Transitioning Young Adults With Type 1 Diabetes to Campus Life

Parent and Young Adult Perspectives About the Transition to College During the COVID-19 Pandemic

PURPOSE

The purpose of this study was to describe the influence of COVID-19 on parents and their young adults with type 1 diabetes as they navigated the college environment during the COVID-19 pandemic.

PARTICIPANTS

A sample of 9 college students with type 1 diabetes and their parents were recruited to participate in interviews via purposive sampling methodology.

METHODS

A descriptive, qualitative study was conducted using semi-structured questions via recorded video conferencing interviews.

RESULTS

Three themes related to navigating type 1 diabetes at college during the pandemic emerged: (1) isolation and mental health: COVID-19-related isolation and loneliness; (2) risk and exposure to COVID-19: balancing risk of COVID-19 with type 1 diabetes; and (3) management of type 1 diabetes on campus during the pandemic: academics, university policies, and their impact on type 1 diabetes.

CONCLUSIONS

Students with type 1 diabetes and their parents had to navigate a complex set of concerns that extended beyond the usual challenges of diabetes management during the COVID-19 pandemic. Providers must provide additional support and incorporate education about type 1 diabetes management strategies to families affected by large-scale health crises.

Lifestyle in Emerging Adults with Type 1 Diabetes Mellitus: A Qualitative Systematic Review

Emerging adulthood is a transitional stage with significant lifestyle changes, making it especially challenging for those living with type 1 diabetes mellitus. This systematic review synthesizes qualitative research to explore how emerging adulthood (18-29 years) influences lifestyle behaviors in individuals with type 1 diabetes mellitus. CINAHL, Cochrane Library, Global Health, Nursing & Allied Health Premium, PsycINFO, PubMed, Scopus, and WOS were searched for original qualitative studies addressing the lifestyle of 18-31-year-olds with type 1 diabetes mellitus, published between January 2010 and March 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thirty-five studies met the inclusion criteria and their findings were categorized into eight topics (emotions and feelings, nutrition, perceptions, risky behaviors, self-care, sleep, social relationships, and stigma) using meta-aggregation, as outlined in the Joanna Briggs Institute Manual for Evidence Synthesis. The spontaneity characteristic of emerging adulthood can undermine self-care. This is because new environments, schedules, and relationships encountered during this life stage often lead to the neglect of diabetes management, owing to the various social, academic, and occupational demands. This review highlights the necessity of creating health promotion strategies tailored to the unique lifestyle aspects of emerging adults with type 1 diabetes mellitus.

Sleep, Nutrition, Disordered Eating, Problematic Tobacco and Alcohol Use, and Exercise in College Students With and Without Diabetes

The purpose of the current study was to examine the health behaviors of college students with diabetes and compare behaviors to college students without diabetes. This descriptive study used the American College Health Association-National College Health Assessment II and included 1,216 students between ages 18 and 24. Health behaviors related to sleep, nutrition, disordered eating, problematic tobacco and alcohol use, and exercise were examined. Students with diabetes (n = 528) reported a higher frequency of meeting exercise recommendations and less healthy behaviors related to nutrition and problematic tobacco and alcohol use. Both groups of students reported inadequate sleep. Students with diabetes reported more academic problems due to sleep difficulties, disordered eating, and problematic alcohol use. Health behaviors in both groups showed similar needs for improvement. Nurses are in a position to guide new, prospective, and continuing college students with diabetes in practicing behaviors associated with positive health outcomes. Opportunities for interventions are numerous. [Journal of Psychosocial Nursing and Mental Health Services, 57(12), 23-32.].

Barriers and Facilitators Influencing Parental Transition of College-Bound Youth with Type 1 Diabetes Mellitus: An Integrative Review

PURPOSE OF REVIEW

The purpose of this review was to synthesize current research about potential barriers impacting parents as they transition their college-bound youth with type 1 diabetes mellitus (T1DM) to college.

