Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Profile of a tertiary diabetes clinic for young adults focusing on psychosocial assessment (#204)

Helen Demden 1 , Brett McDermott 2 , Kristen Gibbons 1 , Thomas Dover 1 , Trisha O’Moore-Sullivan 1
  1. Mater Hospital, South Brisbane, QLD, Australia
  2. Director, kids in Mind, Mater Hospital, South Brisbane, QLD, Australia

Background

Young adults with type 1 diabetes have a higher prevalence of psychiatric disorders[1, 2]. Routine psychological screening and plans for management of identified problems is recommended.[3, 4].

Aims

Profile young adults (18–25years) attending a tertiary hospital diabetes clinic including demographics, diabetes related health indicators and psychosocial characteristics. This will provide evidence to inform clinical care pathways and policies.

Methods

Over a 20 week period, young adults were recruited to complete self-report measures including: Problem Areas in Diabetes (PAID)(diabetes related distress), Kessler10 (psychological distress), WHO-5 (quality of life), Eating Disorder Inventory Risk Composite Scale (EDI-3RC), the Perceived Stress Scale (PSS), Multidimensional Scale of Perceived Social Support (MSPSS)and Connor Davison Resilience Scale (CD-Risc2). Data was also collected from the medical record over the previous 2 years.

Results

164 young adults participated (95%) with the average age 20.8±2.2 years. The group was predominately Caucasian (92.7%), BMI 24.8kg/m2 ±5.3 with 54.9% female.  Most had T1DM (98.2%), were on intensive insulin therapy (MDI 84.4% and Pump 22%) and the duration of diabetes was 9.7±5.3 years. The median clinic attendance was 6 (interquartile range 3) in 2 years and the median HbA1c was 8.0 (interquartile range 1.9)%/64(21)mmol/mmol). Multidisciplinary team engagement in the previous 2 years included 80.5% diabetes nurse educator, 61% dietitian and 38.7% psychologist.  Diabetes related distress (PAID) was found in 19.7% which is lower than previously reported in this population[5, 6].  Kessler10 in the depression/anxiety spectrum was severe, moderate and mild in 8.9%, 11.4% and 19% respectively. Low WHO-5 scores were seen in 29.1% similar to previous reports[7], and 13.6% were at risk of an eating disorder with higher prevalence in females. Mean PSS scores were 15.6±7.4 and mean MSPSS 5.7±1.3 which is similar to population norms[8]. CD-Risc2 6.1±1.5 which is lower than the general population[9].

Conclusions

Diabetes related distress was less than previously reported with our screening completion significantly higher than any other study. Psychological screening outcomes of other parameters were consistent with previous reports. These results will inform a service model and interventions to address the needs of these young adults managing a chronic illness.

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