Psychosocial Factors and Glycemic Control in Young Adults With Youth-Onset Type 2 Diabetes
Authors' conclusion
In this cohort study of young adults with youth-onset type 2 diabetes, beliefs about medicines, high diabetes distress, low diabetes self-efficacy, and self-management support were associated with high HbA1c over time. Future research should assess whether interventions that address these factors result in improved glycemic control in this at-risk group.
Study context
- Population
- Young adults diagnosed with T2D during childhood or adolescence, iCount cohort within TODAY2 observational phase (2017–2019); mean age 26.1 years, 65.8% women, mean HbA1c 9.4%381 enrolled
- Participants
- 348 adults
- Outcome
- High HbA1c (≥8.0%) at T2, HbA1c level at T2, and change in HbA1c (decreased ≥0.5%, stable, or increased ≥0.5%)
- Follow-up
- 1 year (T2)
Methodological detailsmulticenter, observational, Data analyzed December 2021 to September 2023
- Multicenter
- Observational
- Data analyzed December 2021 to September 2023
Main finding
As reported in the abstract
High HbA1c (≥8.0%) at T2 · T2 (1 year)
- Beliefs that diabetes medicines are necessary: OR (95% CI 1.03-1.37); P = .02
- 1.19
- Concerns about medicines: OR (95% CI 1.00-1.45); P = .049
- 1.20
- Diabetes distress: OR (95% CI 1.02-1.15); P = .006
- 1.08
- High distress: OR (95% CI 1.15-4.13); P = .02
- 2.18
- Greater support: OR (95% CI 0.46-0.97); P = .04
- 0.67
- Diabetes self-efficacy: OR (95% CI 0.84-0.99); P = .02
- 0.91
Observational data: associations, not effects.
Further findings
HbA1c level at T2
- Diabetes distress: coefficient (95% CI 0.02-0.13); P = .01
- 0.08
HbA1c decrease of at least 0.5% over 1 year
- Beliefs that diabetes medicines are necessary: OR (95% CI 1.03-1.39); P = .02
- 1.20
- Concerns about medicines: OR (95% CI 1.00-1.47); P = .048
- 1.22
Original publication
Psychosocial Factors and Glycemic Control in Young Adults With Youth-Onset Type 2 Diabetes. JAMA Netw Open. Published 1 April 2024. doi:10.
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