Publication date: Jan 28, 2025

Young adults with type 1 diabetes mellitus often face challenges managing their condition, leading to elevated glucose and heightened psychosocial distress. Diabetes care traditionally focuses on biomedical outcomes, with less emphasis on well-being. Occupational therapy offers a holistic approach to managing diabetes by integrating changes to daily habits and routines and psychosocial support. This randomized controlled trial involved participants aged 18-30 with HbA1c ≥ 7. 5 % (≥58 mmol/mol). Participants received either telehealth occupational therapy or usual care. The intervention addressed diabetes management, daily habits and routines, and emotional well-being. Data collected at baseline, 3 months, and 6 months included HbA1c, continuous glucose monitoring metrics, and psychosocial outcomes. Analyses employed intent-to-treat principles, using ANCOVA to evaluate between-group differences. Participants (n = 209) were 24. 3 (+/-3. 7) years old, 59. 8 % female, 44. 5 % non-Hispanic White, and 47. 4 % publicly insured. No significant differences were found in glycemic outcomes. Intervention participants had improved diabetes-related quality of life (DQoL; least-squares [LS] mean 0. 67, 95 % CI 0. 02 to 1. 32, p = 0. 045) and reduced diabetes distress (LS-mean -0. 36, CI -0. 65 to -0. 07, p = 0. 01). Generalizability may be impacted by external factors related to COVID-19. The findings suggest occupational therapy may be beneficial for young adults experiencing diabetes-related distress and poor DQoL.

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