Diabetes care provision: Barriers, enablers and service needs of young adults with type 1 diabetes — ASN Events
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Diabetes care provision: Barriers, enablers and service needs of young adults with type 1 diabetes (#280)

Katherine Kibbey 1 , Jane Speight 2 3 , Jennifer Wong 1 , Laura Smith 2 3 , Helena Teede 1 4
  1. Southern Health, Melbourne, VIC, Australia
  2. Australian Centre for Behavioural and Social Research in Diabetes, Melbourne, Australia
  3. Deakin University, Melbourne, Australia
  4. School of Public Health and Preventative Medicine Monash University, Melbourne, Australia

Objective:

To ascertain the barriers and enablers to engaging with specialist diabetes care and the service requirements of a high risk young adult population with type 1 diabetes living in a low socioeconomic multicultural region with limited availability of life stage appropriate diabetes services.

Research Design and Methods:

A cross-sectional survey of 357 young adults with type 1 diabetes aged 18 to 30 years was conducted, recruited from hospital outpatient clinics, inpatient records and the National Diabetes Services Scheme Register. Participants completed a short questionnaire booklet to assess barriers and enablers to diabetes care, service requirements in addition to demographic characteristics.

Results:

A total of 87 (25%) responses were received: mean±SD age: 23.5±3.8 years; duration of diabetes: 11.5±7.1 years; 63% were women. The mean±SD HbA1c was 8.6±1.8%, and 11.6% reported one or more microvascular complication. The cohort displayed indicators of social disadvantage including 46% of participants noting a family income of <$40, 000 per year. Barriers to attending diabetes care appointments included appointment-related issues (time of day, seeing a different practitioner at each appointment, long waiting times in clinic), transport issues due to location of diabetes service, time constraints, forgetting appointments and cost. Enablers included a clinic close to home, flexible appointment times, resource provision at appointments and continuity of care. Over 90% preferred their diabetes to be managed in a multidisciplinary team environment, close to home with appointments after usual business hours.

Conclusions:

There are clearly identifiable barriers to obtaining and maintaining optimal diabetes care in young adults with T1DM. The impact of this research is in designing a life-stage appropriate diabetes services that specifically targets this vulnerable population.  By removing barriers and addressing enablers, a T1DM service for young adults can optimise engagement, access, attendance and ultimately outcomes.