Understanding cognitive, emotional, and social aspects in diabetes (type 1) self-management in young adults

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Background: Diabetes type 1 (T1D) is a chronic disease in which the pancreas producesinsufficient amounts of the hormone insulin. Patients must make complex decisions about self-managementbehaviour to keep blood glucose levels within a safe range and reduce long-termcomplications. Patients must follow an intensive regime of multiple insulin injections,continuously adjusting insulin dosage depending on food intake, exercise, and other factorswhile mood and cognition are affected by low and high glucose levels. The demanding nature ofdiabetes often causes patients to experience diabetes-related distress. Young adults with T1D,particularly university students, struggle to practice good self-management and are less likely toseek medical support. This not only presents an increased risk of mental health challenges butalso factors into 26% of university students with diabetes being hospitalised due to diabetescomplications. My project aims to understand how young adults make decisions about takinginsulin or glucose when needed to treat low or high blood glucose levels. Psychology is key tounderstanding this, because successful self-management depends on the cognitive ability andresilient personality to deal with complex decisions and the effects of diabetes on mental health.New available diabetes technologies (e.g., glucose sensors) have recently changed self-management,but little to no research exists exploring why young adults don't use thistechnology effectively. Additionally, there is no comprehensive understanding of what decisionsyoung adults make regarding diabetes self-management.Research Questions: What does self-managementin young adult diabetes patients involve and how do they make decisions aboutdiabetes self-management? Why are these decisions not leading to the ideal safe range of bloodglucose values?Methodology: This multi-methodology project will focus on young adults withdiabetes (N =80) completing 3 studies, as this is the adult age group experiencing most selfmanagementproblems. This was confirmed by my preliminary research in my final yearpsychology thesis. Study 1 will analyse how young adults manage their diabetes using semistructuredinterviews. The aim is to gain a detailed understanding of how students makedecisions about their self-management depending on different social and personal situations.Study 2 will explore self-management behaviour and mood during different glucose levels over aperiod of 2 weeks. Participants will record their glucose level, mood, and decisions in response totheir glucose level multiple times each day using an app. This will provide an in-depth insight ofpsychological correlates of a variety of blood glucose values. For the period of the two-weekstudy, glucose sensor data will be collected. Study 3 will involve participants completing abattery of cognitive tests to study how cognition is affected during different blood glucose levels.This will be compared to a group of age and socio-economically matched healthy controls.Impact This project will improve the field's understanding of the decisions young adults make inresponse to glucose variations and why optimal self-management is difficult to achieve in thiscohort. The results will inform healthcare and university services on how to better support youngadults with diabetes live a healthy life during a high-risk period, in the hope of improvingwellbeing and reducing long-term complications.