Reducing diabetes distress in the type 1 community: A peer-delivered intervention using an interactive social media platform


  • Tricia Tang
  • Alan Ruddiman
    Rural Coordination Centre of BC
  • Deanne Taylor
    Interior Health
  • Marshall Dahl
  • Ramya Hosak & Danielle Hessler University of California, San Francisco
  • Lawrence Fisher
    University of California, San Francisco
  • William Polonsky
    University of California, San Diego

Executive sponsor:

  • Marshall Dahl

Psychological distress is often overlooked in diabetes care. In fact, British Columbia’s medical services plan fails to cover this patient-identified health care priority, allowing only those with means or extended health care access to these services.  

Among the different emotional struggles that patients with diabetes experience, it is diabetes distress that is most strongly associated with poor glycemic control and worse diabetes-related health outcomes.

Diabetes distress refers to the unique and often hidden emotional burdens, relentless worries, and ongoing concerns that are part of the spectrum of patients’ experience while managing this demanding disease. In 2027, it is estimated there will be 69,700 British Columbians diagnosed with type 1 diabetes (T1D), of which almost 50% will likely experience clinically significant levels of diabetes distress.

Research shows that in the absence of any type of targeted intervention, elevated distress levels will continue to persist. Given the shortage of diabetes-trained physicians and psychologists in rural and remote settings, T1D patients living in these communities have the least access to specialized health and psychological care. Accordingly, BC has identified mental health and rural and remote health care services as two of the five provincial health care priorities.

This project will seek to address three major gaps in BC’s diabetes care: the availability, affordability, and accessibility of psychosocial support for T1D patients living in low-resource settings. Specifically, this study will adapt an evidence-based, low-cost peer support model using an interactive social media platform to reduce diabetes distress among T1D adults living in the Interior Health region.

The intended outcomes are to:

  1. Demonstrate reductions in diabetes distress in rural and remote populations using a social media-delivered peer support intervention.
  2. Establish a recruitment and training infrastructure to support a sustainable peer supporter “workforce”.
  3. Engage key stakeholders including Interior Health, Diabetes Canada, Young and Type 1, Joint Standing Committee on Rural Issues, and BC Rural Coordination Centre.

If successful, this innovative approach to reaching the “hard to reach” can be adopted across Canada, targeting and improving quality of life for the most vulnerable, high-risk, and geographically marginalized patients.