Stressful Life Events in Young Adults With Type 1 Diabetes in the U.S. T1D Exchange Clinic Registry.
Kevin L Joiner, Margaret L Holland, Margaret Grey
PMID 30246919WHAT IT FOUND
48.6% of 2,921 young adults with type 1 diabetes reported a stressful life event in the past year.
Those who did missed insulin more often and had A1c 8.7% versus 8.2%.
Key findings
0148.6% of the analyzed young adults with type 1 diabetes reported at least one stressful life event in the previous year.
02Those reporting a stressful life event were more likely to miss insulin doses three or more times a week.
03Mean A1c was 8.7% among those reporting a stressful life event and 8.2% among those who did not.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data were collected at one time, so the study cannot show that stressful life events came before missed insulin doses or higher A1c. Stressful life events were measured with a short 16-item checklist developed for the registry, without strong evidence of validity and reliability, and with only a limited list of events. Missed insulin doses were self-reported, which can be affected by memory and social desirability. The sample was not representative of all young adults with type 1 diabetes in the United States. It was 83.1% non-Hispanic White and 4% non-Hispanic Black, and more Black participants were dropped because of missing data. The data were collected between September 2010 and August 2012, so they may not reflect current diabetes technology or care. Household income was missing for 39.0% and insurance for 31.5% of the sample, so cost and access could not be considered. The study did not measure depression or anxiety, which could be linked to stress and self-management.
Declared interests
The supplied text does not include an author conflict-of-interest declaration. The publication type lists NIH extramural research support.
The easy way to misread this
Do not read the higher A1c and missed insulin doses as proof that stressful life events caused poor diabetes control. The data were collected at one time, and the paper did not test a stress-screening or psychosocial intervention.