Emerging adulthood and Type 1 diabetes: insights from the DAWN2 Study

• Published in: Diabetic medicine Vol. 35; no. 2; pp. 203 - 213
• Main Authors: Vallis, M., Willaing, I., Holt, R. I. G.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.02.2018
• Subjects: Adolescent; Adult; Attitude to Health; Blood Glucose - metabolism; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - psychology; Diabetes Mellitus, Type 1 - therapy; Disease management; Family Relations; Female; Humans; Hypoglycemia; Hypoglycemia - blood; Hypoglycemia - etiology; Male; Patient Education as Topic; Prejudice; Quality of Life; Self-Management; Social interactions; Social Support; Stress, Psychological - etiology; Transition to Adult Care; Young Adult; Young adults
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.13554

Aims To compare clinical, psychological, education and social variables in emerging adults (aged 18–30 years) with Type 1 diabetes with their adult counterparts aged >30 years. Methods A single assessment multinational sample was surveyed as part of the larger second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Participants completed a series of surveys incorporating demographic as well as clinical questions (comorbidities, hypoglycaemia) and validated self‐report scales concerning psychosocial (health impact, quality of life, beliefs and attitudes, self‐management behaviours, healthcare experience and family support) and diabetes education factors. Results Emerging adults differed from adults aged >30 years with regard to a number of psychosocial variables. Emerging adults reported better overall quality of life, social support and support from their healthcare team compared with adults aged >30 years of age; however, emerging adults experienced greater diabetes‐specific distress and were less engaged in self‐management. Diabetes education was related to a number of indicators, while experience of discrimination was harmful, but these impacts did not differ between emerging adults and adults aged >30 years. An analysis of geographical regions suggested that emerging adults in North America and Europe had better well‐being than older adults, while the opposite was observed in Asia. Conclusions Emerging adults, particularly those in the later phase (ages 25–30 years) are especially at risk in terms of diabetes‐specific distress. There is a need for novel interventions to meet the needs of these vulnerable emerging adults more effectively. What's new? Compared with individuals with Type 1 diabetes aged >30 years, emerging adults reported better overall quality of life but greater diabetes distress and lower levels of self‐management. Diabetes education appears to be as valuable to emerging adults with Type 1 diabetes as it is to adults aged >30 years. These results support the recommendation of assessing diabetes distress in emerging adults with Type 1 diabetes. Assessing overall quality of life is likely to miss important psychological issues, specific to the experience of Type 1 diabetes.