] D.M. Janicke, W.N. Gray, N.A. Kahhan, K.W. Follansbee Junger, K.K. Marciel, et al.,

[57] E.A. Storch, A. Lewin, J. Silverstein, A. Heidgerken, M. Strawser, A. Baumeister, et al*.,* 

[58] E.A. Storch, A. Heidgerken, G.R. Geffken, A. Lewin, V. Ohleyer, M. Freddo, et al.,

[59] A. Bechara, A.R. Damasio, H. Damasio, & S.W. Anderson, "Insensitivity to future

[60] D.M. Bagner, L.B. Williams, G.R. Geffken, J.H. Silverstein, & E.A. Storch, "Type 1

[61] K. McNally, J. Rohan, J. Pendley, A. Delamater, & D. Drotar, "Executive functioning,

[62] L.B. Williams, "Executive functioning, parenting stress, and family factors as predictors

[63] T. Wysocki, R. Iannotti, J. Weissberg-Benchell, K. Hood, L. Laffel, B.J. Anderson, et al.,

[64] O. Hsin, A.M. La Greca, J.M. Valenzuela, C.T. Moine, & A.M. Delamater, "Adherence

Disease," *Journal of Pediatric Psychology*, Vol. 34, pp. 769-773, 2009.

diabetes*," Clinical Pediatrics,* Vol. 43, pp. 467-471, 2004

*Children's Healthcare*, Vol. 36, pp.169-179, 2007.

*Diabetes Care*, Vol. 33, pp. 1159–1162, 2010.

insulin regimens," *University of Florida, 2008*.

*Journal of Pediatric Psychology*, Vol. 33, pp. 875-884, 2008.

1Diabetes," *Journal of Pediatrics*, Vol. 148, pp. 784-787, 2006.

Rogers, C. et al., "A multicenter randomized controlled trial of motivational interviewing in teenagers with diabetes." *Diabetes Care,* Vol. 30, 1390–1395, 2007. [52] N. R. Crick, & M. A. Bigbee, "Relational and overt forms of peer victimization: A

multiinformant approach," *Journal of Consulting and Clinical Psychology*, Vol. 66,

learning disabilities," *Child and Adolescent Social Work Journal*, Vol. 25, pp.11-23,

Silverstein,"Peer Victimization and Depressive Symptoms in Obese Youth: The Role of Perceived Social Support Children's Health Care," *Children's Heath Care,* 

et al., "Social-psychological correlates of peer victimization in children with

"Brief Report: The Association Between Peer Victimization, Prosocial Support, and Treatment Adherence in Children and Adolescents with Inflammatory Bowel

*"*Peer victimization, and psychosocial adjustment in children with type 1

"Bullying, regimen self-management, and metabolic control in youth with type

consequences following damage to human prefrontal cortex," *Cognition*, Vol. 50,

diabetes in youth: The relationship between adherence and executive functioning,"

treatment adherence, and glycemic control in children with Type 1 Diabetes,"

of diabetes management in pediatric patients with type 1 diabetes using intensive

"Diabetes problem solving by youths with type 1 diabetes and their caregivers: Measurement, validation and longitudinal associations with glycemic control,"

and glycemic control among Hispanic youth with type 1 diabetes: role of family involvement and acculturation," *Journal of Pediatric Psycholology,* Vol. 26, 2009.


[37] M. Kovacs, D. Charron-Prochownik, & D. S. Obrosky, " A longitudinal study of

[38] C.M. McDonnell, E.A. Northam, S.M. Donath, G.A. Werther, & F.J. Cameron,

[39] S. Naar-King, A. Idalski, D. Ellis, M. Frey, T. Templin, P.B. Cunningham, et al*."*Gender

[40] D.K. Duke, G.R. Geffken, A.B. Lewin, L.B. Williams, E.A. Storch, & J.H. Silverstein,

