![]() The conceptual model in Figure 1 highlights the role of self-regulation as an intervention target leading to improved outcomes. These self-regulatory mechanisms promote improved T1D regimen adherence and HbA 1c. The goal of the selected intervention components is to improve self-regulatory mechanisms including self-monitoring, goal setting, self-efficacy about diabetes management, and problem-solving skills. The proposed intervention model offers a multipronged self-regulation approach for targeting glycemic control that is tailored for young adults. These results highlight a major gap in and need for more rigorous research on effective ways to improve glycemic outcomes among young adults with T1D. Since this review, several protocols and intervention development studies have been published several reported the results of uncontrolled studies with none showing impact on HbA 1c to date and one showing significant effects on HbA 1c for continuous glucose monitor (CGM) use versus blood glucose meters. Only 67% (12/18) of studies reported HbA 1c outcomes and, of these, only 2 were randomized, both showing no impact on HbA 1c. Across studies, the most common intervention strategy (13/18, 72%) targeted engaging young adults with clinical services, an important goal, but unfortunately one that did not routinely result in improved glycemic control in most trials. A 2017 systematic review found 18 intervention studies for young adults with T1D. ĭespite the unique clinical needs of patients in this age group, few interventions have been tested for this high-risk population. Furthermore, young adulthood is a critical developmental period when adult habits are formed as patients transition from parental involvement with diabetes management to independence in self-management of their T1D. ![]() One in 4 young adults aged 18 to 35 years already have one or more medical complications related to their T1D, most commonly renal problems reflecting micro- or macroalbuminuria and/or retinopathy. Young adults are a population at unique risk, with only 14% of young adults aged 18 to 25 years meeting the target HbA 1c goal (HbA 1c≤7%) versus 30% of those over 30 years. T1D also significantly increases mortality, especially among those with above target hemoglobin A 1c (HbA 1c) levels. The incidence of type 1 diabetes (T1D) is rising, and T1D results in significant economic costs in the United States, with yearly medical expenditures estimated at approximately $7 billion with an additional $7 billion in lost wages.
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