For young people with diabetes, care can take a backseat to life
November 26, 2014

By Hope Hamashige/USC News

Trying to manage the ups and downs of diabetes is tough enough. But for teenagers and young adults who are juggling school, work and caring for family members, taking a healthful approach to managing their own diabetes can become a low priority.

That’s what Beth Pyatak ’02, MA ’04, PhD ’10 discovered as an occupational therapy graduate student at Los Angeles County+USC Medical Center. The more young people with diabetes she interviewed, the more she realized that some people with diabetes — particularly young minority patients — had trouble controlling their disease’s symptoms because of other challenges in their life.

“Some were taking care of younger siblings while their parents worked; one young woman was taking care of her mother after [the mother’s] leg was amputated,” explained Pyatak, now an assistant professor at the USC Chan Division of Occupational Science and Occupational Therapy.

Pyatak soon discovered that these sources of stress, combined with fewer resources and the high demands of work or school, often pushed diabetes into the background — and interfered with patients’ regular visits to a doctor.

That set Pyatak on a path to develop a new type of disease management program for young minority patients with Type 1 or Type 2 diabetes that she hopes will help keep them on track. She was recently awarded a $460,000 career development grant from the National Institutes of Health to put her program to the test.

REAL help

Pyatak will soon begin enrolling patients in the diabetes self-management program she designed, which she has dubbed the Resilient, Empowered, Active Living With Diabetes (REAL) Interventions. Through REAL, a professional assesses each patient’s needs, then tailors a custom strategy the patient can use to manage diabetes.

The grant funds a six-month study in which 40 participants will go through the REAL Interventions, and another 40 participants will serve as a comparison control group, during which the research team will measure glycemic control, self-care behaviors and quality-of-life outcomes data for all participants.

It’s critical to find ways to help young people with diabetes because their complex issues can stand in the way of their well-being.

As Pyatak explained, many young people with chronic disease tire of the ongoing management of their health. They often experience “disease burn-out” — a lapse in how diligently they care for themselves. It’s also more common for young adults to engage in risk-taking behaviors that may undermine their condition. In addition, the number of older teens and young adults from underserved communities with Type 2 diabetes has grown in recent years and will continue to rise.

People with Type 2 diabetes, Pyatak noted, are less likely to adequately manage their condition than those with Type 1 diabetes because they can more easily ignore their symptoms.

“A lot of them will continue to eat foods they know they shouldn’t because they don’t suffer the consequences right away,” she explained. “Even if they know that what they are doing might cause life-threatening complications later, some of them will ignore that until they have to face it.”

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