Diabetes care provision: barriers, enablers and service needs of young adults with Type 1 diabetes from a region of social disadvantage

Authors:
Publisher website
Google Scholar
Abstract
Aims: To determine the barriers to and enablers of engaging with specialist diabetes care and the service requirements of young adults with Type 1 diabetes mellitus from a low socio‐economic, multicultural region.Methods: A cross‐sectional survey targeted 357 young adults with Type 1 diabetes, aged 18–30 years. Participants completed questions about barriers/enablers to accessing diabetes care and service preferences, self‐reported HbA1c, plus measures of diabetes‐related distress (Problem Areas in Diabetes), depression/anxiety (Hospital Anxiety and Depression Scale), and illness perceptions (Brief Illness Perceptions Questionnaire).Results: Eighty‐six (24%) responses were received [55 (64%) female; mean ± sd age 24 ± 4 years; diabetes duration 12 ± 7 years; HbA1c 68 ± 16 mmol/mol (8.4 ± 1.5%)]. Logistical barriers to attending diabetes care were reported; for example, time constraints (30%), transportation (26%) and cost (21%). However, ‘a previous unsatisfactory diabetes health experience’ was cited as a barrier by 27%. Enablers were largely matched to overcoming these barriers. Over 90% preferred a multidisciplinary team environment, close to home, with after‐hours appointment times. Forty per cent reported severe diabetes‐related distress, 19% reported moderate‐to‐severe depressive symptoms and 50% reported moderate‐to‐severe anxiety.Conclusions: Among these young adults with Type 1 diabetes, glycaemic control was suboptimal and emotional distress common. They had identifiable logistical barriers to accessing and maintaining contact with diabetes care services, which can be addressed with flexible service provision. A substantial minority were discouraged by previous unsatisfactory experiences, suggesting health providers need to improve their interactions with young adults. This research will inform the design of life‐stage‐appropriate diabetes services targeting optimal engagement, access, attendance and ultimately improved healthcare outcomes in this vulnerable population.

This publication has 22 references indexed in Scilit: