Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes: results from the International Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Study

AimYoung adults with Type 2 diabetes have higher physical morbidity and mortality than other diabetes sub-groups, but differences in psychosocial outcomes have not yet been investigated. We sought to compare depression and anxiety symptoms and self-care behaviours of young adults with Type 2 diabetes with two matched control groups. MethodsUsing cross-sectional survey data from the Australian and Dutch Diabetes Management and Impact for Long-term Empowerment and Success (MILES) studies, we matched 93 young adults (aged 18-39 years) with Type 2 diabetes (case group) with: (i) 93 older adults (40 years) with Type 2 diabetes (Type 2 diabetes control group; matched on country, gender, education, diabetes duration and insulin use) and (ii) 93 young adults with Type 1 diabetes (Type 1 diabetes control group; matched on country, gender, age and education). Groups were compared with regard to depression symptoms (nine-item Patient Health Questionnaire), anxiety symptoms (seven-item Generalised Anxiety Disorder questionnaire) and frequency of selected self-care behaviours (single item per behaviour). ResultsParticipants in the case group had higher depression scores (Cohen's d =0.40) and were more likely to have clinically meaningful depressive symptoms (Cramer's V=0.23) than those in the Type 2 diabetes control group. Participants in the case group had statistically equivalent depression scores to the Type 1 diabetes control group. The groups did not differ in anxiety scores. Those in the case group were less likely than both control groups to take insulin as recommended (Cramer's V =0.24-0.34), but there were no significant differences between the groups in oral medication-taking. The case group were less likely than the Type 2 diabetes control group to eat healthily (Cramer's V =0.16), and less likely than the Type 1 diabetes control group to be physically active (Cramer's V =0.15). ConclusionsOur results suggest that Type 2 diabetes is as challenging as Type 1 diabetes for young adults and more so than for older adults. Young adults with Type 2 diabetes may require more intensive psychological and self-care support than their older counterparts. What's new? Young adults with Type 2 diabetes have higher rates of physical morbidity and mortality than other diabetes subgroups, but differences in psychosocial outcomes have not yet been investigated. Using a case-control analysis, the present study is the first to compare emotional well-being and self-care outcomes of young adults with Type 2 diabetes with those of older adults with Type 2 diabetes and young adults with Type 1 diabetes. As the number of young adults with Type 2 diabetes rises, healthcare professionals must consider the ways in which information and services can be tailored for this group to provide optimum support.