Young Type 1 Diabetes Patients Experience Extreme Stress, Require Education and Psychological Therapy: Study
Poland: Young individuals with Type 1 Diabetes Mellitus face significant psychological stress due to lifelong insulin dependence and continuous glucose management. The study found that stress levels increase with higher BMI and longer disease duration, while better acceptance of the condition is linked to improved glycemic control (lower HbA1c). Education and psychological therapy can help reduce stress and enhance disease management outcomes.
A new study published in Frontiers in Endocrinology by Anna Stefanowicz-Bielska and colleagues from the Division of Internal and Pediatric Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Medical University of Gdansk, Poland, explored the levels of knowledge, stress, and acceptance of illness among young adults living with Type 1 Diabetes Mellitus (T1DM). The researchers aimed to assess how sociodemographic and medical factors influence these aspects and their overall impact on diabetes management.
The cross-sectional survey included 274 adults aged 18 to 35 years who had been living with T1DM for an average of 13.4 years. Participants completed original questionnaires along with standardized psychological tools — the Perceived Stress Scale (PSS-10) and the Acceptance of Illness Scale (AIS). The study was conducted between August 2023 and November 2024.
The study led to the following notable findings:
- Stress levels among young adults with Type 1 Diabetes Mellitus (T1DM) were found to be significantly high.
- Many participants reported fatigue, anxiety, and psychological strain due to the chronic and demanding nature of diabetes management.
- Median AIS and PSS-10 scores reflected moderate acceptance of the illness but considerable stress levels.
- Individuals with higher BMI and longer disease duration experienced greater stress, particularly those with frequent nighttime hyperglycemia.
- Women with primary education, those in relationships, and individuals with comorbid conditions such as hypertension, hypothyroidism, or lipohypertrophy reported higher stress levels.
- Patients treated with multiple daily insulin injections (MDI) experienced more stress compared to those using advanced insulin delivery systems.
- Better acceptance of the illness was observed among individuals who were single, nonsmoking, and not maintaining manual (“paper”) self-monitoring journals.
- Regular contact with diabetes educators and nursing staff at specialized clinics was linked to improved acceptance of the disease.
- Higher acceptance of illness correlated with lower HbA1c levels and fewer daytime hyperglycemic episodes, indicating that psychological adjustment positively influences metabolic control.
The researchers emphasized that while understanding diabetes management principles contributes to improved glycemic outcomes, it does not necessarily correlate with lower stress levels or higher acceptance. They also highlighted the beneficial role of modern diabetes technologies, which appear to reduce emotional strain and promote better adjustment to the disease.
The study concluded that young adults with T1DM experience considerable psychological distress and often struggle to accept their condition. Continuous education, technological support, and psychological counseling were identified as key strategies to improve their quality of life and disease outcomes.
However, the authors acknowledged limitations such as the relatively small sample size, recruitment from only two centers, and the absence of long-term follow-up. They recommended larger, multicenter studies with extended observation to further assess how stress, knowledge, and illness acceptance evolve over time among young adults with T1DM.
Reference:
Rąpała, M., Mazuryk, K., & Dygaszewicz, E. (2025). Level of knowledge, stress and acceptance of illness in young adults with type 1 diabetes mellitus. Frontiers in Endocrinology, 16, 1648260. https://doi.org/10.3389/fendo.2025.1648260
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