Taking a Walk in Their Shoes: The Lived Experiences of Emerging Adults with Type 1 Diabetes
Main Article Content
Abstract
The period of emerging adulthood, which has been defined as the time from 18-30 years old, is one of the most challenging developmental periods to navigate through because of all of the significant life changes that occur during this time. Add type 1 diabetes to the mix and the period of emerging adulthood becomes even more challenging. This paper is a secondary analysis of a qualitative descriptive study on challenges of diabetes self-management in emerging adults with type 1 diabetes. It presents three vignettes of emerging adults with type 1 diabetes to help clinicians better understand how these individuals view diabetes management and related challenges during this especially critical developmental stage that is rife with transitions. The vignettes exemplify the multitudes of thoughts, feelings, and emotions experienced by emerging adults with type 1 diabetes when dealing with various aspects of their everyday lives. Important takeaway messages include that apparent diabetes mismanagement is usually not due to negligence, females have extreme fear of hypoglycemia, trying to exercise can be frustrating, mature considerations are made when deciding whether or not to drink alcohol, and diabetes technology can be very helpful but is not helpful for everybody. Additionally, regarding diabetes follow-up visits, the emerging adults in this study desired the personal touch of in-person visits. It is hoped that if clinicians are better able to understand what emerging adults with diabetes are going through during this period of time, in their own words, interventions and care plans can be devised to best meet their needs.
Article Details
How to Cite
RAMCHANDANI, Neesha.
Taking a Walk in Their Shoes: The Lived Experiences of Emerging Adults with Type 1 Diabetes.
Medical Research Archives, [S.l.], v. 11, n. 10, oct. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4429>. Date accessed: 21 nov. 2024.
doi: https://doi.org/10.18103/mra.v11i10.4429.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Arnett JJ. Emerging Adulthood: The Winding Road From the Late Teens Through the Twenties. Oxford University Press; 2004.
2. Arnett JJ. Emerging Adulthood: The Winding Road From the Late Teens Through the Twenties (Second Edition ed.). Oxford University Press; 2015.
3. Peters A, Laffel L. Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care systems: a position statement of the American Diabetes Association, with representation by the American College of Osteopathic Family Physicians, the American Academy of Pediatrics, the American Association of Clinical Endocrinologists, the American Osteopathic Association, the Centers for Disease Control and Prevention, Children with Diabetes, The Endocrine Society, the International Society for Pediatric and Adolescent Diabetes, Juvenile Diabetes Research Foundation International, the National Diabetes Education Program, and the Pediatric Endocrine Society (formerly Lawson Wilkins Pediatric Endocrine Society). Diabetes Care.2011;34(11):2477-2485. doi: 10.2337/dc11-1723
4. Charpentier G, Benhamou PY, Dardari D, Clergeot A, Franc S, Schaepelynck-Belicar P, . . . Penfornis A. The Diabeo software enabling individualized insulin dose adjustments combined with telemedicine support improves HbA1c in poorly controlled type 1 diabetic patients: a 6-month, randomized, open-label, parallel-group, multicenter trial (TeleDiab 1 Study). Diabetes Care. 2011;34(3):533-539. doi: 10.2337/dc10-1259
5. Harrison S, Stadler M, Ismail K, Amiel S, Herrmann-Werner A. Are patients with diabetes mellitus satisfied with technologies used to assist with diabetes management and coping?: A structured review. Diabetes Technol Ther. 2014;16(11):771-783. doi: 10.1089/dia.2014.0062
6. Duke DC, Wagner DV, Ulrich J, Freeman KA, Harris MA. Videoconferencing for teens with diabetes: family matters. J Diabetes Sci Technol. 2016;10(4):816-823. doi: 10.1177/1932296816642577
7. Esmatjes E, Jansa M, Roca D, Perez-Ferre N, del Valle L, Martinez-Hervas S, . . . de Sola-Morales O. The efficiency of telemedicine to optimize metabolic control in patients with type 1 diabetes mellitus: telemed study. Diabetes Technol Ther. 2014;16(7):435-441. doi: 10.1089/dia.2013.0313
8. Wood CL, Clements SA, McFann K, Slover R, Thomas JF, Wadwa RP. Use of telemedicine to improve adherence to American Diabetes Association standards in pediatric type 1 diabetes. Diabetes Technol Ther. 2016;18(1):7-14. doi: 10.1089/dia.2015.0123
9. Freeman KA, Duke DC, Harris MA. Behavioral health care for adolescents with poorly controlled diabetes via Skype: does working alliance remain intact? J Diabetes Sci Technol. 2013;7(3):727-735. doi: 10.1177/193229681300700318
10. Raymond JK, Berget CL, Driscoll KA, Ketchum K, Cain C, Fred Thomas JF. CoYoT1 clinic: Innovative telemedicine care model for young adults with type 1 diabetes. Diabetes Technol Ther. 2016;18(6):385-390. doi: 10.1089/dia.2015.0425
11. Ramchandani N, Way N, Melkus GD, Sullivan-Bolyai S. Challenges to diabetes self-management in emerging adults with type 1 diabetes. Diabetes Educ. 2019;45(5):484-497. doi: 10.1177/0145721719861349
12. Garvey KC, Markowitz JT, Laffel LM. Transition to adult care for youth with type 1 diabetes. Curr Diab Rep. 2012;12(5):533-541. doi: 10.1007/s11892-012-0311-6
13. Peters A, Laffel L. Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care systems: a position statement of the American Diabetes Association, with representation by the American College of Osteopathic Family Physicians, the American Academy of Pediatrics, the American Association of Clinical Endocrinologists, the American Osteopathic Association, the Centers for Disease Control and Prevention, Children with Diabetes, The Endocrine Society, the International Society for Pediatric and Adolescent Diabetes, Juvenile Diabetes Research Foundation International, the National Diabetes Education Program, and the Pediatric Endocrine Society (formerly Lawson Wilkins Pediatric Endocrine Society). Diabetes Care. 2011;34(11):2477-2485. doi: 10.2337/dc11-1723
14. Steinbeck KS, Shrewsbury VA, Harvey V, Mikler K, Donaghue KC, Craig ME. A pilot randomized controlled trial of a post-discharge program to support emerging adults with type 1 diabetes mellitus transition from pediatric to adult care. Pediatr Diabetes. 2015;16(8):634-639. doi: 10.1111/pedi.12229
15. Wafa S, Nakhla M. Improving the transition from pediatric to adult diabetes healthcare: a literature review. Can J Diabetes. 2015;39(6):520-528. doi: 10.1007/s12160-013-9552-010.1016/j.jcjd.2015.08.003
16. Winocour PH. Care of adolescents and young adults with diabetes - much more than transitional care: a personal view. Clin Med. 2014;14(3):274-278. doi: 10.7861/clinmedicine.14-3-274
17. Lee JM, Davis MM, Menon RK, Freed GL. Geographic distribution of childhood diabetes and obesity relative to the supply of pediatric endocrinologists in the United States. J Pediatr. 2008;152(3):331-336. doi: 10.1016/j.jpeds.2007.08.037
18. Vigersky RA, Fish L, Hogan P, Stewart A, Kutler S, Ladenson PW, . . . Hupart KH. The clinical endocrinology workforce: current status and future projections of supply and demand. J Clin Endocrinol Metab. 2014;99(9):3112-3121. doi: 10.1210/jc.2014-2257
19. Balfe M, Brugha R, Smith D, Sreenan S, Doyle F, Conroy R. Why do young adults with type 1 diabetes find it difficult to manage diabetes in the workplace? Health Place. 2014;26:180-187. doi: 10.1016/j.healthplace.2013.12.016
20. Pyatak E. Participation in occupation and diabetes self-management in emerging adulthood. The American Journal of Occupational Therapy. 2011;65(4):462-9. doi: 10.5014/ajot.2011.001453
21. Geddes J, McGeough E, Frier BM. Young adults with type 1 diabetes in tertiary education: do students receive adequate specialist care? Diabet Med. 2006;23(10):1155-7. doi: 10.1111/j.1464-5491.2006.01933.x
22. Steinbeck KS, Shrewsbury VA, Harvey V, Mikler K, Donaghue KC, Craig ME, Woodhead HJ. A pilot randomized controlled trial of a post-discharge program to support emerging adults with type 1 diabetes mellitus transition from pediatric to adult care. Pediatr Diabetes. 2015;16(8):634-9. doi: 10.1111/pedi.12229
23. Winocour PH. Care of adolescents and young adults with diabetes - much more than transitional care: a personal view. Clin Med (Lond). 2014;14(3):274-8. doi: 10.7861/clinmedicine.14-3-274
