P-483: Youth with type 2 diabetes have high levels of diabetes distress prior to participation in shared medical appointments
H Chesser, J C Wong, J F Garcia, M Reid, B Manzanarez, C A Navarro, F Aguilar, T Mitchell, J Solano-Martinez, V Europa, C E Muñoz, N T Chang, L C ChaoAbstract
Introduction
Youth with type 2 diabetes (YT2D) struggle with glycemic management and develop early complications. Shared medical appointments (SMA) that incorporate group education modules have demonstrated benefits in youth with T1D. Similar models have not been tested in YT2D.
Objectives
To describe the baseline characteristics and clinic attendance of YT2D enrolled in a randomized controlled trial of an SMA model (Team Clinic for Type 2 Diabetes, or TCT2), co-developed with patient- and caregiver-advisory boards and clinical stakeholders.
Methods
TCT2 was implemented at two academic medical centers in California. YT2D aged 12–18 and their caregivers were randomized 3:2 to TCT2 or standard care for one year. The TCT2 curriculum includes 4 quarterly modules. Youth and their caregivers had separate but concurrent group sessions. Baseline measures included diabetes characteristics and diabetes-related distress. Descriptive statistics summarized baseline data.
Results
Fifty-three youth (mean age 15.5 ± 1.7 years; 56% female; 92% Latinx; 100% publicly insured) and 51 caregivers were enrolled. Among caregivers, 49% completed less than high school and 67% reported Spanish as their primary language. High diabetes distress (DDS ≥2) was reported by 40% of youth, with a moderate mean distress score (2.9 ± 0.9). Youth reported high emotional burden (3.5 ± 1.2) and regimen-related distress (3.6 ± 1.1). Of 38 youth randomized to TCT2, 71% attended the first session with at least one caregiver.
Conclusions
YT2D in this study demonstrated markedly elevated diabetes distress compared with national samples, underscoring the need for support for YT2D from historically underserved populations. Attendance at the initial TCT2 session was comparable to standard clinic rates, supporting the feasibility of this model for youth experiencing substantial psychosocial burden.