Type 1 diabetes mellitus (T1DM) self-management is poorest during late adolescence and early adulthood (~18-25 years of age), increasing the risk of micro- and macrovascular complications. Many individuals are college students during these years. Although there are several known barriers to T1DM self-management in college students, the relationship between embodiment and T1DM self-management remains unclear. Embodiment means that psychological states and behavior are shaped by the body. Mindfulness and interoception?two facets of embodiment?are closely related to a common characteristic of the college experience: stress. Based on what is known, mindfulness practice may be a promising modality to improve T1DM self-management behaviors and glycemic control by modulating interoception and reducing stress; however, these relationships need to be investigated in college students with T1DM. Thus, the objective of this study is to determine the feasibility and acceptability of a mixed-methods approach to the relationships between mindfulness, interoception, stress, T1DM self-management behaviors, and glycemic control among college students with T1DM. Exploratory analyses will be used to investigate trends in these relationships. Sixty participants (30 individuals with T1DM and 30 without T1DM) will be exposed to the Trier Social Stress Test (TSST) and changes in glycemia, interoception, and stress response will be measured. To further understand trends in the findings among the participants with T1DM, a subsample will be interviewed to explore the subjective experience of hypo-, eu-, and hyperglycemic states and the relationship of those experiences to T1DM self-management behaviors. The findings of this study will be used to inform a larger study of the relationships of mindfulness and interoception to other barriers and facilitators of T1DM self-management. The ultimate goal is to develop and implement a mindfulness-based T1DM self-management intervention to improve health outcomes in late adolescents and early adults.

Public Health Relevance

Type 1 diabetes mellitus (T1DM) self-management is poorest during late adolescence and early adulthood (~18-25 years of age). This study will explore the relationships between mindfulness, interoception, stress, T1DM self-management behaviors, and glycemic control among college students with T1DM to advance the understanding of self-management in this high-risk, understudied population. The findings of this study may lead to novel T1DM self-management interventions in the future.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
1F31NR017108-01A1
Application #
9394355
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Banks, David
Project Start
2017-09-01
Project End
2019-06-30
Budget Start
2017-09-01
Budget End
2018-08-31
Support Year
1
Fiscal Year
2017
Total Cost
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Type
Schools of Nursing
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Schultz, Michael B (2018) Conceptual Congruence in Mindfulness-Based Weight Loss Intervention Studies. Mindfulness (N Y) 9:1028-1036