P-349: Diabetes distress and psychosocial support needs among young people with type 1 diabetes in Marsabit Kenya
J MureuAbstract
Introduction
Children and adolescents with Type 1 Diabetes (T1D) in remote Kenyan regions face compounded psychosocial and structural barriers to self-management. Marsabit County, with its pastoralist communities and linguistic diversity, offers a unique setting to assess diabetes distress and support needs among young people.
Objectives
To assess diabetes-related distress, sources of support, and structural barriers to care among children and adolescents with T1D attending Camp Subira in Marsabit, and to generate recommendations for a more contextually appropriate psychosocial assessment approach for this population.
Methods
A cross-sectional psychosocial assessment was conducted among 89 children and adolescents with T1D (aged 6–25 years) attending Camp Subira, Marsabit, Kenya,. The Diabetes Distress Scale (DDS-17) was administered to evaluate emotional burden, regimen-related distress, interpersonal distress, and physician-related distress. Given the multilingual composition of the sample, 20% of participants (n≈18) required translation of assessment questions into their mother tongue. Structured clinical interviews and observation supplemented the quantitative findings.
Results
Participants reported high optimism and motivation toward self-management, with strong physician and family/friend support. Challenges included: language barriers and low comprehension of assessment items (20% of participants); time constraints and length of the DDS-17; long travel distances to clinics; limited glucometer access for home testing; and low community knowledge hindering follow-up and sustained support
Conclusions
Young people with T1D in Marsabit show resilience and strong support networks but face structural barriers limiting self-management. The DDS-17’s length reduced its practicality in this multilingual setting. We recommend standardising to a shorter tool (e.g., DDS-A, 6 items) capturing the same domains with better comprehension for larger, diverse populations, and integrating context-adapted screening into future camps.