Background: Despite known risks, young adults (YAs) may ration insulin and type 1 diabetes (T1D) supplies past their recommended use for many reasons, such as changes in health insurance, increased insulin costs, and gaps in health care. In this study, we examined the frequency with which YAs ration insulin and T1D supplies, and related individual and social factors.
Methods: We surveyed 203 YAs with T1D (age 18-25; 54% Female, 1.5% Transgender, 82% Non-Hispanic White, 9% Hispanic/Latino, 11% Non-Hispanic Black, 46% in college, 63% pump-users, and mean HbA1c = 7.69 ± 1.61%.) in a cross-sectional design. Participants completed a validated risk questionnaire including a question about how often they “tried to make insulin or diabetes supplies last longer than recommended” (Likert scale: Never to Daily), and the Diabetes Distress Scale. Participants also reported on social factors including race/ethnicity, insurance status, frequency of T1D appointments, and living with parents (Yes or No). We examined bivariate correlation between diabetes distress (DD) and frequency of rationing insulin/supplies and performed independent samples t-tests comparing groups based on social factors.
Results: Sixty percent of the sample reported rationing insulin/supplies at least once in the last year. Frequency of rationing insulin/supplies correlated with diabetes distress (r= 0.24). Independent samples t-test revealed that participants who lived with a parent or other family member were less likely to ration insulin/supplies t(201) = 2.34, p< 0.05. No other social factors were significant.
Conclusion: Rationing insulin/supplies is common in YAs. YAs who live away from their parents may be at greater risk for rationing, though the relation is not causal. Similarly, YAs who ration insulin/supplies may report higher DD. Clinicians may consider assessing for rationing supplies and its potential detrimental effect on glycemic control. Additional research is needed to examine why YAs might ration insulin/supplies.
K.Noriega: None. A.Monzon: None. J.Corry: None. S.R.Patton: None. M.Carakushansky: None. R.M.Wasserman: None.
Society of Pediatric Psychology