Young Adult with Type 1 Diabetes’ Discrimination Stress and Cardiovascular Health

Case Western Reserve University, Cleveland OH

Investigators

Abstract

It is well-established that Type 1 diabetes (T1D) is an independent risk factor for cardiovascular disease (CVD), and young adults with T1D face substantial variability in risk and life expectancy across cardiovascular health (CVH) factors and behaviors. CVH includes four health behaviors (diet, physical activity, nicotine exposure, and sleep duration) and four health factors (body mass index, glucose, low-density lipoprotein cholesterol [LDL-C], and blood pressure [BP]) at optimal levels. Achieving ideal CVH is associated with greater CVD-free survival, longevity, and higher quality of life. However, differences in CVH outcomes remain across Individuals with T1D, including those living within various community settings. The purpose of this F31 training plan and proposed descriptive study is to examine the associations among contextual and psychosocial factors related to CVH, as well as describe the lived experience of stress among young adults aged 18–31 years with T1D at University Hospitals, Case Western Reserve University, Cleveland, Ohio. In Aim 1, we will examine the association between contextual challenges and stress (a path), 1a. stress and CVH (b path); 1b. contextual challenges and CVH (c path); 1c. the role of stress as a mediator; and 1d. multiple intersecting characteristics in these associations among 125 young adults ages 18–31 years with T1D living in Ohio. In Aim 2, we will describe the lived experiences of stress among 15–22 young adults with T1D residing in Ohio. We will prospectively enroll adults with T1D from University Hospitals, a large regional healthcare system in Ohio. Our central hypothesis is that higher contextual challenges and greater stress are associated with lower CVH among young adults with T1D. These pathways may serve as important targets for improving cardiovascular outcomes in groups facing contextual challenges, where such clinical gains might otherwise be difficult to achieve.