Adults with newly diagnosed type 1 diabetes need early psychosocial support
medwireNews: It is just as important to help adults with newly diagnosed type 1 diabetes learn how to live with the condition as it is to teach them about it, show results of a narrative study among patients from the UK and Denmark.
“Attending to the emotional impact of diabetes; supporting adults to develop more positive adaptive strategies; and enhancing communication by health professionals after diagnosis, may help attenuate the development of common diabetes-specific psychosocial problems,” report Mette Due-Christensen (King’s College London, UK) and co-authors in Diabetic Medicine.
They add: “Further research is needed to develop such tailored interventions in collaboration with people with diabetes and health professionals.”
The researchers conducted semi-structured interviews with 30 adults (median age 29 years, 53% men) newly diagnosed with type 1 diabetes (median duration 23.5 months) in order to understand their experiences following diagnosis and how they adapt to life with diabetes physically, psychologically, and socially.
The interviews showed that each patient has a different experience following diagnosis, but there were three recurring themes that “shaped the way in which people responded to their diagnosis and moved on to accommodate diabetes in their lives”: the diagnosis itself; learning about diabetes; and learning to live with diabetes.
Study participants described the time around their diagnosis as “a period of uncertainty” and often delayed seeking help. Once diagnosed, many participants felt relieved that they knew “what was wrong with them” and began to feel better after starting insulin.
“For most participants this relief was short-lived, however, as they began to realize the potential seriousness of their condition and its impact on their lives,” Due-Christensen et al remark.
There were a number of subthemes relating to learning about diabetes. These included learning self-management, which was largely self-directed and “initially overwhelming”, and encountering hypoglycemia and hyperglycemia.
Learning to live with diabetes was also broken down into a number of subthemes such as disruption (eg, need for constant awareness and impact on life plans), emotional response (eg, loss of previous life, sadness), acceptance, and social adaptation (eg, asserting needs in unfamiliar situations).
Due-Christensen and team note that “the psychological and social adaptation to diabetes […] unfolded over a long period of time and seemed to be ongoing.”
Furthermore, “[t]he narratives suggested that participants found learning to live with diabetes much harder than learning about diabetes.”
Of note, although all participants described a sense of life disruption following their diagnosis, it was expressed differently depending on age.
Younger participants compared it with other transitions they had experienced in life, and reacted more positively to their diagnosis, whereas older participants saw it as more of a disturbance to their set ways, which negatively affected their quality of life.
The authors conclude: ““After diagnosis, adults need much more support in adapting to [diabetes] emotionally, psychologically and socially. Such support may reduce or prevent the development of negative psychosocial reactions that can impede self-management behaviours and reduce well-being.”
By Laura Cowen
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