SweetGoals COULD INCENTIVES AND COACHING HELP YOUNG ADULTS WITH TYPE 1 DIABETES? By Ashley Festa
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hen young adults begin leaving home for the first time, they become responsible for managing their lives without parent supervision. For those with type 1 diabetes, a chronic autoimmune disease that requires a complex medical regimen, this independence can put a strain on their health. “Type 1 diabetes is often one of the most challenging chronic conditions to manage, and young people face unique obstacles when transitioning from pediatric to adult medical care,” says Catherine Stanger, PhD, professor of psychiatry and of biomedical data science at the Geisel School of Medicine at Dartmouth and a faculty member at the Center for Technology and Behavioral Health (CTBH) at Dartmouth. “There are lots of things people with type 1 diabetes have to do every day for self-management, especially tracking carbs.” And, Stanger says, their long-term health is at stake. About 70% to 80% of young people with type 1 diabetes (T1D) don’t meet the benchmark
for healthy blood sugar levels. While they typically get better at glycemic control (blood sugar management) later in adulthood, Stanger explains that there’s a lifetime negative impact from any period of poor glycemic control—a “debt” that cannot be recouped. This sobering fact was the impetus for Stanger’s work to help young people develop healthy habits early that they can maintain throughout their life. In a national randomized clinical trial, she’s currently testing whether two strategies—either financial incentives or human support through evidence-based health coaching—will help them do just that.
DARTMOUTH HEALTH | GEISEL SCHOOL OF MEDICINE • 8