Diabetes care provision: barriers, enablers and service needs of young adults with Type 1 diabetes from a region of social disadvantage

Abstract

Among these young adults with Type 1 diabetes, glycaemic control was suboptimal and emotional distress common. They had identifiable logistical barriers to accessing and maintaining contact with diabetes care services, which can be addressed with flexible service provision. A substantial minority were discouraged by previous unsatisfactory experiences, suggesting health providers need to improve their interactions with young adults. This research will inform the design of life-stage-appropriate diabetes services targeting optimal engagement, access, attendance and ultimately improved healthcare outcomes in this vulnerable population.

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

“…Some results were aligned with previous findings. Approximately one third had poor quality of life or psychological well-being, and/or high to very high levels of psychological distress, higher than Australian norms for 18-24 year olds (K10 high or very high ratings of 11.8%) (11,26). High rates of disordered eating persist from adolescent years to adulthood (27).…”

“…The lower rates of severe diabetes related distress (19.4% PAID ≥40), than young adults from socially disadvantaged backgrounds (40%) (11) or the MILES Study (28%) (25), could be due to socioeconomic advantage, the multidisciplinary team care, or other unidentified factors. Some results were aligned with previous findings.…”

“…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).…”

The Detection and Management of Diabetes Distress in People With Type 1 Diabetes

“…In scoping the literature we identified 11 studies which have reported proportions of type 1 populations with elevated DD (2,21,38,47,(54)(55)(56)(57)(58)(59)(60). These proportions range from 8% (57) to 65% (2).…”