"I should have been asked how I was doing": The impact of healthcare encounters on mental health among young adults living with type 1 diabetes.

Abstract

This study explores the experiences of diabetes distress among young adults, aged 18-29 years, living with type 1 diabetes (T1D), focusing on how these experiences are shaped by healthcare encounters and self-management practices. Using an interpretive descriptive design, 19 participants were interviewed as part of a co-design trial aimed at developing a mental health intervention for young adults with T1D. Two main themes were identified: 1) the perceived overemphasis on glycemic metrics by healthcare professionals, which often overshadowed the broader emotional and social dimensions of living with T1D, and 2) the conceptualization of distress as an "everyday" reality rather than an acute or episodic phenomenon. Participants reported feeling reduced to "a set of data points" during clinical encounters, contributing to feelings of inadequacy and exacerbating mental health challenges and worsening diabetes self-management. The findings highlight the need for healthcare professionals to adopt a more holistic, strengths-based approach to care, which recognizes the complex interplay between physical and mental health and supports the overall wellbeing of young adults with T1D. The study calls for a re-evaluation of current care practices, emphasizing the importance of integrating emotional support into routine diabetes care to enhance quality of life.