Nearly half of the country’s district health boards don’t have specialist diabetic care for young adults, despite that group experiencing some of the worst social stress.
Sam Williams, 19, has been dealing with diabetes since she was five.
"You’re constantly thinking, 'What am I feeling? What are my levels doing?' Three-hundred thoughts are going around your head on top of everything else you’re doing as a teenager,” she said.
She thought when she moved from children’s diabetic services to the one for young adults at Auckland’s North Shore Hospital, it would mean independence, but it hasn’t turned out the way she pictured it.
That’s despite Waitematā DHB being among the 65 per cent of DHBs that do have specific help for her age group.
“You were patient number 25, rather than Sam Williams or whoever you are. That was a real big difference for me,” the teenager said.
In a statement, Waitematā DHB says it “recognises the transition can be stressful”, and it individualises follow-up appointments “based on clinical need”.
Unlike Waitematā, seven of New Zealand’s 20 DHBs don’t have specific services for young adults.
A recent report by medical experts found that across the board, the ratio of specialist staff-to-patient numbers is well short of international guidelines.
In comparison, New Zealand has three-times less the number of diabetes nurses, 10-times less dietitians and 30-times less psychologists.
The report said young adults have the worst control of all age brackets over their blood sugar levels because of social stress, puberty and risk-taking behaviours.
Ryan Paul, co-author of the report, said the understaffing issue is very concerning, especially for young adults.
“It’s probably the highest risk population across the lifespan. These patients often need psychologists, youth workers, dietitians, much more than a doctor or a nurse… That’s what’s severely lacking.”
The chronic condition also impinges 17-year-old Emma Twentyman’s life.
“If I stress about an exam, or something I’ve forgotten to do, or need to do, it'll either put me high or low, or usually a bit of both… which then becomes more stressful.”
Report co-author Vickie Corbett said young diabetes sufferers are at risk of anxiety and developing eating disorders.
“Young people with diabetes do have higher risk of mental health deterioration, over and above that of their peers. We see that manifesting as low mood, anxiety and also eating disorders,” Corbett said.
Many of the DHBs recognise mental health resources are limited, with four of the boards telling 1 NEWS they’re reviewing those services.
Williams wishes she had more access to specialist psychologists in diabetes services when she first moved into services for young adults.
“I would’ve had a much easier time. I did struggle a lot… I had more support from work than a diabetes clinic.”
The report says the prevalence of both type 1 diabetes and type 2 diabetes in New Zealand continues to increase in the young adults age group