Diabetes Distress and Glycemic Control in Young Adults with Type 1 Diabetes: Associations by use of Insulin Pumps and continuous glucose monitors

Inspite of technological advancements, the levels of HbA1c in youth and young adults has surged over the decades.
The term ‘Diabetes Distress’(DD) is a disease-specific term that encapsulates negative emotions such as guilt, frustration and isolation that results from having diabetes. Although ‘DD’ is linked to self-management skills, it is not known how is it related with glycemic control in young adults among users and non-users of these two devices (insulin pumps and CGMS). Kathryn E. Nagel and colleagues thereby conducted a research titled ‘Diabetes Distress and Glycemic Control in Young Adults with Type 1 Diabetes: Associations by use of Insulin Pumps and continuous glucose monitors’ the summary of which has been given below.

Objective:

The study aimed to evaluate whether high DD in young adults with Type-1-Diabetes was related to higher HbA1c levels and if this relation between high DD and higher HbAc levels was on the same grounds among individuals who were and were not using insulin pumps and CGMS devices.

Method:

The data was acquired from the study conducted in 2017 titled ‘T1 Flourish: Strengths and Challenges for Young Adults with Type-1-Diabetes’. The study was conducted as a secondary analysis using the data of this research. The primary outcome was HbA1c and ‘Diabetes Distress’ was the primary exposure.

Findings:

The DD levels were high irrespective of whether the patients used insulin pumps or CGMs. Besides DD has been persistently linked with high HbA1c levels.
The findings also shift focus on the aspect that young adults must learn autonomy with disease-management.
Even though technological advancements have taken place, a device does not always attend to the concerns of a diabetes patient. This research makes it evident that there is a high prevalence of DD and routine-related distress even post the use of diabetes devices.

Limitations:

The study being a cross-sectional study did not allow the possibility of a casual inference.
Certain possibilities cannot be excluded such as DD may result from glycemic control or those with higher DD or higher HbA1c levels are more probable to select modern devices to reduce their glucose levels.
The study was conducted among young adults under diabetes care and the findings do not apply to the entire youth populace.
Certain aspects of distress such as cost-related or hypoglycemia related distress were not covered.

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