24. Krueger RA, Casey MA. Focus Groups: A Practical Guide for Applied Research. 5th ed. Thousand Oaks, CA: Sage; 2015.
25. Ergin BD, Ergin I, Gökşen D. Fear of hypoglycemia and longer disease duration associated with physical activity avoidance in children and adolescents with type 1 diabetes mellitus. J Clin Res Pediatr Endocrinol. 2023;15(3):238-247. doi: 10.4274/jcrpe.galenos.2023.2022-9-13
26. Ferreira M, Neves JS, Neves C, Carvalho D. Physical exercise and glycemic management in patients with type 1 diabetes on insulin pump therapy – a cross-sectional study. Acta Diabetol. 2023;60(7):881-889. doi: 10.1007/s00592-023-02070-7
27. Briskin A. Tidepool expands closed loop access, wins clearance from FDA. diaTribe Learn. Published January 26, 2023. Accessed September 9, 2023. https://diatribe.org/tidepool-loop-cleared-fda .
28. Medtronic Diabetes. MiniMed 780G system. Published June 2023. Accessed September 9, 2023. https://www.medtronicdiabetes.com/products/minimed-780g-insulin-pump-system .
29. Beta Bionics. Introducing the iLet bionic pancreas. Published 2023. Accessed September 9, 2023. https://www.betabionics.com/ilet-bionic-pancreas/ .
30. Paldus B, Morrison D, Lee M, Zaharieva DP, Riddell MC, O’Neal DN. Strengths and challenges of closed-loop insulin delivery during exercise in people with type 1 diabetes: Potential future directions. J Diabetes Sci Technol. 2023;17(4):1077-1084.
doi: 10.1177/19322968221088327
31. Lenhart A, Purcell, K., Smith, A., Zickuhr, K. Social Media & Mobile Internet Use among Teens and Young Adults. Millenials. http://pewinternet.org/Reports/2010/Social-Media-and-Young-Adults.aspx: Pew Internet & American Life Project / Pew Research Center, 2010.
32. Iyengar J, Thomas IH, Soleimanpour SA. Transition from pediatric to adult care in emerging adults with type 1 diabetes: a blueprint for effective receivership. Clin Diabetes Endocrinol. 2019;5:3. doi: 10.1186/s40842-019-0078-7
33. Zurynski Y, Carrigan A, Meulenbroeks I, Sarkies MN, Dammery G, Halim N, Lake R, Davis E, Jones TW, Braithwaite J. Transition models of care for type 1 diabetes: a systematic review. BMC Health Serv Res. 2023;23(1):779. doi: 10.1186/s12913-023-09644-9
2. Arnett JJ. Emerging Adulthood: The Winding Road From the Late Teens Through the Twenties (Second Edition ed.). Oxford University Press; 2015.
