Emerging adults, ages 18-25, with type 1 diabetes (T1D) may be vulnerable to financial and psychological barriers to self-management as they grapple with the developmental milestones of financial and self-management independence. This correlational, cross-sectional study described the relationships among financial stress factors (perceived stress, financial stress, and financial independence) and psychological factors (depressive symptoms, trait anxiety, and diabetes distress) on self-management outcomes (HbA1c and diabetes-related quality of life [DQoL]) in emerging adults with T1D. Data from 413 emerging adults recruited from the T1D Exchange (mean age 22.1±1.83 years; 62% female; 80.4% white; 37.3% private high-deductible insurance; T1D duration 13.2±4.41 years; 8.0±1.6 HbA1c) were analyzed. The Perceived Stress Scale, Personal Financial Well-Being Scale, Willingness to Pay Scale, Financial Independence Visual Analog Scale, Center for Epidemiological Studies-Depression Inventory, State-Trait Anxiety Inventory, Diabetes Distress Scale and DQoL Measure were completed via REDCap surveys. Hierarchical Multiple Regression analyses revealed that 20.6% of variance in HbA1c (F=15.555, p<.001) was explained by greater financial stress (β=-.197, p<.001) and diabetes distress (β=.181, p<.001); 64.5% of the variance in DQoL (F=148.469, p<.001) was explained by greater financial stress (β=-.112, p = .002), diabetes distress (β=.512, p<.001), trait anxiety (β=.183, p=.001) and depressive symptoms (β=.162, p=.001). Greater financial stress and psychological factors have detrimental impacts on self-management outcomes during emerging adulthood. Future interventions should assess and address these self-management barriers in practice.


J.E. Blanchette: Other Relationship; Self; Tandem Diabetes Care. V.B. Toly: None. J.R. Wood: Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc. Speaker’s Bureau; Self; Xeris Pharmaceuticals, Inc. C.M. Musil: None. D.L. Morris: None. M.E. Votruba: None.


Frances Payne Bolton School of Nursing; Sigma Theta Tau International

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.