Patient age: a neglected factor when considering disease management in adults with type 2 diabetes
Danielle M Hessler1, Lawrence Fisher, Joseph T Mullan
1Department of Family & Community Medicine, University of California, San Francisco, 94143, USA. hesslerd@fcm.ucsf.edu
Objective:
The average age at diagnosis for type 2 diabetes is decreasing. However, because age is most often controlled for in clinical research, little is known regarding how adult age is associated with diabetes disease-related variables.
Methods:
In a community based study with type 2 diabetes patients (N=506), after adjusting for potentially confounding variables, we examined associations between patients' age and: stress, depression, diabetes-related distress, self-efficacy, diet, exercise, and glycemic control. We then explored to what extent age interacts with these variables in their association with glycemic control.
Results:
Younger age was independently associated with: greater chronic stress and negative life events, higher levels of diabetes-related distress, higher depressed affect, eating healthier foods and exercising less frequently, lower diabetes self-efficacy, and higher HbA1c. Interactions showed that younger patients with high stress and/or low self-efficacy were more likely to have higher HbA1c levels than older patients.
Conclusions:
Results suggest younger adult patients with type 2 diabetes represent a unique patient subgroup with specific needs and health risks based on their developmental stage and life context.
Practice Implications:
Treatment programs need to target younger adult patients and may need to utilize different media or modalities (e.g., social media) to reach this group.
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