Young people's experiences of managing Type 1 diabetes at university: a national study of <scp>UK</scp> university students

Kellett, Joanne; Sampson, Mike; Swords, Francesca; Murphy, Helen; Clark, Allan; Howe, Amanda; Price, Chris; Datta, Vipan; Myint, Khin Swe

doi:10.1111/dme.13656

Cited by 18 publications

(70 citation statements)

References 25 publications

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“…Normal developmental issues during this period, such as living more independently for the first time, can be challenging for people who need to regularly monitor and manage their condition [1,2]. Young adults with diabetes face increased difficulties in navigating the healthcare system, including often having minimal guidance on how the transition from pediatric to adult care will occur, longer waits to access care in the adult system, and adjusting to a new care environment and culture [1,3]. Similarly, this transitional period represents a challenge for providers in retaining and providing appropriate care to their young adult patients [4].…”

Section: Introductionmentioning

confidence: 99%

Improving the transitioning of pediatric patients with type 1 diabetes into adult care by initiating a dedicated single session transfer clinic

Williams

Newhook

Power

et al. 2020

Clin Diabetes Endocrinol

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Background: Young adults with type 1 diabetes face potential health problems and disruptions in accessing care related to their move from pediatrics into adult care. At a medium-sized pediatric hospital with no formal transition support program, we developed and evaluated the use of a single-session transfer clinic as an initial quality improvement intervention to improve patient satisfaction, clinic attendance, and knowledge of transition related issues. Methods: Following a jurisdictional scan of other diabetes programs, the pediatric diabetes program developed a half-day transfer clinic. After the first transfer clinic was held, evaluation surveys were completed by patients, parents, and healthcare providers. Based on the feedback received, we altered the structure and evaluated the revised clinic by surveying patients and parents. Results: All patients and parents who attended reported high levels of satisfaction with the clinic. Providers were also mostly positive regarding their participation. Feedback from the first clinic was used to modify the structure of the second clinic to better meet the needs of participants and to allow the clinic to run more efficiently. The use of group sessions and adapting resources developed by other diabetes programs were viewed favourably by participants and lessened the burden on staff who delivered the clinic. Conclusions: A half-day transfer clinic is a viable step towards improving patient and parent satisfaction during the transition into adult care without requiring additional staff or significant expenditures of new resources. This type of clinic can also be incorporated into a larger program of transition supports or be adopted by programs serving young adults with other chronic diseases.

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Section: Introductionmentioning

confidence: 99%

Improving the transitioning of pediatric patients with type 1 diabetes into adult care by initiating a dedicated single session transfer clinic

Williams

Newhook

Power

et al. 2020

Clin Diabetes Endocrinol

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show abstract

“…In contrast, 16.6% and 5.6% reported their HbA1c as being 'slightly better' or 'much better' respectively. 9 These data for students contrast to data for young adults generally where, from age 18 onwards, there tends to be a sustained improvement in HbA1c. 10 Worsening of HbA1c after starting university was more common in female students and in those who moved to a different health care team when they started university.…”

Section: Outcomes For Diabetes Controlmentioning

confidence: 87%

Going to university: considerations for students with diabetes

Dalton

Poole

2020

Practical Diabetes

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The majority of students attending UK university for the first time are in their late teens or early 20s. 1 This age has been described as emerging adulthood and characterised by the ability to accept responsibility for oneself, make independent decisions and become financially independent. 2 This is considered a vulnerable time for people with diabetes and the need for uninterrupted, coordinated, flexible, comprehensive and accessible care is recognised. 3,4 Many groups have looked at the challenges of transition from paediatric to adult care 4,5 but there exists very little data on the specific challenges of university for students with diabetes. 6 What's important for students? Going to university: considerations for students with diabetes ❙ DIABETES IN SPECIAL CIRCUMSTANCES Going to university 220

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“…Developmental theorists have defined the age between 18 and 25 years old as emerging adulthood [10, 11]. In some studies, especially in developed countries, the levels of emotional distress were higher at this patient’s developmental stage [11, 15]. This was in part explained because patients in that age range face new challenges such as carrier decisions, moving out from parents’ houses to complete education and consequently the loss of parents’ supervision to manage T1D.…”

Section: Discussionmentioning

confidence: 99%

“…The sources of depressive symptoms and emotional distress in T1D patients vary at different ages because they face distinct challenges across the adult life span [10, 11, 15]. The patient’s developmental stage, with its related demands such as work and family, psychological adjustments and the potential burden of T1D treatment and comorbidities should be evaluated carefully.…”

Section: Introductionmentioning

confidence: 99%

Relatively young T1D adults using fixed doses of insulin have higher diabetes distress levels in a sample of patients from a Brazilian tertiary hospital

Silveira

Bovi

Pavin

2019

Diabetol Metab Syndr

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BackgroundElevated rates of anxiety and depressive symptoms in Type 1 Diabetes patients (T1D) and high rates of diabetes-specific distress (DD) have been shown. Several factors may be responsible for increase the DD levels such as age, life changes, lack of familiar support, education, insulin regimens (IRs) and chronic complications. The goals of this study were: 1—to compare DD levels, anxiety and depressive symptoms according to age (< and ≥ 25 years old), 2—to evaluate the association between DD levels, anxiety and depressive symptoms and IRs, and 3—to evaluate the association between DD levels, anxiety and depressive symptoms and chronic complications.MethodsIn a cross-sectional study, T1D patients receiving outpatient care at Unicamp tertiary hospital were included. Inclusion criteria were age at least 18 years old and diagnosis of T1D for 6 months. Exclusion criteria were cognitive impairment, major psychiatric disorders, severe diabetes-related complications, and pregnancy. Depressive symptoms were evaluated by the depression subscale of the Hospital Anxiety and Depression Scale (HAD-D) and the anxiety symptoms by the anxiety subscale of the same instrument (HAD-A). DDS scale assessed DD. Glycemic control was evaluated by HbA1C. The latest lipid panel results were recorded and IRs and chronic complications were obtained through chart review.ResultsOf all 70 patients, 70% were younger than 25 years old. No differences were found between two groups according to gender, education, and income (p = 0.39, p = 0.87, and p = 0.52, respectively). HbA1c mean was 10% in both groups (p = 0.15). Older patients had higher levels of total DD and physician DD than younger (p = 0.0048 and p = 0.0413; respectively).Total DD and DD on subscales 1 and 2 were higher in patients using fixed doses of insulin compared to variable doses according to carbohydrates count (p = 0.0392, p = 0.0383 and p = 0.0043, respectively). No differences were found between anxiety and depressive symptoms and age and IRs. Similarly, no differences were found among DD levels, anxiety and depressive symptoms in patients with and without chronic complications.ConclusionsWhen providing education and care for T1D patients, health providers should consider age, patient’s developmental stage, with its related demands and the burden of insulin regimen.

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Young people's experiences of managing Type 1 diabetes at university: a national study of UK university students

Abstract: The study quantifies the high level of risk experienced by students with Type 1 diabetes during the transition to university, in particular, female students and those moving to a new university healthcare provider.

Cited by 18 publications

References 25 publications

Improving the transitioning of pediatric patients with type 1 diabetes into adult care by initiating a dedicated single session transfer clinic

Improving the transitioning of pediatric patients with type 1 diabetes into adult care by initiating a dedicated single session transfer clinic

Going to university: considerations for students with diabetes

Relatively young T1D adults using fixed doses of insulin have higher diabetes distress levels in a sample of patients from a Brazilian tertiary hospital

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