Social support, access to care Key issues for young adults with T1D
Patients said they benefited from diabetes management technology, but also from social responsibility.
According to a new study, young adults with type 1 diabetes (T1D) face a number of challenges, from managing the physiological changes that emerge with age to finding ways to pay for their medical care. But they also benefit from social responsibility, including social media.
These are some of the key takeaways from new research published in the journal Clinical medical insights: endocrinology and diabetes. The report is based on interviews with 21 patients between the ages of 18 and 30.
Corresponding author Bailee Sawyer, MS, PhD, of Tarleton State University, and her colleagues explained that the period of “emerging adulthood” is a time of great change for everyone, but it is a particularly significant period for patients with T1D for a number of key factors. the reasons.
Among them, once young adults reach the age of 26, they can no longer stay on their parents’ medical insurance in the United States. Risk-taking is also common in this age group, Sawyer and colleagues noted, and people in this age group often experience significant changes in their financial and social circumstances.
“Emerging adults are in a dynamic flux of change, such as temporary disengagement from professional medical care when transitioning between homes, jobs, school, etc. and also, [they] may be difficult to recruit for research purposes,” the authors noted.
Sawyer and his colleagues decided to use a qualitative survey to ask the volunteers about their diabetes management and the barriers and challenges they face. Most of the respondents (n=19) were female and the patients had been diagnosed with T1D at a median age of 15 years.
After telephone interviews, the investigators used grounded theory to generate consistent themes based on the interviews.
The analysis identified 3 main barriers to diabetes management: physiology, environment and insurance. In the case of physiology, the investigators said that all participants reported experiencing difficulty coping with changes in their metabolism, which required them to regularly adjust their insulin dosage.
Regarding the patient environment, respondents said lack of social support was a barrier to diabetes management, but also seasonal changes in temperature.
“An interesting barrier was weather, specifically temperature or season of the year,” Sawyer and colleagues wrote. “Participants explained that the season of the year affected glycemic variability by increasing the difficulty of physical activity or daily walks.”
When it comes to insurance, many respondents said their plans did not cover costs such as continuous glucose monitoring (CGM) devices or, in some cases, even primary care visits.
When asked about the strategies they use to manage their diabetes, 3 other themes emerged: medical technology, access to social support and physical activity. Participants said they liked the diabetes management devices; 11 of the participants used CGMs and insulin pumps.
“Participants who were diagnosed with diabetes at an earlier age explained that advances in medical technology over the past few years have helped reduce anxiety and fear about the future,” the authors said.
Many patients said they received social support from family, healthcare providers and diabetes educators, although they also received support from social media, where they enjoyed seeing celebrities and athletes. professionals who were open about their T1D diagnosis, Sawyer and colleagues said.
Patients also saw the benefits of exercise in their diabetes management. All of the participants said they typically took short walks in the afternoon to counter blood sugar spikes.
Sawyer and his colleagues said their survey shows that future diabetes education programs should emphasize promoting social support, but also address topics related to physiology, seasons and changes in weather.
“Additionally, diabetes education management training for family and other supporters, and increased mental health resources would be beneficial for diabetes management,” they said.
Finally, they said changes in public policy should be made to make it easier for patients to access the devices and medical care they need.
Sawyer B, Hilliard E, Hackney KJ, Stastny S. Barriers and strategies for managing type 1 diabetes in emerging adults: a qualitative study. Clin Med Insights Endocrinol Diabetes. Published online May 21, 2022. doi:10.1177/11795514221098389