Intended for healthcare professionals

Practice Practice Pointer

Managing the psychosocial impact of type 1 diabetes in young people

BMJ 2022; 377 doi: https://doi.org/10.1136/bmj-2022-070530 (Published 04 April 2022) Cite this as: BMJ 2022;377:e070530
  1. Sze May Ng, consultant paediatric endocrinologist1 2,
  2. Tracy Corbett, senior lecturer, public health,
  3. Emma Doble, patient4,
  4. Abigail Brooks, GP partner,5,
  5. Partha Kar, national specialty adviser, diabetes6
  1. 1Paediatric department, Southport and Ormskirk NHS Trust, Ormskirk, UK
  2. 2Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK
  3. 3University of Bolton, Bolton, Greater Manchester, UK
  4. 4The BMJ, London, UK
  5. 5Priory Medical Group, York, UK
  6. 6Diabetes and endocrine department, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
  1. Correspondence to S M Ng may.ng{at}nhs.net

What you need to know

  • Adolescent and young people with type 1 diabetes (T1D) experience higher rates of psychological distress, periods of burnout, and feelings of being unable to cope with the daily burden of living with diabetes, compared with those who are diagnosed as adults

  • Family, peer, and psychological support and education on living with diabetes can help to reduce distress and improve management of diabetes and wellbeing

  • Consider using psychological screening assessment tools at diagnosis and annually, and developing appropriate local referral pathways to ensure adequate mental health support

  • Psychological and behavioural interventions, such as solution focused therapy, coping skills training, motivational interviewing, cognitive behavioural therapy, or family centred interventions aimed at supporting the emotional wellbeing and mental health of people with T1D have shown significant improvements in quality of life and overall management of diabetes

A 19 year old patient who attends the local university recently received a diagnosis of type 1 diabetes. She requests an appointment with the GP to discuss sleep and insomnia, hoping for advice or medication to help.

On further exploration of her symptoms, it becomes apparent that she has substantial anxiety in relation to the diagnosis. She is feeling overwhelmed with the diabetes clinic appointments, frequency of blood glucose testing, insulin injections, and rumination around the potential long term complications of type 1 diabetes. The patient is living in university accommodation away from her family home and is feeling isolated. Poor sleep is one of several symptoms she describes, including loss of appetite, palpitations, and a feeling of panic. She had approached the university support services but felt they didn’t fit her needs.

The incidence and prevalence of type 1 diabetes (T1D) have increased in recent decades.1 Receiving a diagnosis of T1D is a life changing experience for the individual and their family. Learning how to …

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