Barriers to Care and Provider Involvement in Weight Management for Youth with Type 1 Diabetes Public Deposited

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  • February 26, 2019
  • Watts, Madison
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
  • Overweight and obesity are common in youth with Type 1 Diabetes (T1D), but no current clinical guidelines focus on weight management in this population. The present study aimed to characterize the patient-perceived experience of and barriers to weight management and to understand the role of the provider in supporting weight management in T1D youth. Participants were youth ages 12-17 with T1D for greater than 1 year and HbA1c < 13% recruited from the University of North Carolina (n=16, 56% female, 60% white, 50% pump users, mean age 14.8, mean HbA1c 8.5%) and the University of Colorado (n=18, 50% female, 80% white, 53% pump users, mean age 15.3, mean HbA1c 9.3%). Data were collected through an online questionnaire contained in a secure interface and through focus groups held at the two study sites. The questionnaire used items from the Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS 3.0) to examine the barriers of contextual care, communication and getting information with regards to weight management care. Perceptions of weight management in the context of T1D and the role of provider in weight management care were gathered from focus groups. Focus groups were stratified by gender and weight status (BMI cutoff=25) and guided by a consistent set of questions. Discussions were audio-taped, transcribed, and analyzed using standard inductive qualitative methods. Barriers to weight management care were common in this population. The highest prevalence of barriers was associated with female gender (p=0.02) and HbA1c >9% (p=0.02), but not weight status. Focus group data indicated that youth feel weight management and T1D care are inherently antagonistic. As a result, youth with T1D report a need to access members of the care team for weight goals and a desire for personalized and T1D2 specific weight-related recommendations to overcome the inherent antagonism between T1D and weight management.
Date of publication
Resource type
Rights statement
  • In Copyright
  • Funding: Honors Undergraduate Research Fund
  • Mayer-Davis, Elizabeth
  • Bachelor of Science in Public Health
Academic concentration
  • Nutrition
Honors level
  • Honors
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017
  • English

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