1616-P: Financial Toxicity as a Source of Diabetes Distress Resulting in Cost Coping Strategies in Emerging Adults with Type 1 Diabetes in the United States

Introduction and Objective: Although 40-60% of emerging adults report rationing insulin or supplies to treat type 1 diabetes (T1D), little is known about their experiences related to coping with diabetes costs. This study aimed to explore emerging adults’ feelings, attitudes, and experiences of coping with the costs of diabetes. Methods: Qualitative descriptive design analyzed using standard content analysis procedures. Results: Participants (N = 15, 53% male, 80% White) age 23 ± 3.8 yrs; T1D duration 11 yrs; 60% were on their parents’ health insurance; 100% used diabetes technology. Four themes were identified: 1) Diabetes distress is substantial and embedded within the developmental stage of emerging adulthood; 2) The emotional burden of independently affording diabetes care impacts participants’ present and plans for the future; 3) The financial costs of diabetes are exacerbated by insurance barriers, leading to inadequate access to diabetes management resources; and 4) Cost coping strategies are used to manage diabetes in the present and when planning for the future. Conclusion: Participants experienced financial toxicity as evidenced by high diabetes care costs, which contributed to diabetes distress and resulted in multiple cost coping strategies, all of which are embedded in the larger context of emerging adulthood. Disclosure K. Wentzell: None. J.M. Flanagan: None. C.A. Mooney: None. C. O'Connor: None. S. Dimanche: None. K. Hood: Consultant; Current; Sanofi, MannKind Corporation, Insulet Corporation. L.M. Laffel: Other - Travel support for scientific presentations; Ended; Boehringer Ingelheim International GmbH. Other - DSMB Chair; Ended; Janssen Pharmaceuticals, Inc. Consultant; Current; Dexcom, Inc. Advisory Panel; Current; Medtronic, Sequel, Tandem Diabetes Care, Inc. Consultant; Current; Roche Diabetes Care, Sinocare. Advisory Panel; Ended; Sanofi. Advisory Panel; Current; MannKind Corporation. L.J. Wood Magee: None. Funding National Institutes of Health (K23DK138324)