Assessing treatment barriers in young adults with type 1 diabetes

Diabetes Res Clin Pract. 2010 Dec;90(3):243-9. doi: 10.1016/j.diabres.2010.07.003. Epub 2010 Oct 28.


Aims: The current study was designed to identify barriers that prevent young adults with DM1 from achieving glycemic control.

Methods: Eighty-three young adult patients with DM1 [age 22.2 ± 2.8 years (mean ± SD), duration diabetes 11.3 ± 5.6 years, HbA1c 8.8 ± 2.1%] completed a battery of surveys assessing potential barriers to achieving glycemic control. Results of questionnaires were correlated with the patient's most recent HbA1c, and a multiple regression analysis was conducted to determine what barriers were significantly associated with HbA1c levels.

Results: Questionnaires that significantly correlated with HbA1c levels included the Conflict Subscale of the Diabetes Responsibility and Conflict Scale (r = .55, p < .01), the Modified Barriers to Adherence Questionnaire (r = .42, p < .01), and the Hospital Anxiety and Depression Scale (r = .31, p < .05). An item analysis of the Modified Barriers to Adherence Scale suggested that patient confidence with carbohydrate counting was most statistically associated with HbA1c [F(3, 80) = 12.95, p < .01, R²=.35].

Conclusions: Results suggest that despite attempts to educate patients; barriers such as family conflict, psychological issues, and carbohydrate counting remain obstacles impeding glycemic control in young adults with DM1.

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / therapy*
  • Dietary Carbohydrates / administration & dosage
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Insulin Infusion Systems
  • Life Style
  • Male
  • Patient Compliance*
  • Patient Education as Topic
  • Regression Analysis
  • Surveys and Questionnaires
  • Young Adult


  • Blood Glucose
  • Dietary Carbohydrates
  • Glycated Hemoglobin A