Developing a Personal and Social Identity With Type 1 Diabetes During Adolescence

Abstract

This study explored the incorporation of type 1 diabetes mellitus (T1DM) into self-identity among adolescents. Guided interviews explored 40 adolescents' views of T1DM in relation to their sense of self and relationships with others. Responses were analyzed using thematic analysis. Results revealed that the entire sample described T1DM as a significant burden; many described how T1DM made them feel less "normal." Adolescents described both positive and negative aspects of self-management in social relationships, though most reported benefits in sharing T1DM with friends. Females were more likely to share information about T1DM and to describe positive changes in self-perception as a result of T1DM. The psychosocial processes related to integration of T1DM into self-identity described in these qualitative data provide hypothesis-generating findings that can guide future quantitative research examining incorporation of T1DM into adolescent self-identity in relation to measures of self-esteem, peer orientation, self-management, and glycemic control.

Self-care support for the management of type 1 diabetes during the transition from childhood to adolescence

“…In addition to the changes in everyday life due to diabetes, the results of this study show that concern about and fear of disease-related complications and previous negative experiences lived by them or by family members due to poor knowledge of the disease can have a negative impact on the lives of pre-adolescents with T1D. One study (4) found that, as a result of pre-adolescents not receiving adequate support in the transition phase from childhood to adolescence, many of them focused on negative aspects and difficulties of coping with the management of the disease, which led to obstacles to addressing their therapeutic needs.…”

“…With self-care support, pre-adolescents with T1D can assume a leading role in their care, rendering this approach effective in preparing this population for the management of their own health during the transition from childhood to adolescence (4) .…”

“…Pre-adolescents hide their diabetes diagnoses from their friends out of fear of exclusion and because they feel different from their peers (4,15) . This becomes a stressful situation that can compromise the empowerment gained from self-care (16) .…”

“…In addition to the transition inherent to this age range, diabetic pre-adolescents undergo another transition phase related to disease management. The transfer of disease management from the family to the pre-adolescent, who gradually takes increasing responsibility for self-care, often does not coincide with the maturity of the pre-adolescent's selfefficacy, especially when the disease management transfer occurs prematurely (4) .…”

Self-stigma of Patients with Type 1 Diabetes and Their Coping Strategies

“…Because patients with type 1 diabetes cannot face the "stigma" of diabetes, they tend to refuse to use insulin. In addition, the younger the patients are at the onset of type 1 diabetes, the more susceptible they are to stigma because the disease forces them to have a different lifestyle (Commissariat et al, 2016). 7 The characteristics of patients with type 1 diabetes in Japan are (i) relatively low age of onset, (ii) small disease population, and (iii) required insulin supplementation for the rest of their lives.…”