Tracy Corbett

A diagnosis of type 1 diabetes mellitus often comes as a shock and can be difficult for the patient to accept. When arriving during the already challenging adolescent period, this can be particularly difficult. This article explores the impact of a diagnosis during this time and offers suggestions to improve the care provided to this unique group of patients. It considers the complex nature of the condition and the challenges of day to day management for young people. There is limited research which solely focuses on the timing of a type 1 diabetes diagnosis; therefore, these findings add an insight into the experience for those who are diagnosed during those critical adolescent years. This will allow nurses and other healthcare professionals to consider the factors which are important in terms of improving the care of this group of patients.

The period of adolescence and a diagnosis of type 1 diabetes increase the risk of eating disorders, and specifically disordered eating behaviours, which have a significant impact on blood glucose levels and can result in short- and longterm complications. The necessary focus on dietary intake, portion precision and carbohydrate counting as part of the management of their diabetes can result in adolescents developing a fixation on food, a negative body image, and ‘dialbulimia’.
Eating disorders are common in girls but also occurs in boys and is often under recognised.
This article describes the links between body image and disordered eating behaviours and considers how recognition and treatment can be improved in practice.

This literature review considers the personal and practice implications of type 1 diabetes amongst adolescents. The review is part of a wider Post Graduate study and here 25 largely qualitative articles are critically considered. The selection process and thematic review lead to the identification of the themes: ‘social and emotional transition’ and ‘service related transition’. Social and emotional transition relates to the experiences of adolescents diagnosed with type 1 diabetes. These included increased risk of anxiety, depression and eating disorders which were exasperated during the challenging adolescent period. The service related transition refers to this vulnerable group not fitting well into child or adult services and the added pressures of managing the move from one to another.
This included expectation of increased autonomy and problems of poor self-management. There are some examples of positive practice found in this review largely grounded in improved personal and service transition. The review considers problems encountered and informs professionals of gaps in practice, encompassing the distinct difficulties adolescents with type 1 diabetes may experience.

Parenting a teenager is not easy, but the challenge is increased when he or she has type 1 diabetes. Here, the mother of a boy with type 1 diabetes describes her and her family’s experiences in the period leading up to her son’s diagnosis and how their lives have changed as a result. She makes a number of suggestions about how awareness of symptoms can be raised and how patients and their families can be supported to achieve the best outcomes.