Meeting the needs of younger adults with type 2 diabetes

The prevalence of type 2 diabetes (T2D) is rising worldwide, increasingly affecting younger adults (aged 18-39 years). As this is a relatively new trend, there is a lack of research about younger adults with T2D. Epidemiology studies show that younger-onset T2D is an aggressive form of the condition, predisposing individuals to early onset and rapid progression of a range of complications. As a consequence, young adults with T2D are at risk of experiencing diabetes-related complications by mid-life. Clinicians have called for intensive medical management, early complications screening and active diabetes self-management. However, young adults with T2D have reported a lack of age-appropriate self-management information, and that existing educational and support services do not meet their specific needs.

In response, the ACBRD has developed a research program to explore and identify the specific informational, emotional and psychosocial needs young adults with T2D, with the aim of supporting them to achieve optimal diabetes self-care. For example, in a matched-case analysis of Diabetes MILES study participants, we explored how Australians manage their diabetes, the support they receive and the impact that diabetes had on their lives. This revealed a clear need for intensive, targeted psychological and self-care support for young adults with T2D.

In another ACBRD led study, factors underlying low retinal screening uptake by this group who are at high risk of vision loss from diabetic retinopathy, were explored via in-depth interviews and a nationwide study.  Supported by Vision 2020 Australia and with the involvement of young adults with T2D themselves, we developed the first eye health and retinal screening promotion resource tailored to this group.

Our ongoing program of work includes exploring the links between T2D, personality and lifestyle behaviours; as well as preferences for and engagement with diabetes technologies, such as health ‘apps’.  Moving forward, we aim to explore the psychosocial factors impacting a range of diabetes self-care activities, with a view to developing more resources tailored to this priority population.

ACBRD team

We have received funding from Diabetes Victoria, the National Diabetes Services Scheme and Vision 2020 Australia. We also acknowledge our collaborators: Dr Jessica Browne (formerly ACBRD), Dr Gwyn Rees (Centre for Eye Research Australia) and Prof Frans Pouwer (University of Southern Denmark).

ACBRD Publications

Lake AJ, Bo A, Hadjiconstantinou M. Developing and evaluating behaviour change interventions for people with younger-onset type 2 diabetes: lessons and recommendations from existing programmes. Current Diabetes Reports, 2021; 21(12).

Lake AJ, Hateley-Browne JL, Rees G, Speight J. (2020) Effect of a tailored leaflet to promote diabetic retinopathy screening among young adults with type 2 diabetes: a randomised controlled trial. BMC Ophthalmology, 2020; (1):80.

Lake, A. J., Browne, J. L., Rees, G., & Speight, J. (2017). What factors influence uptake of retinal screening among young adults with type 2 diabetes? A qualitative study informed by the Theoretical Domains Framework. Journal of Diabetes and its Complications, 31(6), 997-1006.

Browne, J. L., Nefs, G., Pouwer, F., & Speight, J. (2014). Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes: Results from the International Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Study. Diabetic Medicine, 32(1), 133-140.

Browne, J. L., Scibilia, R., & Speight, J. (2013). The needs, concerns, and characteristics of younger Australian adults with type 2 diabetes. Diabetic Medicine, 30(5), 620-626.

Further reading

Click on the hyperlinks above for the key ACBRD publications

Key papers by other researchers in this field include:

Middleton T, Constantino M, McGill M, D’Souza M, Twigg SM, et al. An Enhanced SMS Text Message-Based Support and Reminder Program for Young Adults With Type 2 Diabetes (TEXT2U): Randomized Controlled Trial. Journal of Medical Internet Research (2021), 23(10):e27263

Gopalan A, Blatchins MA, Altschuler A, Mishra P, Fakhouri I, Grant RW, Disclosure of New Type 2 Diabetes Diagnoses to Younger Adults: a Qualitative Study. Journal of General Internal Medicine, 2021; 36(6): 1622–1628.

Bo A, Thomsen RW, Nielsen JS, Nicolaisen SK, Beck-Nielsen H, Rungby J et al. Early-onset type 2 diabetes: Age gradient in clinical and behavioural risk factors in 5115 persons with newly diagnosed type 2 diabetes—Results from the DD2 study. Diabetes/Metabolism Research and Reviews, 2018 Mar; 34 (3).

Lascar N, Brown J, Pattison H, Barnett AH, Bailey CJ & Bellary S. Type 2 diabetes in adolescents and young adults. The Lancet Diabetes & Endocrinology, 2018; Jan;6(1):69-80

Al-Saeed AH, Constantino MI, Molyneaux L, D’Souza M, Limacher-Gisler F, Luo C et al. An inverse relationship between age of type 2 diabetes onset and complication risk and mortality: the impact of youth-onset type 2 diabetes. Diabetes Care, (2016); 39: 823-829