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Adapting diabetes education for neurodiverse patients: A COM-B framework analysis of type 1 diabetes and attention
Elise Chivoret1, Nader Perroud2, Zoltan Pataky3
1Unit of Diabetology, Division of Endocrinology, Diabetology and Nutrition, Department of Medicine, Geneva University Hospitals, Switzerland.
Objective:
To highlight the unique challenges faced by individuals with co-occurring Type 1 Diabetes (T1D) and Attention Deficit Hyperactivity Disorder (ADHD), and to advocate for the adaptation of Therapeutic Patient Education (TPE) through tailored strategies and interdisciplinary care models.
Methods:
Using the COM-B model (Capability, Opportunity, Motivation - Behavior) as an analytical framework, we explore how executive dysfunction in ADHD impacts diabetes self-management. Drawing on current literature, clinical insights, and behavioral theory, the article identifies barriers to effective care and proposes adaptations to TPE that better address cognitive and behavioral needs.
Results:
Executive function deficits in ADHD impair psychological capability to perform essential diabetes management tasks, while limited access to mental health integration and inadequate caregiver involvement reduce environmental opportunity. Motivational challenges are compounded by repeated experiences of perceived "non-compliance." Tailored education strategies, including simplified routines, technological supports, structured environments, and affirming communication can enhance engagement and outcomes. Interdisciplinary collaboration is critical to implementing these adaptations.
Conclusion:
Current TPE models are not fully equipped to serve patients with both T1D and ADHD. Integrating cognitive screening, personalized education techniques, and cross-disciplinary expertise can close this gap. By embracing neurodiversity in chronic disease education, health systems can move toward more equitable and effective care for all.
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