medwireNews: Emerging adults with type 1 diabetes are particularly prone to developing diabetes distress, despite reporting a relatively good quality of life, research suggests.
Of 308 emerging adults (aged 18–30 years) with type 1 diabetes who participated in the second Diabetes Attitudes Wishes and Needs (DAWN2) study, 60.1% were categorized as having diabetes distress on the Problem Areas in Diabetes (PAID)-5 scale, compared with 50.8% of the 1060 adults who were older than 30 years.
They also scored significantly higher on all PAID-5 items except coping with diabetes complications; however, the younger group had fewer of these than the older adults.
Yet the emerging adult group had significantly higher scores on two measures of life quality, with 49.7% rating themselves as having a good or very good quality of life, compared with 40.2% of the older adults.
“Our results are interesting in that they emphasize the importance of understanding the lived experience of diabetes specifically,” write Michael Vallis (Nova Scotia Health Authority and Dalhousie University, Halifax, Canada) and study co-authors in Diabetic Medicine.
“If one were not to assess diabetes-specific distress the emerging adults would appear to be doing better than the adults aged >30 years. Instead, the data suggest that emerging adults need specific help in addressing the psychological burden of diabetes.”
The emerging adults also had greater diabetes distress despite reporting more support from their main support person and more positive relationships with their healthcare providers, compared with older adults.
“This would suggest that diabetes distress stems more from a psychological issue than from a lack of helping relationships or support,” say the researchers.
Breaking the age groups down further, they found that the 169 emerging adults who were in the later phase, aged 25–30 years, had both poorer life quality and greater diabetes distress than the 139 younger emerging adults, aged 18–24 years. In all, 67.5% versus 51.1% were distressed.
This suggests “that this later phase of development might be particularly difficult for coping with diabetes,” say Vallis et al. “Emotional management interventions targeted toward this specific group might be very valuable.”
They note that diabetes education appeared to be of equal benefit for emerging and older adults. However, the emerging adults were more likely to use newer forms of education, such as online interventions and motivational groups.
The emerging adults were less successful than the older ones with self-management behaviors, such as healthy eating, self-testing, and taking medication, but the team notes that this group appeared to be “quite aware of these self-management deficits,” because more of the younger than older adults were trying to improve in these areas.
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