[41] K. Gelfand, G. Geffken, A. Lewin, A. Heidgerken, M. Grove, T. Malasanos, et al*,* "An

children with diabetes," *Journal of Child Health Care,* Vol. 8, pp.113-123, 2004. [42] L. M. Sancheza, A.M. Chronisa & S.J. Hunter, *"*Improving Compliance With Diabetes

[43] S.M. Markowitz, J.S. Gonzalez, J.L. Wilkinson, & S.A. Safren, "A Review of Treating

[44] R.M. Ghandour, M.D. Kogan, S.J. Blumberg, & D.F. Perry, "Prevalence and correlates of

[45] P.J. Lustman & R. E. Clouse, "Depression in diabetic patients: the relationship between

[46] M.M. Garrison, W.J. Katon, & L.P. Richardson. "The impact of psychiatric comorbidities on readmissions for diabetes in youth*." Diabetes Care,* Vol. 28, pp. 2150-2154, 2005. [47] V. S. Helgeson, K. A. Reynolds, L. Siminerio, O. Escobar, & D. Becker, "Parent and

[48] A.M. La Greca & J.S. Skyler, "Psychological issues in IDDM; A multivariate framework," in *Stress, Coping, and Disease*, Erlbaum, 1991, pp. 169-109. [49] P. J. Lustman, R.J. Anderson, K.E. Freedland, M. de Groot, R.M. Caney, & R.E. Clouse,

[50] S. He, H. Cao, C.G.M. Magnusson, M. Eriksson-Berg, M. Mehrnaz, K. Schenck-

Journal of Pediatric Psychology, Vol. 33, pp. 497-508, 2008.

bond," *Thrombosis Research*, Vol. 103, pp. 241–248, 2001.

*Diabetes Care*, Vol. 23, pp. 934-942, 2000.

142-148, 1995.

2006.

2005.

e269-e277, 2010.

*Diabetes Care, 30*, pp. 2211–2215, 2007.

*of Pediatric Psychology,* 31, pp. 793-802, 2005.

*Journal of Pediatric Psychology,* Vol. 33, 719-727, 2008.

biomedical and psychosocial predictors of multiple hospitalizations among young people with insulin-dependent diabetes mellitus," *Diabetic Medicine*, Vol. 12, pp.

"Hyperglycemia and externalizing behavior in children with type 1 diabetes,"

differences in adherence and metabolic control in urban youth with poorly controlled type 1 diabetes: The mediating role of mental health symptom*," Journal* 

"Glycemic control in youth with type 1 diabetes: Family predictors and mediators,"

initial evaluation of the design of pediatric psychology consultation service with

Management in Young Adolescents With Attention-Deficit/Hyperactivity Disorder Using Behavior Therapy," *Cognitive and Behavioral Practice*, Vol. 13, pp. 134-145,

Depression in Diabetes: Emerging Findings," *Psychosomatics,* Vol. 15, pp. 1-18, 2011.

internalizing mental health symptoms among CSHCN," *Pediatrics,* Vol. 125, pp.

mood and glycemic control," *Journal of Diabetes Complications*, Vol. 19, pp. 113–122,

adolescent distribution of responsibility for self-care: Links to health outcome."

"Depression and poor glycemic control: a meta-analytic review of the literature.

Gustafsson, & M. Blombäck, "Are increased levels of von Willebrand factor in chronic coronary heart disease caused by decrease in von Willebrand factor cleaving protease activity? A study by immunoassay with antibody against intact


Contributing Factors to Poor Adherence and Glycemic

32(6), 1014-1016. 2009.

33(3), pp. 457-462. 2010.

pp. 9-17. 2009.

pp. 155-162. 1992.

*Metabolism*, Vol. 11(10). pp. 913-930. 2009.

*Psychology*, Vol. 31, pp. 928-938. 2006.

*Diabetes Spectrum*, Vol. 22(1), pp. 56-62. 2009.

