Introduction and Objective: Diabetes distress, the emotional and behavioral challenges of living with type 1 diabetes (T1D), is common over the lifespan and can lead to adverse medical and psychological outcomes. Interventions that incorporate stakeholder input on diabetes distress across the lifespan remain limited. The ReDUCe Study aims to reduce diabetes distress in adults with T1D by incorporating stakeholder input into its cognitive behavioral therapy protocol.Methods: We used user-centered design to obtain input from younger (18-35) and middle-age (35-64) adults with T1D. We completed remote group sessions to discuss diabetes distress, review the study protocol and receive feedback. Participants were recruited from Montefiore Medical Center and Breakthrough T1D’s Patient Advisory Council. A modified inductive coding approach with two independent coders was conducted. Workshops were recorded, transcribed, and analyzed using deductive coding until thematic saturation.Results: We conducted a total of 4 young adult and 2 middle-age adult user-centered design sessions. Young adults: n=12, mean age 27 (Range: 23-33) years; 50% female. Middle-age adults: n=5, mean age 45 (Range: 35-58) years; 100% female. Common themes included: competing priorities with lifestyle management, financial barriers, and system-level issues (e.g., insurance). Both groups viewed financial and insurance issues as major stressors, feeling overwhelmed by the high costs of treatment and medication, which hindered effective diabetes management. Middle-age adults worried about co-existing conditions and costs associated with managing diabetes, while younger adults were concerned with immediate challenges, such as how diabetes disrupted their lifestyle and daily routine.Conclusion: Both young adults and middle-age adults with T1D experience diabetes distress, but differences exist. Adapting interventions to the context for diabetes distress across the life course may enhance engagement.
M. Finnan: None. R. Rayden: None. G. Crespo-Ramos: None. C.J. Hoogendoorn: None. T. Farchione: Research Support; National Institutes of Health. S. Agarwal: Research Support; Dexcom, Inc. J.S. Gonzalez: None.
Breakthrough T1D (4-SRA-2021-1071-M-B)
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