Transitions in care: support group for young adults with Type 1 diabetes

Abstract

Aims Young adulthood is a challenging period for patients with Type 1 diabetes as developmental changes complicate Type 1 diabetes management and gaps in care may arise as patients transition from paediatric to adult providers. This period has been associated with worsening diabetes outcomes. One approach to aid young adults during this transition period could entail professionally led support groups to enhance self-motivation and facilitate peer-to-peer interactions. We implemented and evaluated a support group for young adults with Type 1 diabetes as a pilot project. Methods Young adults with Type 1 diabetes (18–30 years) participated in monthly, professionally led support groups for 5 months. Questionnaires were completed pre- and post-group and chart review data were collected regarding glycaemic control and visit frequency in the year before and after group participation. Results Participation in the group was associated with improvement in HbA1c and decreased self-reported diabetes burden, along with a trend for an increase in diabetes-related self-care behaviours. Frequency of visits did not vary from pre- to post-group. Discussion topics identified by participants included managing diabetes in day-to-day life, experiences and interactions with others who do not have diabetes and emotions related to diabetes. Participants identified that they sought a diabetes care team that offers knowledge, support and a multidisciplinary team. Conclusions Professionally led support groups may have utility for increasing social support and optimizing diabetes outcomes in young adults with Type 1 diabetes.

Identifying Factors Associated with Participation in T1D Support Program for Young Adults

“…While looking at the transitions individuals have encountered in young adulthood, the findings are similar to those found by others in the field with transitions such as: moving from home, attending college, having a child, transitioning to adult medical care, and graduating high school [5,8]. Interestingly, cost was not found to be a barrier of attendance by this young adult population.…”

“…Young adulthood may be one of the most challenging times in a person's life with T1D because of various complex changes occurring, such as moving away from their major support systems, attending college, and hormonal changes [8]. Young adulthood is a period in life commonly marked as one for decreased motivation and a lapse in proper glycemic control among individuals with T1D because of other overwhelming stressors such as: college, stigma, parental involvement, and medical provider interactions [6,5].…”

Psychosocial screening and management of young people aged 18–25 years with diabetes

“…Additionally, transition from paediatric to adult health services occurs and they can be lost to follow-up care. It is a time where glycaemic control can deteriorate and complications can result (5,6), as well as increased rates of depression, anxiety and eating disorders (7)(8)(9). Optimal diabetes management is intensive, and regular medical checks and multiple daily selfmanagement tasks are required.…”

The Diabetes Mixer: Fostering a Diabetes Community to Support Peer Health

“…For example, peer health can improve coping [3], increase psychosocial support [4][5][6][7][8][9][10][11], and decrease diabetes distress [12] by means of shared experiences [7,8,10,13,14]. Peer health can also increase patient knowledge [4,15,16], confidence in diabetes management [17], self-efficacy [12,18,19], and improve glycosylated hemoglobin (A1C) [12,16,[20][21][22][23][24][25][26].…”