3. Peters A, Laffel L. Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care systems: a position statement of the American Diabetes Association, with representation by the American College of Osteopathic Family Physicians, the American Academy of Pediatrics, the American Association of Clinical Endocrinologists, the American Osteopathic Association, the Centers for Disease Control and Prevention, Children with Diabetes, The Endocrine Society, the International Society for Pediatric and Adolescent Diabetes, Juvenile Diabetes Research Foundation International, the National Diabetes Education Program, and the Pediatric Endocrine Society (formerly Lawson Wilkins Pediatric Endocrine Society). Diabetes Care.2011;34(11):2477-2485. doi: 10.2337/dc11-1723
4. Charpentier G, Benhamou PY, Dardari D, Clergeot A, Franc S, Schaepelynck-Belicar P, . . . Penfornis A. The Diabeo software enabling individualized insulin dose adjustments combined with telemedicine support improves HbA1c in poorly controlled type 1 diabetic patients: a 6-month, randomized, open-label, parallel-group, multicenter trial (TeleDiab 1 Study). Diabetes Care. 2011;34(3):533-539. doi: 10.2337/dc10-1259
5. Harrison S, Stadler M, Ismail K, Amiel S, Herrmann-Werner A. Are patients with diabetes mellitus satisfied with technologies used to assist with diabetes management and coping?: A structured review. Diabetes Technol Ther. 2014;16(11):771-783. doi: 10.1089/dia.2014.0062
6. Duke DC, Wagner DV, Ulrich J, Freeman KA, Harris MA. Videoconferencing for teens with diabetes: family matters. J Diabetes Sci Technol. 2016;10(4):816-823. doi: 10.1177/1932296816642577
7. Esmatjes E, Jansa M, Roca D, Perez-Ferre N, del Valle L, Martinez-Hervas S, . . . de Sola-Morales O. The efficiency of telemedicine to optimize metabolic control in patients with type 1 diabetes mellitus: telemed study. Diabetes Technol Ther. 2014;16(7):435-441. doi: 10.1089/dia.2013.0313
8. Wood CL, Clements SA, McFann K, Slover R, Thomas JF, Wadwa RP. Use of telemedicine to improve adherence to American Diabetes Association standards in pediatric type 1 diabetes. Diabetes Technol Ther. 2016;18(1):7-14. doi: 10.1089/dia.2015.0123
9. Freeman KA, Duke DC, Harris MA. Behavioral health care for adolescents with poorly controlled diabetes via Skype: does working alliance remain intact? J Diabetes Sci Technol. 2013;7(3):727-735. doi: 10.1177/193229681300700318
10. Raymond JK, Berget CL, Driscoll KA, Ketchum K, Cain C, Fred Thomas JF. CoYoT1 clinic: Innovative telemedicine care model for young adults with type 1 diabetes. Diabetes Technol Ther. 2016;18(6):385-390. doi: 10.1089/dia.2015.0425
11. Ramchandani N, Way N, Melkus GD, Sullivan-Bolyai S. Challenges to diabetes self-management in emerging adults with type 1 diabetes. Diabetes Educ. 2019;45(5):484-497. doi: 10.1177/0145721719861349
12. Garvey KC, Markowitz JT, Laffel LM. Transition to adult care for youth with type 1 diabetes. Curr Diab Rep. 2012;12(5):533-541. doi: 10.1007/s11892-012-0311-6
13. Peters A, Laffel L. Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care systems: a position statement of the American Diabetes Association, with representation by the American College of Osteopathic Family Physicians, the American Academy of Pediatrics, the American Association of Clinical Endocrinologists, the American Osteopathic Association, the Centers for Disease Control and Prevention, Children with Diabetes, The Endocrine Society, the International Society for Pediatric and Adolescent Diabetes, Juvenile Diabetes Research Foundation International, the National Diabetes Education Program, and the Pediatric Endocrine Society (formerly Lawson Wilkins Pediatric Endocrine Society). Diabetes Care. 2011;34(11):2477-2485. doi: 10.2337/dc11-1723
14. Steinbeck KS, Shrewsbury VA, Harvey V, Mikler K, Donaghue KC, Craig ME. A pilot randomized controlled trial of a post-discharge program to support emerging adults with type 1 diabetes mellitus transition from pediatric to adult care. Pediatr Diabetes. 2015;16(8):634-639. doi: 10.1111/pedi.12229