Control in Pediatric Type 1 Diabetes: Facilitating a Move Toward Telehealth 157

[78] I. B. Hirsch, J. Abelseth, B. W. Bode, J. S. Fischer, F. R. Kaufman, J.Mastrototaro, et al.,

[80] C. E. Smart, K. Ross, J. A. Edge, B. R. King, P. McElduff, & C. E. Collins, "Can children

[82] A. D. Heidgerken, L. Merlo, L. B. Williams, A. B. Lewin, K. Gelfand, T. Malasanos, et al.,

[84] J.L. Woolston, S.J. Berkowitz, M.C. Schaefer, & , J.A. Adnopoz, "Intensive, integrated,

*Child and Adolescent Psychiatric Clinics of North America*, Vol. 7*,* 615-633. 1998. [85] E. A. Balas, F. Jaffrey, G. J. Kuperman, S. A. Boren, G. D. Brown, F. Pinciroli, & J. A.

[87] M. Azar, & R. Gabbay, "Web-based management of diabetes through glucose uploads:

[88] B. H. Stamm, "Integrating telehealth into mental health care", *In T. L. Jackson (Ed.), Innovations in clinical practice: A source book,* Vol. 18*.* pp. 385-400.2000. [89] N. Holt, & M.A. Crawford, "Medical information service via telephone: The pioneer of

[90] J. Polisena, K. Tran, K. Cimon, B. Hutton, S. McGill, & K. Palmer, "Home telehealth for

[91] J.D. Piette,M. Weinberger M, S. J. McPhee, C.A. Mah, F.B. Kraemer, L.M., Crapo, "Do

effective,and practical?", *Diabetes Care,*Vol. 26*,* pp. 1626-1628. 2003.

and psychometrics", *Children's Health Care*, Vol. 36(2), pp. 117-136. 2007. [83] M. B. Koontz, L. Cuttler, M. R. Palmert, M. O'Riordan, E. A. Borawski, J. McConnell, &

"Sensor-augmented insulin pump therapy: Results of the first randomized treat-totarget study", *Diabetes Technology & Therapeutics*, Vol. 10(5), pp. 377-383. 2008. [79] S. N. Mehta, N. Quinn, L. K. Volkening, & M. B. Laffel, "Impact of carbohydrate

counting on glycemic control in children with type 1 diabetes", *Diabetes Care*, Vol.

with type 1 diabetes and their caregivers estimate the carbohydrate content of meals and snacks?", *Diabetic Medicine*, (2010). (2010). Vol. 27(3), pp. 348-353. 2010. [81] F. K. Bishop, D. M. Maahs, G. Spiegel, D. Owen, G. J. Klingensmith, A. Bortsov, et al.,

"The carbohydrate counting in adolescents with type 1 diabetes (CCAT) study",

"Diabetes awareness and reasoning test: A preliminary analysis of development

E. O. Kern, "Development of validation of a questionnaire to assess carbohydrate and insulin-dosing knowledge in youth with type 1 diabetes", *Diabetes Care,* Vol.

in-home psychiatric services: The catalyst to enhancing outpatient intervention",

Mitchell, "Electronic communication with patients: Evaluation of distance medicine technology", *Journal of the American Medical Association,* Vol. 278*,* pp. 152-159. 1997. [86] D. C. Klonoff, "Diabetes and telemedicine: Is the technology sound, effective, cost

Has the time come for telemedicine?" *Diabetes Research and Clinical Practice, Vol. 83*,

physician consultation services", *Annals of the New York Academy of Science*, Vol. 670.

diabetes management: A systematic review and meta-analysis", *Diabetes, Obesity &* 

automated calls with nurse follow-up improve self-care and glycemic control among vulnerable patients with diabetes?" *Am J Med,* Vol. 108, pp. 20-27. 2000. [92] T. Wysocki, M. A. Harris, L. M. Buckloh, D. Mertlich, A. S. Lochrie, A. Taylor, et al.,

