Peer support influences outcomes for youths with type 1 diabetes
medwireNews: Peer and parental support are important factors influencing diabetes-related distress among adolescents and young adults with type 1 diabetes, researchers report.
In addition to the challenges associated with puberty, “adolescents with type 1 diabetes have to cope with treatment-related daily challenges,” say Koen Raymaekers (University of Leuven, Belgium) and study co-authors.
“These challenges may provide patients with additional stress, possibly resulting in poor treatment adherence,” they add.
The team conducted a questionnaire-based study in which 467 patients aged 14–25 years with type 1 diabetes were asked about emotional support from peers, parental support and warmth (parental responsiveness), and peer orientation, in addition to diabetes-related distress and treatment adherence, at baseline and 1 year later.
Using a structural equation modeling approach to assess the associations between these variables, Raymaekers and colleagues found that a higher degree of peer support at baseline was significantly associated with a lower level of diabetes-related distress at the 1-year follow-up, with standardized correlation coefficients of –0.12, –0.17, and –0.15 for emotional, food, and treatment distress, respectively.
Greater parental responsiveness was also significantly associated with a lower degree of food distress (correlation coefficient=–0.12).
On the other hand, there was a significant positive correlation between extreme peer orientation – the degree to which fitting in with others is valued more highly than carrying out important tasks such as managing diabetes – and treatment distress 1 year later (correlation coefficient=0.1). When the participants were categorized by age, extreme peer orientation at baseline significantly predicted glycated hemoglobin levels at 1 year among those aged between 18–25 years, but not among those younger than 18 years.
“[A]s an undesirable reciprocal relationship between extreme peer orientation and glycemic control was obtained for emerging adults, it seems important to monitor patients who value fitting in with peers at the expense of managing their diabetes,” write the researchers in Diabetes Care.
The team also found that treatment adherence at baseline was significantly associated with decreases in extreme peer orientation, treatment distress, and levels of glycated hemoglobin from baseline to the 1-year follow-up, suggesting that “[h]elping patients in accepting their disease and acquiring adequate treatment adherence may prevent them from experiencing treatment distress and neglecting treatment in favor of fitting in with peers.”
Raymaekers and co-authors caution that their study results do not demonstrate causality, and that the initial survey response rate, at 41.16%, was “rather low,” which could limit the generalizability of the findings.
And they conclude: “Provided that the present results can be replicated longitudinally using more intensive longitudinal designs, the multidisciplinary clinical team should, apart from focusing on parents, pay attention to patient-peer interactions as well.”
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