Support Group to Reduce Diabetes Distress in Adolescents with Type 1 Diabetes

Abstract

Background: Adolescents have the poorest glycemic control of all age groups with type 1 diabetes mellitus (T1DM). One-third of adolescents with T1D experience severe diabetes distress. Diabetes distress can negatively affect daily diabetes management, glycemic control, and quality of life. Screening for diabetes distress is important because it can be difficult to identify and may be present in patients with well-controlled diabetes. Purpose: We aim to assess a support group intervention to reduce diabetes distress and improve glycemic control in adolescents with T1DM. Description of topic: We will use a quasi-experimental single group design with pre- and post-intervention evaluation of glycated hemoglobin levels (HbA1c) and diabetes distress. Adolescents will participate in a month-long intervention comprising weekly professional-led support groups focusing on diabetes distress. Support group topics include recognizing diabetes distress, appropriate age-related diabetes management guidelines, problem-solving, coping, and communication skills. Interactive activities include discussion, question and answer, skills practice, modeling, problem-solving, and goal-setting exercises. We will measure distress using the Diabetes Distress Scale (DDS). The DDS consists of 17 questions with four subscales: emotional burden, regimen distress, interpersonal distress and physician distress. Participants rate their perceived level of distress (“not a problem” to “very serious problem”) for each item. Results are anticipated to be available in Spring 2020. Hypothesized results include reduced DDS without significant changes in HbA1c. Decreases in emotional burden and interpersonal distress are hypothesized to have the most significant change after participation in the support group. Clinical Implications: A T1DM support group provides exposure to health care professionals outside of the clinic setting and may be effective tool for managing T1DM. Recognizing and discussing diabetes distress may have positive effects on glycemic control as well as physical and psychological well-being. Support from peers may help normalize diabetes self-care behaviors, making it more likely for adolescents to participate in daily diabetes management.