The Journal of clinical endocrinology and metabolism · 2025
Navigating Transition to Adult Care in Youth-Onset Type 2 Diabetes: Facilitators, Attitudes, Barriers, and Behaviors.
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Glaros Sophia Beth, Dixon Sydney Annemarie, Malandrino Noemi, Davis Faith Suzanne, Chowdhury Aruba, Kacker Ila Nikki, Macheret Natalie Ann, Cantor Samson Levy, Thota Geethika, Mabundo Lilian, Gordon Catherine Mason, Lightbourne Marissa, Estrada Doris Elizabeth, Monaghan Maureen, Chung Stephanie Therese
Аннотация
CONTEXT: Transitioning from pediatric to adult-centered diabetes care may be challenging, especially for young individuals at risk for and with youth-onset type 2 diabetes (Y-T2D) who have a high disease burden and rapidly progressive disease. However, the scope of transition readiness, range of psychosocial factors, and perceived barriers among Y-T2D are understudied.
OBJECTIVE: In Y-T2D attending an adult diabetes transition clinic, our objectives were to (1) characterize attitudes toward transition readiness, (2) examine relationships among depressive and anxiety-related symptoms and transition readiness, and (3) identify perceived barriers and facilitators of diabetes self-care.
METHODS: Transition readiness was assessed with the Endocrine Society "Self-assessment of Worries, Concerns, and Burdens Related to Diabetes and Preparation for Transitioning," and mood symptoms with the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7) questionnaire. Logistic regression analyses evaluated the response to transition readiness by mood symptoms. Qualitative analysis identified themes of diabetes self-care in a subset of Y-T2D.
RESULTS: Survey response rate was 89%; n = 65; age: 19.6 ± 2.0 years (mean ± SD); 85% Y-T2D; 15% prediabetes; 57% female; 78% Black; body mass index: 38.0 ± 8.2; and hemoglobin A1c: 7.6 ± 2.7%. Perceived challenges were reported in 95% of participants, and 54% reported worrying about their future. Mild or greater depressive and anxiety-related symptoms were associated with higher odds of reporting social, emotional, and cognitive challenges. Stress, socioeconomic difficulties, and challenges with organizational cognitive functioning were reported barriers to diabetes self-care.
CONCLUSION: Mood symptoms and difficulties with organizational cognitive functioning were commonly reported in Y-T2D during the transitioning period. Interventions are needed to successfully address these psychosocial factors.
OBJECTIVE: In Y-T2D attending an adult diabetes transition clinic, our objectives were to (1) characterize attitudes toward transition readiness, (2) examine relationships among depressive and anxiety-related symptoms and transition readiness, and (3) identify perceived barriers and facilitators of diabetes self-care.
METHODS: Transition readiness was assessed with the Endocrine Society "Self-assessment of Worries, Concerns, and Burdens Related to Diabetes and Preparation for Transitioning," and mood symptoms with the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7) questionnaire. Logistic regression analyses evaluated the response to transition readiness by mood symptoms. Qualitative analysis identified themes of diabetes self-care in a subset of Y-T2D.
RESULTS: Survey response rate was 89%; n = 65; age: 19.6 ± 2.0 years (mean ± SD); 85% Y-T2D; 15% prediabetes; 57% female; 78% Black; body mass index: 38.0 ± 8.2; and hemoglobin A1c: 7.6 ± 2.7%. Perceived challenges were reported in 95% of participants, and 54% reported worrying about their future. Mild or greater depressive and anxiety-related symptoms were associated with higher odds of reporting social, emotional, and cognitive challenges. Stress, socioeconomic difficulties, and challenges with organizational cognitive functioning were reported barriers to diabetes self-care.
CONCLUSION: Mood symptoms and difficulties with organizational cognitive functioning were commonly reported in Y-T2D during the transitioning period. Interventions are needed to successfully address these psychosocial factors.