Social support, access to care key issues for young adults with T1D

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Patients said they benefited from diabetes management technology but also from social responsibility.

Young adults with type 1 diabetes (T1D) face a number of challenges ranging from dealing with physiological changes that come with age to finding ways to pay for their medical care, according to a new study. But they also benefit from social accountability, including social media.

These are some of the key findings 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 colleagues explained that the “mature adult” period is a time of great change for all people, but a particularly momentous one for patients with T1D for a number of keys Time is reasons for it.

Among them, young adults, once they turn 26, can no longer remain with their parents’ health insurance in the United States. Risk-taking is also prevalent in this age group, Sawyer and colleagues found, and people in this age group often experience significant changes in their financial and social situations.

“Aspiring adults are in a dynamic flow of change, such as [they] can be difficult to recruit for research purposes,” the authors noted.

Sawyer and colleagues chose to use a qualitative survey to ask volunteers about their diabetes management and the barriers and challenges they face. Most respondents (n=19) were female and patients were diagnosed with T1D at a median age of 15 years.

After telephone interviews, investigators used grounded theory to generate coherent themes based on the interviews.

The analysis identified 3 main barriers to diabetes management: physiology, environment and insurance. In terms of physiology, the researchers said all of the participants struggled to cope with changes in their metabolism, forcing them to regularly adjust their insulin dose.

Regarding the patient’s environment, respondents indicated that a lack of social support was a barrier to diabetes management, but so was seasonal temperature variation.

“One interesting obstacle has been weather, particularly temperature or time of year,” Sawyer and his colleagues wrote. “Participants explained that the time of year affects glycemic variability through increasing difficulty in physical activity or daily walks.”

In terms of insurance, many respondents said their plans do 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, three other themes emerged: medical technology, access to social support, and physical activity. Participants reported appreciating diabetes management devices; 11 of the participants used CGM and insulin pumps.

“Participants who were diagnosed with diabetes at an earlier age stated that advances in medical technology in recent years have helped reduce fears and anxiety about the future,” the authors said.

Many patients reported benefiting from social support from family, healthcare providers, and diabetes advisors, although they also received support from social media, where they appreciated seeing celebrities and professional athletes speaking openly about their T1D diagnosis, said Sawyer and colleagues.

Patients also saw the benefits of exercise in their diabetes management. All participants indicated that they usually took short afternoon walks to counteract the rise in blood sugar levels.

Sawyer and colleagues said their survey shows that future diabetes awareness programs should have an emphasis on promoting social support, but should also address issues related to physiology, seasons and weather changes.

“Additionally, diabetes awareness management training for families and other supporters, and increased mental health resources would be beneficial for diabetes management,” they said.

Finally, they said public policy changes should be made to make it easier for patients to access the equipment and medical care they need.

Relation:

Sawyer B, Hilliard E, Hackney KJ, Stastny S. Barriers and strategies to managing type 1 diabetes in emerging adults: a qualitative study. Clin Med Insights Endocrinol Diabetes. Published online May 21, 2022. doi:10.1177/11795514221098389

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