Diabetes disclosure strategies in adolescents and young adult with type 1 diabetes.

OBJECTIVE: Adolescence and young adulthood have social and developmental challenges that can impact type 1 diabetes (T1D) management. New relationships (e.g. friends, schoolmates, dating partners, teachers, employers) introduce opportunities for disclosure of T1D status. Characterizing how adolescents and young adults (AYAs) disclose having T1D to others may help inform clinical strategies to help AYAs ensure their safety by obtaining social support. METHODS: As part of a study about diabetes health-related quality of life across the lifespan, transcriptions of semi-structured qualitative interviews with AYAs with T1D (n = 16, age 12-25 years, mean age 18.7 ±â€¯4.9, 38% female) were coded to derive themes related to T1D disclosure. RESULTS: Participants described three disclosure strategies: (1) Open Disclosure: shares T1D status in straightforward, direct manner and readily requests diabetes-related support; (2) Disclosure Hesitancy: reluctant to tell others about or actively hides having T1D; (3) Passive Disclosure: discloses T1D via other people (e.g., parents) or through others' observation of T1D management tasks. CONCLUSION: AYAs may benefit from guidance in approaches to informing others about having T1D in different contexts. Identifying individuals' use of these strategies can inform education and intervention strategies aimed at engaging AYAs in healthy T1D-related disclosure to seek and receive support.

Perceived peer support and diabetes management from adolescence into early emerging adulthood.

OBJECTIVES: The objective of the study was to examine longitudinal associations of perceived diabetes-specific peer support with adherence and glycemic control among late adolescents with type 1 diabetes as they transition out of high school and into early emerging adulthood. METHOD: As part of a larger study, 211 high school seniors with type 1 diabetes completed confidential online surveys and were reassessed 1 year later. Perceived diabetes-specific peer support and adherence were assessed in each survey. Glycemic control was measured with HbA1c assay kits. RESULTS: Perceived diabetes-specific peer support in high school predicted better adherence across the subsequent year while controlling for initial levels of adherence. Perceived peer support during early emerging adulthood was also associated with better adherence across time, after controlling for initial levels of both adherence and peer support. CONCLUSIONS: Perceived diabetes-specific peer support may be a protective factor as late adolescents with type 1 diabetes transition out of high school. Building strong peer support during the transition into early emerging adulthood may facilitate better diabetes management during this high-risk time of development. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Individual differences and day-to-day fluctuations in perceived self-regulation associated with daily adherence in late adolescents with type 1 diabetes.

OBJECTIVE: To examine whether individual differences and intraindividual (within-person day-to-day) fluctuations in late adolescents' self-regulation were associated with daily adherence to the type 1 diabetes regimen. METHODS: 110 school seniors (M age = 17.78 years) and their mothers assessed adolescents' skills underlying self-regulation (executive function, attention, self-control, behavioral inhibition and activation, emotion regulation) and adherence, with glycosylated hemoglobin from medical records. Teens completed daily diaries reporting self-regulation failures surrounding monitoring blood glucose, adherence, and number of blood glucose checks each day for 14 days. RESULTS: Hierarchical Linear Models indicated that better daily adherence was associated with teen and mother reports of better self-regulation skills and teens' reports of fewer daily self-regulation failures. Daily adherence was unrelated to temperamental differences in behavioral inhibition and activation. CONCLUSIONS: Results indicate that both individual and intraindividual differences in self-regulation contribute to daily adherence highlighting the importance of daily self-regulatory challenges to adherence.