Summary
The ADAPT programme for university students with diabetes is a collaboration between NHS primary care, universities and specialist diabetes care. It focuses on close collaboration between clinical and university services to ensure students experience a coordinated and easily accessible diabetes service on campus. The service runs monthly diabetes clinics and invites a specialist diabetes team and academic staff for pastoral care, a group lunch and diabetes education in both the clinic and lecture halls. This has increased patient engagement and physical and mental well-being. The programme is expanding in the UK and has been disseminated internationally.Innovation
The University of Essex is the only university with a dedicated programme to support students with diabetes. The team comprises both NHS and university staff with the following aims: to ensure that all students with diabetes register and engage with the NHS primary care on campus and are seen by diabetes specialist nurses and GPs; to support students in their academic trajectories, as diabetes is known to interfere with studying due to difficulties with glycaemic control; to bring students with diabetes together to create peer-support and new friendships, as many of them are often isolated and lonely with their disease; to bring specialist diabetes services to campus because travel to specialist services is often difficult; to educate students about diabetes because many have not received structured diabetes education; to work with the university’s academic and disability services to ensure that barriers to studying are resolved, plus to reach out to and support other universities to create a similar safe university campus for students with diabetes. The ADAPT programme relates to the transitions students go through. It began in 2022 and runs monthly diabetes clinics, education sessions, and peer-support lunches combined with psychosocial support. This programme has received excellent feedback from stakeholders and colleagues, nationally and internationally.Equality, Diversity and Variation
Data analysis suggests a barrier in access to university education for young people with diabetes. Anecdotal reports state that they are discouraged from going to university out of fear of difficulties with managing the disease in the hectic university environment. The ADAPT programme has shown that creating an accessible and safe university environment for young adults with diabetes is possible in a cost-effective way. It not only addresses the general issue of access, but also works with the diversity within the group of students. The university’s students with diabetes are a racially and socioeconomically diverse group from around the world with different cultures and dietary patterns. The team explains diabetes care in England and informs them of their rights, including the Equality Act 2010. It also communicates the diverse student needs, for example regarding diet, to the university services who work to provide healthy and internationally acceptable foods. Students are also helped with the paperwork for airport security and for the ‘year abroad’ some students enrol for. Finally, the group lunches cater for the food preferences of the diverse cohort.Results
This programme began in September 2022 and two academic years have been completed. It has led to major improvements for students with diabetes at the university. There is a focus not only on physical health, but also on psychological well-being. The student diabetes clinic has been well attended, as have the group lunches both at this university and the partner university in Poland. HbA1c decreased in the majority of attending patients. None of the patients with type 1 diabetes in the ADAPT support group has needed diabetes-related emergency care. Diabetes education has been provided to students, mainly focused on information about carb counting and dealing with insulin. Students report high satisfaction with the programme. The team has worked with the university Disability Champion and communications team to send out regular emails to all students on campus, including those without diabetes and those with disabilities. Reasonable adjustment plans have been set up for students with diabetes. New diabetes technology awareness has been raised with academic staff and exam invigilators receiving specific training. Senior university management have been supportive of the initiative and provided funding.User Feedback
Feedback is being analysed and a PhD student, funded by the Economic and Social Research Council, is researching the experiences of university students with diabetes. Students’ feedback was collected anonymously via online surveys. Students are highly satisfied with the support, as measured by clinic attendance, including group lunches.Dissemination and Sustainability
After the first year of the ADAPT programme, the University of Essex provided £10,000 to implement the programme with collaborators at Jagiellonian University (Krakow, Poland). As a result, medical and academic staff were exchanged, as well as two involved PhD students, and a successful ADAPT group is now established in Poland. A dedicated website https://adapt.diabetes-at-university.info has been set up to help other universities roll out this initiative. The programme was presented at the Diabetes UK Conference (April 2024), the Psychosocial Aspects of Diabetes conference (PSAD) (April, 2024, Germany) and the British Psychological Society Diabetes conference (March, 2024). The Lancet:Diabetes & Endocrinology published on the collaborative work with the Polish university. The presentation at the London BPS conference was awarded best poster and the presentation at the Diabetes UK conference was shortlisted for the Young People Award. Excellent feedback was received at both the Diabetes UK and PSAD conferences, where the team made contact with staff from other UK universities interested in rolling out this programme in the future. The implementation of ADAPT relies on developing good local connections between the NHS primary care, diabetes specialist care and university services. A key factor in success is a willingness to collaborate between services that otherwise work quite differently. The collaboration needs to focus on the shared interest of improving the well-being of students.