15. Wafa S, Nakhla M. Improving the transition from pediatric to adult diabetes healthcare: a literature review. Can J Diabetes. 2015;39(6):520-528. doi: 10.1007/s12160-013-9552-010.1016/j.jcjd.2015.08.003
16. Winocour PH. Care of adolescents and young adults with diabetes - much more than transitional care: a personal view. Clin Med. 2014;14(3):274-278. doi: 10.7861/clinmedicine.14-3-274
17. Lee JM, Davis MM, Menon RK, Freed GL. Geographic distribution of childhood diabetes and obesity relative to the supply of pediatric endocrinologists in the United States. J Pediatr. 2008;152(3):331-336. doi: 10.1016/j.jpeds.2007.08.037
18. Vigersky RA, Fish L, Hogan P, Stewart A, Kutler S, Ladenson PW, . . . Hupart KH. The clinical endocrinology workforce: current status and future projections of supply and demand. J Clin Endocrinol Metab. 2014;99(9):3112-3121. doi: 10.1210/jc.2014-2257
19. Balfe M, Brugha R, Smith D, Sreenan S, Doyle F, Conroy R. Why do young adults with type 1 diabetes find it difficult to manage diabetes in the workplace? Health Place. 2014;26:180-187. doi: 10.1016/j.healthplace.2013.12.016
20. Pyatak E. Participation in occupation and diabetes self-management in emerging adulthood. The American Journal of Occupational Therapy. 2011;65(4):462-9. doi: 10.5014/ajot.2011.001453
21. Geddes J, McGeough E, Frier BM. Young adults with type 1 diabetes in tertiary education: do students receive adequate specialist care? Diabet Med. 2006;23(10):1155-7. doi: 10.1111/j.1464-5491.2006.01933.x
22. Steinbeck KS, Shrewsbury VA, Harvey V, Mikler K, Donaghue KC, Craig ME, Woodhead HJ. A pilot randomized controlled trial of a post-discharge program to support emerging adults with type 1 diabetes mellitus transition from pediatric to adult care. Pediatr Diabetes. 2015;16(8):634-9. doi: 10.1111/pedi.12229
23. Winocour PH. Care of adolescents and young adults with diabetes - much more than transitional care: a personal view. Clin Med (Lond). 2014;14(3):274-8. doi: 10.7861/clinmedicine.14-3-274
24. Krueger RA, Casey MA. Focus Groups: A Practical Guide for Applied Research. 5th ed. Thousand Oaks, CA: Sage; 2015.
25. Ergin BD, Ergin I, Gökşen D. Fear of hypoglycemia and longer disease duration associated with physical activity avoidance in children and adolescents with type 1 diabetes mellitus. J Clin Res Pediatr Endocrinol. 2023;15(3):238-247. doi: 10.4274/jcrpe.galenos.2023.2022-9-13
26. Ferreira M, Neves JS, Neves C, Carvalho D. Physical exercise and glycemic management in patients with type 1 diabetes on insulin pump therapy – a cross-sectional study. Acta Diabetol. 2023;60(7):881-889. doi: 10.1007/s00592-023-02070-7
27. Briskin A. Tidepool expands closed loop access, wins clearance from FDA. diaTribe Learn. Published January 26, 2023. Accessed September 9, 2023. https://diatribe.org/tidepool-loop-cleared-fda .
28. Medtronic Diabetes. MiniMed 780G system. Published June 2023. Accessed September 9, 2023. https://www.medtronicdiabetes.com/products/minimed-780g-insulin-pump-system .
29. Beta Bionics. Introducing the iLet bionic pancreas. Published 2023. Accessed September 9, 2023. https://www.betabionics.com/ilet-bionic-pancreas/ .
30. Paldus B, Morrison D, Lee M, Zaharieva DP, Riddell MC, O’Neal DN. Strengths and challenges of closed-loop insulin delivery during exercise in people with type 1 diabetes: Potential future directions. J Diabetes Sci Technol. 2023;17(4):1077-1084.
doi: 10.1177/19322968221088327
31. Lenhart A, Purcell, K., Smith, A., Zickuhr, K. Social Media & Mobile Internet Use among Teens and Young Adults. Millenials. http://pewinternet.org/Reports/2010/Social-Media-and-Young-Adults.aspx: Pew Internet & American Life Project / Pew Research Center, 2010.
32. Iyengar J, Thomas IH, Soleimanpour SA. Transition from pediatric to adult care in emerging adults with type 1 diabetes: a blueprint for effective receivership. Clin Diabetes Endocrinol. 2019;5:3. doi: 10.1186/s40842-019-0078-7
33. Zurynski Y, Carrigan A, Meulenbroeks I, Sarkies MN, Dammery G, Halim N, Lake R, Davis E, Jones TW, Braithwaite J. Transition models of care for type 1 diabetes: a systematic review. BMC Health Serv Res. 2023;23(1):779. doi: 10.1186/s12913-023-09644-9