Are better blood glucose levels linked to resilience in young adults with type 1 diabetes?

Abstract

Young people with type 1 diabetes frequently find it difficult to live effectively with their condition as evidenced by poor blood sugar control. This problem has been identified in many countries, but is pronounced in England. However, there is no consensus in understanding this issue. Resilience as adaptive and effective handling of adversity has been suggested as a protective factor. The aim of this pilot study was to determine how members of this group with either good or poor glucose control differ with regards to resilience and correlated factors including social support and wellbeing. We recruited 41 young adults with good or poor blood glucose HbA1c levels (defined as HbA1c <58 or >75mmol/mol respectively) from 2 secondary care centres in England (21 women; age M=19.7 years). Standardised questionnaires were used. A subset of participants (n=21) took part in semi-structured interviews and filled in event diaries (n=11). Ethical approval was granted. Participants with lower glucose levels showed stronger resilience (P<0.0005). Better social support was associated with a lower HbA1c (emotional support p=0.007; practical support p=0.02). Wellbeing and attachment were not associated with HbA1c (p>0.1). Qualitative findings illustrate how diabetes is negotiated in everyday life, how it shapes identity and promotes a sense of agency where young people actively take control of their own situations. Self-care involves an understanding of transitions and pathways through the condition and its medical implications, alongside the notion of embodied self-care. In conclusion, resilience should be explored in a longitudinal study, in conjunction with social support.