RECENT FINDINGS

Seven studies, 5 qualitative and 2 quantitative, met the qualifications for inclusion in this study by focusing on parents and were included in this review. Three potential barriers impacting the parental experience during the transition of their youth with T1DM to college were identified: developing and promoting autonomy, evolving relationships and roles in the parent/youth dyad, and distress. Parents consistently indicated concern about their youth's ability to self-manage their T1DM and lack of support for their own transition. This review indicates that several barriers may influence parents of adolescents with T1DM as they transition to becoming the parent of a college-bound youth with T1DM. The parental transition of launching their youth to college is more complex and unique for parents of youth with T1DM parents of youth without chronic conditions. Additional research focusing on the identification of desired supports for parents and the development of specific interventions to assist parents as they transition with their college-bound youth with T1DM is recommended.

Does sleep duration, napping, and social jetlag predict hemoglobin A1c among college students with type 1 diabetes mellitus?

AIMS

The first aim examined the relationship between sleep behaviors (duration, napping, and social jetlag) and hemoglobin A1c (HbA1c) among emerging young adults (EYAs) with T1DM between 18 and 25 years old, who are living on a college campus. The second aim characterized the gender differences in glucose management, sleep behaviors, caffeine intake, and nighttime technology.

METHODS

A cross-sectional study of eligible participants used a convenience sample of eligible participants. Using Research Electronic Data Capture (REDCap), participants completed surveys about diabetes management, caffeine intake, nighttime technology use, and sleep-related behaviors. Data were analyzed using correlation and multiple linear regression to predict HbA1c from sleep behaviors, adjusting for covariates.

RESULTS

Participants (N = 76) average years with T1DM was 10.25 ± 5.70. Compared to females, males had a longer sleep duration lower HbA1c levels. HbA1c levels were negatively correlated with weekday sleep (r = -0.24, p = 0.03) and positively correlated with napping (r = 0.34, p = 0.003). After adjusting for covariates, participants who napped had a higher HbA1c level (β = 0.74, p = 0.03) compared with non-nappers.

CONCLUSIONS

Higher HbA1c levels were found among EYAs with T1DM in college who were nappers and had a longer sleep duration. Modifying sleep behaviors may be an appropriate target to improve glycemic control.

Positive Health Benefits of Peer Support and Connections for College Students With Type 1 Diabetes Mellitus

Purpose The purpose of this study is to examine the characteristics and health outcomes of college students with type 1 diabetes mellitus (T1DM) as it relates to membership in a local university-based diabetes student organization. Methods This descriptive, correlational research design is a secondary analysis of data. The sample consisted of nationally representative young adults in college (n = 317) between 18 and 30 years of age who were diagnosed with T1DM. Data were collected during April 2017 using a secure electronic diabetes management survey to inquire about self-reported barriers to diabetes management, hypoglycemia, and diabetic ketoacidosis of members of a diabetes organization. Results Students were evenly distributed from freshman to senior year of college with a slight decrease at the graduate level. Students who were affiliated members of a student-led diabetes student organization were less likely to report increased levels of isolation, depressive symptoms, and anxiety related to their diabetes than were general members. Conclusion Participation in a university-based diabetes student organization on campus and connecting with other college students with diabetes may have health benefits. In conclusion, the current study underscores the potential importance of peer-led, diabetes-specific support for adolescents emerging into adulthood.

Maternal Experiences of Transitioning Their Emerging Adult With Type 1 Diabetes to College

Purpose The purpose of this study was to gain a deeper understanding about mothers' experiences of transitioning their emerging adult with type 1 diabetes mellitus to college. Methods A descriptive, qualitative study was conducted with 9 mothers of high school seniors with type 1 diabetes (T1DM) using semi-structured questions via recorded telephone interviews. Results Among the 9 participants, 8 had daughters, and 1 had a son. The thematic analysis resulted in 4 themes: (1) concern for health and safety at college, (2) evolving roles of the parent and emerging adult dyad, (3) communication dynamics, and (4) social support systems. Conclusions Results indicate that mothers of emerging adults with T1DM experience heightened levels of concern during the college transition. These concerns are above and beyond those that are experienced by mothers of emerging adults without T1DM. Findings indicated that increasing levels of support for both parents as well as emerging adults with T1DM during the college transition may serve to decrease maternal stress and enhance the development of preparedness for diabetes self-management. Recommendations for diabetes educators in clinical practice include a family-centered approach focusing on the transition before the late adolescent period, interventions from colleges to promote a smooth transition, and interventions that address concerns of both the emerging adult with T1DM and the parent. Further research is necessary to identify barriers and facilitators to support parent/emerging adult dyads during the college transition period.