Table 6.

online only. Barriers to Blood Pressure and/or Lipid Management

Patient barriers	Never/Rarely	Sometimes	Often/Always
Do not have sufficient support for successful lifestyle changes	3%	28%	69%
Are not motivated to control blood pressure and/or lipid levels	4%	34%	62%
Are not confident that they can follow-through with lifestyle changes	3%	35%	61%
Are resistant to start a medication that may be life-long	13%	43%	44%
Do not understand that untreated blood pressure or elevated lipid levels may increase risk of diabetes complications	16%	41%	43%
Are focused on diabetes management and cannot add another condition	14%	49%	37%
Do not believe blood pressure and/or lipid medications are important in youth with diabetes	34%	38%	28%
Medical barriers
Insufficient patient education materials on hypertension and/or hyperlipidemia for these youth	21%	40%	40%
Visits too short to focus on diabetes AND hypertension and/or hyperlipidemia	19%	42%	39%
Limited provider training on hypertension and/or hyperlipidemia management in youth with type 1 diabetes	34%	33%	33%
Insufficient evidence for hypertension and/or lipid management in youth	51%	31%	18%
Practice systems make it difficult to recognize when BP or lipid levels need intervention	53%	32%	14%
Lack of familiarity with practice guidelines	56%	31%	13%
Do not want to distract from blood glucose management	56%	33%	11%
Lack of local subspecialists for referral for hypertension and/or lipid management appropriate for youth with type 1 diabetes	71%	20%	9%
Discomfort discussing complication risk with concurrent diabetes and hypertension and/or hyperlipidemia	73%	20%	7%
Prescription barriers
Concerns about pregnancy (in females)	26%	39%	35%
Concerns about patient adherence	24%	44%	32%
Lack of expertise in this area	39%	39%	23%
Hesitancy to start a medication that may be life-long	47%	33%	21%
Limited evidence in youth with type 1 diabetes	39%	43%	18%