Associations of demographic and behavioural factors with glycaemic control in young adults with type 1 diabetes mellitus

Abstract

In young adults with T1DM, geographical separation, socioeconomic disadvantage and risk-taking behaviours did not influence glycaemic control. Longer duration of diabetes identifies young adults at higher risk of poor control, while attendance at a multidisciplinary clinic and engagement in work or study was associated with better glycaemic control. Additional studies are warranted to clarify the role of behavioural interventions to improve diabetes management in young adults.

Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: A systematic review

“…An association between low SES (as measured by education, social class or income) and poorer glycaemic control was found in nine of the twelve studies [10;16;19;21;31;36;40;43;51]. Two studies found no SES association with glycaemic control [17;35]. …”

A longitudinal, observational study examining the relationships of patient satisfaction with services and mental well‐being to their clinical course in young people with Type 1 diabetes mellitus during transition from child to adult health services

“…Our justification for using ketoacidosis was that episodes are associated with poor disease control and poor adherence to treatment [6]. We considered clinic attendance to be an important part of satisfactory transitional care because it correlates with a better disease outcome [23]. Clinic and annual retinal screening attendance are markers of positive health behaviour and are both recommended by the National Institute of Health and Care Excellence (NICE) guidelines for transition services and management of young people with diabetes [27].…”

“…There is no consensus on how best to assess a satisfactory clinical course during transition. Following discussion among the authors, the wider Transition Research Collaborative group and a review of the literature [11,23,24], a set of criteria based on collected clinical and attendance data was established to define a satisfactory clinical course. The four markers were: glycaemic control (HbA 1c ), any episode of diabetic ketoacidosis, clinic attendance and retinal screening attendance.…”

Psychosocial screening and management of young people aged 18–25 years with diabetes

“…They included: The Problems Areas in Diabetes (PAID) (20 items) with scores ≥ 40 representing severe diabetes-related distress (12,13), and a score ≥ 30 representing significant diabetes-related distress; The Kessler 10 (K10; 10 items) assessing psychological distress, focusing on depression and anxiety symptoms, ow levels of distress (10)(11)(12)(13)(14)(15), moderate (16)(17)(18)(19)(20)(21), high level (22)(23)(24)(25)(26)(27)(28)(29) and very high are defined (14,15); The WHO-5 Well-being Index (5 items) assessing quality of life, with scores ≤ 13 indicative of low well-being, and scores < 8 indicative of depression (16,17) (22), (23) were compared to USA normative data (non-diabetic), and 4 items assessed financial concerns.…”

“…A multidisciplinary team approach seems indicated with evidence this model is related to better glycaemic control (10), more support, lower diabetes-related distress, and higher satisfaction with their diabetes care than those seeing a private endocrinologist, general practitioner or other provider (11).…”