BackgroundDiabetes distress is a general term that refers to the emotional burdens, anxieties, frustrations, stressors and worries that stem from managing a severe, complex condition like Type 1 diabetes. To date there has been limited research on diabetes-related distress in younger people with Type 1 diabetes. This qualitative study aimed to identify causes of diabetes distress in a sample of young adults with Type 1 diabetes.MethodsSemi-structured interviews with 35 individuals with Type 1 diabetes (23–30 years of age).ResultsThis study found diabetes related-distress to be common in a sample of young adults with Type 1 diabetes in the second phase of young adulthood (23–30 years of age). Diabetes distress was triggered by multiple factors, the most common of which were: self-consciousness/stigma, day-to-day diabetes management difficulties, having to fight the healthcare system, concerns about the future and apprehension about pregnancy. A number of factors appeared to moderate distress in this group, including having opportunities to talk to healthcare professionals, attending diabetes education programmes and joining peer support groups. Young adults felt that having opportunities to talk to healthcare professionals about diabetes distress should be a component of standard diabetes care.ConclusionsSome aspects of living with diabetes frequently distress young adults with Type 1 diabetes who are in their twenties. Clinicians should facilitate young adults’ attendance at diabetes education programmes, provide them with opportunities to talk about their diabetes-related frustrations and difficulties and, where possible, assist in the development of peer-support networks for young adults with diabetes.

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These results indicate that patients with post-operative tumour with an extrasellar remnant should be considered routinely for adjuvant RT to reduce the risk of tumour regrowth while those with no residual tumour can be safely observed. Individualized decisions should be made for patients with an intrasellar remnant.

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International audienceObjective: Craniopharyngioma (CP) is a benign tumour of the suprasellar region that is associated with increased morbidity and mortality in comparison to other causes of hypopituitarism. We aimed to establish the rate and causes of mortality and morbidity in patients with CP who attended our centre. Design: We performed a retrospective case note audit of CP patients who were managed by our service. We established the Standardised Mortality Ratio for CP patients. We compared obesity prevalence with two other hypopituitary groups who are managed by our service. Patients: We identified 70 patients with craniopharyngioma, 97% of whom had undergone surgery and 42% radiotherapy. We compared the prevalence of obesity with that of 89 patients with hypopituitarism secondary to surgery for non-functioning pituitary adenoma, and 29 patients with post-traumatic hypopituitarism. Measurements: Standardised Mortality ratio for CP patients was 8.75 (95% CI of 5.4-13.3); SMR for women was 10.51 (95% CI 5.04-19.3) and 7.55 (95% CI 3.77-13.52) for men. The rates of GH, gonadotrophin, ACTH and TSH deficiencies were 91%, 93.5%, 92% and 86%, respectively. The rate of diabetes insipidus was 81%; 7.1% had adipsic diabetes insipidus. Dyslipidaemia was present in 46.9% and diabetes mellitus in 11.5%. Obesity affected 66% of CP patients, 47% of non-functioning adenoma patients and 31% of those with post-traumatic hypopituitarism (p < 0.001). Conclusions: Patients with craniopharyngioma suffer from high rates of mortality and morbidity. The underlying causes for mortality and for obesity in this population remain poorly-understood. Word count: 24