Date of Award

2021

Publisher

North Dakota State University

Document Type

Dissertation

Degree Awarded

Doctor of Philosophy (PhD)

Program

Exercise Science and Nutrition

Department

Health, Nutrition, and Exercise Sciences

College

Human Sciences and Education

Faculty Advisor

Stastny, Sherri

Description

Emerging adults aged 18 – 30 years with type 1 diabetes (T1DM) make unique lifestyle choices that can create complications for disease management. The objective of this study was to identify barriers and strategies for management of T1DM in young adults (YA). A non-experimental, causal-comparative, observational cross-sectional study using both quantitative and qualitative methods was utilized for the study. In May 2020, YA with T1DM (n = 115; mean age diagnosed 14 ± 7.23) aged 18 – 30 years (64% in age group 25 – 30 years) were recruited to complete the Managing Diabetes in Young Adults Survey. Participant self-reported biomarkers and demographics. The survey included: T1DM management questions from the Diabetes Empowerment Scale (DES), the Diabetes Self-Management Questionnaire (DSMQ), the Diabetes Eating Problems Survey – Revised (DEPS-R), and select questions from the Centers for Disease Control Youth Risk Behavior Surveillance System (YRBSS). Qualitative methods included a telephone interview. From the survey, ‘good’ glycemic control (GC) was associated with higher DSMQ overall scores (p = 0.0003) and the DSMQ glucose management subscale (p = 0.0027) compared to ‘medium’ and ‘poor’ GC. Participants with ‘good’ GC were observed to have higher eating disorder/disordered eating risk (DEPS-R score  20) than the ‘medium’ GC group (mean 28.60 ± 6.86 vs. mean 22.17 ± 2.56, p = 0.0320). Participants who drank more alcohol per session and per week were more likely to adjust dietary intake and insulin dosage: (F (1,114) = 9.52, R^2=0.0770,p=0.0026), (F (1,114) = 5.14, R^2=0.0431,p= 0.0253). There was a weak negative association observed from the Spearman correlation coefficient (-0.0755; 95% CI -0.2665, 0.1154) for ‘good’ GC and those who are at risk for low blood glucose during physical activity. Qualitative examination exposed various barriers and strategies for T1DM management. From the survey participants, 21 volunteered for the telephone interview (female = 19, male = 2) (diagnosed age: mean 15.00 ± 8.00). Barrier themes included physiology, environment, and insurance and subthemes, mental health, lack of social support and weather. Strategy themes included medical technology, social support, and physical activity; and strategy subthemes, supplies, compliance, social media and accountability.

Rights

NDSU policy 190.6.2

Rights Link

https://www.ndsu.edu/fileadmin/policy/190.pdf

Author ORCID Identifier

0000-0001-5874-2398

Handle Identifier

https://hdl.handle.net/10365/32312

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