"Effects of behavioral family systems therapy for diabetes on adolescents' family relationships, treatment adherence, and metabolic control", *Journal of Pediatric* 


[65] M. Grey, E. Boland, C. Yu, S. Sullivan-Bolyai, & W. Tamborlane, "Personal and family

[66] D.A. Ellis, C.L. Podolski, M. Frey, S. Naar-King, B. Wang, & K. Moltz, "The role of

[67] C. Suveg, T.L. Roblek, J. Robin, A. Krain, S. Schendbrand, & G.S. Ginsburg, "Parental

[69] H. Tahirovic & A. Toromanovic, "Glycemic control in diabetic children: role of mother's

[70] M.S. Greene, B. Mandleco, S.O. Roper, E.S. Marshall & T. Dyches, "Metabolic control,

[71] American Diabetes Association, *Living with diabetes: Advantages of using an insulin Pump,*

[72] J. C. Pickup, & A. J. Sutton, "Severe hypoglycaemia and hypocaemic control in type 1

[73] C. A. Paris, G. Imperatore, G. Klingensmith, D. Petitti, B. Rodriguez, A. M. Anderson, et

[74] E. Pankowska, M. Blazik, P. Dziechciarz, A. Szypowska, & H. Szajewska, "Continuous

[75] L. A. Fox, L. M. Buckloh, S. D. Smith, T. Wysocki, & N. Mauras, "A randomized

[76] J. N. Churchill, R. L. Ruppe, & A. Smaldone, "Use of continuous insulin infusion pumps

[77] A. E. Scaramuzza, D. Iafusco, I. Rabbone, R. Bonfanti, F. Lombardo, R. Schiaffini, et al.,

*Diabetes Technology & Therapeutics*, Vol. 13(2), pp. 99-103. 2011.

correlational study," *Diabetes Education,* Vol. 36, pp. 326–336, 2010.

Vol. 21*,* pp. 909-914, 1998.

*2007*.

1985.

2010.

774. 2008.

pp. 183-189. 2009.

*Pediatric Diabetes*, Vol. 10(1), pp. 52-58. (2008).

*Diabetes Care*, Vol. 28(6), pp. 1277-1281. 2005.

*Health Care*, Vol. 23(3), pp.173-179. 2008.

961-964, 2010.

factors associated with quality of life in adolescents with diabetes." *Diabetes Care,* 

parental monitoring in adolescent health outcomes: Impact on regimen adherence in youth with type 1 diabetes." *Journal of Pediatric Psychology,* Vol. 32, pp. 907-917,

involvement when conducting cognitive-behavioral therapy for children with anxiety disorders," *Journal of Cognitive Psychotherapy,* Vol. 20, pp. 287–301, 2006. [68] M., Kovacs, T. L. Feinberg, S. Paulauskas, R. Finkelstein, M. Pollack, & M. Crouse-

Novak, "Initial psychological responses of parents to the diagnosis of insulindependent diabetes mellitus in their children," *Diabetes Care*, Vol. 8. pp. 568–575,

knowledge and socioeconomic status," *European Journal of Pediatrics*, Vol. 169, pp.

self-care behaviors, and parenting in adolescents with type 1 diabetes: a

diabetes: Meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion", *Diabetic Medicine*, Vol. 25(7), pp. 765-

al., "Predictors of insulin regimens and impact on outcomes in youth with type 1 diabetes: The search for diabetes in youth study", *Journal of Pediatrics,* Vol. 155(2),

subcutaneous insulin infusion vs. multiple daily injections in children with type 1 diabetes: A systematic review and meta-analysis of randomized control trials",

controlled trial of insulin pump therapy in young children with type 1 diabetes",

in young children with type 1 diabetes: A systematic review", *Journal of Pediatric* 

"Use of integrated real-time continuous glucose monitoring/insulin pump system in children and adolescents with type 1 diabetes: A 3-year follow-up study",


**Part 3** 

**Perspectives of Diabetes Pathogenesis** 

