As we learn more about the pathophysiology of diabetes mellitus, we find that there is more yet to be learned. This may sound like a trite statement, but in reality it is true. The following article reviews the basic pathophysiology of both type 1 diabetes mellitus and type 2 diabetes mellitus as we understand it today. It continues on to reveal the "things that go wrong" when there is too much or too little glucose available to the body organs and especially to the brain. The article points out the signs and symptoms to be aware of when the person is in the acute state of diabetic ketoacidosis, hyperglycemic hyperosmolar nonketotic coma (or state), and severe hypoglycemia. It concludes with important considerations when the individual is in one of these acute states and contributes key points related to the control of diabetes when the person is in the state of compromise.

The strong relationship between independent decision making and functioning suggests that both aspects are important parts of behavioral autonomy to be assessed by healthcare professionals working with adolescents with type 1 diabetes. Healthcare professionals should encourage parental involvement that facilitates adolescents' independent decision making, which was related to better metabolic control in this study.

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This study examined parental involvement in terms of communication and support and these variables in relationship to diabetes management responsibility and metabolic control from the perspective of adolescents. The sample consisted of 27 adolescents who were 12 to 19 years of age (M=15.0 years, SD=1.9) and had type 1 diabetes. Participants completed Independent Functioning, Independent Decision Making, Parent-Adolescent Communication, and Parental Support Checklists. Adolescents reported relatively high level of communication with parents and relatively low level of parental support. These adolescents reported more agreement than amount of communication with parents and reported more parental support received than sought. Although not significantly different, the means for amount of communication and agreement decreased from early to middle to late adolescence and the means for seeking and receiving support increased from early to middle and then decreased from middle to late adolescence. When working with parents and adolescents with type 1 diabetes, health care professionals need to be cognizant of adolescents' view of specific ways that parents are involved and the developmental influences on parent-adolescent relationships.

Among 182 emerging adults with type 1 diabetes (93% White and 57% female), changes during the year post-high school were examined in perceptions of diabetes-specific conflict with parents, parent-youth shared responsibility, parental tangible aid, and parental autonomy support, as well as the moderating effects of living situation, gender, years with diabetes, and glycemic control. A linear mixed effects model, controlling for baseline values, tested the changes in and relationships among these variables over time. Changes over time in parent-youth conflict were moderated by living independently of parents; autonomy support and shared responsibility were moderated by years with diabetes; and tangible aid was moderated by glycemic control. Future longitudinal research needs to examine whether changes in parental behaviors lead to positive or negative diabetes outcomes among these emerging adults with diabetes.