Affiliation:
1. New York University Rory Meyers College of Nursing, New York, NY
2. Yale School of Nursing, Orange, CT
Abstract
OBJECTIVE
The purpose of this study of adults with type 1 diabetes was to analyze patterns of diabetes self-management behaviors and predictors of glycemic control across the adult life span.
RESEARCH DESIGN AND METHODS
This study was a secondary cross-sectional analysis of data of 7,153 adults enrolled in the T1D Exchange Clinic Registry who were divided into four developmental stages (emerging, young, middle-aged, and older adults). Data were collected by questionnaire and medical record review at enrollment. Statistical analyses compared sociodemographic, clinical, and diabetes-related factors across groups. Logistic regressions were conducted for each group to identify factors associated with hemoglobin A1c ≥7%.
RESULTS
The sample was divided according to adult developmental stage: emerging adults, age 18 to <25 years (n = 2,478 [35%]); young adults, age 25 to <45 years (n = 2,274 [32%]); middle-aged adults, age 45 to <65 years (n = 1,868 [26%]); and older adults, age ≥65 years (n = 533 [7%]). Emerging adults had the highest mean hemoglobin A1c level (8.4 ± 1.7% [68 mmol/mol]), whereas older adults had the lowest level (7.3 ± 0.97% [56 mmol/mol]; P < 0.0001). Emerging adults were less likely to use an insulin pump (56%) or a continuous glucose monitor (7%) but were more likely to miss at least one insulin dose per day (3%) and to have had an episode of diabetic ketoacidosis in the past year (7%) (all P < 0.0001). Different factors were associated with hemoglobin A1c ≥7% in each age-group, but two factors were noted across several groups: the frequency of blood glucose checks and missed insulin doses.
CONCLUSIONS
When discussing diabetes self-management, providers may consider a patient’s developmental stage, with its competing demands (such as work and family), psychosocial adjustments, and the potential burden of comorbidities.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
50 articles.
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