Diabetes management the lived experiences of adolescents with well-controlled type 1 diabetes

Abstract

Type 1 diabetes is regarded as the most common serious endocrinological disorder among adolescents worldwide. Despite suggested annual increases in diagnoses of the disease among children globally, the prevalence thereof among adolescents in South Africa remains unknown. The peak onset period of type 1 diabetes has been identified as puberty. This is due to the fact that the associated insulin resistance leaves adolescents particularly vulnerable to developing this disorder. Being diagnosed with type 1 diabetes not only confronts adolescents with the inevitability of compromised physical wellbeing, but also necessitates immense cognitive, emotional and social adjustment. Moreover, the adolescent has to learn to deal with an intricate and burdensome diabetes management regimen in order to maintain average glycated haemoglobin levels within near normal ranges, prevent the development of serious acute and chronic diabetes-related complications, and uphold a satisfactory quality of life. The aim of this study was to explore and subsequently formulate a condensed description of the lived experiences of diabetes management among a group of adolescents with well-controlled type 1 diabetes. A qualitative research approach with a phenomenological research design was adopted and the study was informed by the theoretical framework of social constructionism. A non-random purposive sampling method was utilised and the final sample consisted of eight adolescents with well-controlled type 1 diabetes. Data was generated by means of in-depth interviews that were audio-recorded and transcribed. A condensed description of the participants’ experiences of the physical, psychological and social aspects of diabetes management was subsequently developed by means of thematic analysis. The findings of this study are that diabetes management had an immense physical, psychological and social impact on the participants. Physically, the execution of a diabetes management regimen was initially experienced as onerous, necessitating the acquisition of knowledge and experience, leading to mastery and adjustment. Mastery of and adjustment to the diabetes management regimen seemed to gradually ease the difficulty. The maintenance of a strict nutritional programme nevertheless remained challenging. Psychologically, diabetes management was primarily associated with dealing with externalised and internalised negative emotions, while perceptions of the self as being different were common. Socially, others’ reactions to the participants following a diabetes management regimen were suggested to be influenced by social ignorance or cognisance of type 1 diabetes management. Social ignorance was associated with paying unwanted attention to the participants’ management of their type 1 diabetes, while social cognisance was associated with support of their attempt to follow a diabetes management regimen. This study demonstrates how adolescents’ perceptions and subsequent experiences of diabetes management are personally and socially constructed through social dialogue, are historically grounded and foundational to subsequent behaviours. Additionally, the need for further research aimed at the development of interventions to assist adolescents with well-controlled type 1 diabetes to cope with the challenging nature of diabetes management, as well as the enhancement of social awareness of type 1 diabetes management, are emphasised