A Secondary Analysis of Cardiovascular Health in Two Emerging Adult Populations With Type 1 and 2 Diabetes

Improvements in cardiovascular health (CVH), an integral component of diabetes self-management, significantly reduce the risk of cardiovascular disease.

In this study, we aimed to compare CVH scores and explore barriers and facilitators to optimal CVH among 2 populations with type 1 diabetes (T1D) and type 2 diabetes (T2D).

This is a secondary analysis from 2 parent-sequential explanatory mixed-methods studies: the first examined a subsample of emerging adults living with T1D; the second included emerging to middle-aged adults living with T2D. Participants' CVH was assessed using the American Heart Association's definition of CVH (Life's Simple 7). Semistructured interviews explored participants' achievement of CVH behaviors. An inductive content analysis method guided data analysis.

The T1D sample (n1 = 50) consisted of 90% self-identifed White adults with a mean age of22 ± 2.4 years and 70% females. The T2D sample (n2 = 60) included adults who self-identifed as Black (63%) and Hispanic (47%), with a mean age of 34.4 ± 5.0 years and 75% females. The mean CVH scores for the T1D and T2D groups were 9.4 ± 2.1 and 8.6 ± 2.2, respectively. For the T1D group, barriers included knowledge deficits, whereas self-efficacy and diabetes technology facilitated self-management. For the T2D group, barriers consisted of unhealthy food convenience and limited space for physical activity, whereas access to healthcare services facilitated CVH behaviors. Shared barriers included time constraints/competing demands and financial burdens; facilitators were social support and individualized care.

Our analysis highlights distinct and shared barriers and facilitators to CVH in 2 emerging adult populations with diabetes, emphasizing the need to assess age-specific factors and tailor clinical interventions accordingly.