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Changing Patterns of Self-Management in Youth with Type I Diabetes

Article  in  Journal of Pediatric Nursing · January 2007

DOI: 10.1016/j.pedn.2006.01.034 · Source: PubMed

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3 authors, including:

Kathleen Knafl Margaret Grey

University of North Carolina at Chapel Hill Yale University
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Margaret Grey
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Type 1 diabetes and living without a partner:
Psychological and social aspects, self-management
Self-management of type I diabetes is key to good physical and psychosocial outcomes of the disease, yet little is known about behaviour, and glycaemic control
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youth and their parents, self-management conflict, and three patterns of self-management in youth across four developmental Lene E. Joensen, Thomas P. Almdal and Ingrid Willaing
stages: preadolescence, early adolescence, mid-adolescence, and late adolescence. Twenty-two youth (8–19 years) with type I Diabetes Research and Clinical Practice • September 2013
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content analysis. Results indicated that parents of preadolescents (8–11 years) performed much of their children’s diabetes Preview View PDF Save PDF
care. Dyads reported some conflicts, particularly over food, amount of bolus, and blood glucose testing. The dyads
demonstrated a self-management pattern that we identified as parent-dominant. Most early adolescents (11–15 years)
performed much of their own daily care, but parents actively participated in their self-management and oversaw it. The
majority of dyads reported conflict over food and blood glucose testing. Most early adolescents demonstrated a transitional self-
management pattern whereby they managed their own daily care, with varying amounts of parental oversight. In mid-
adolescence (15–17 years), youth managed nearly all of their diabetes care; however, some dyads reported that parental
oversight of illness care was still considerable. Exercise was conflictual for the majority of these dyads. Over half of the youth
and, by late adolescence (17–19 years), all youth demonstrated a pattern of adolescent-dominant self-management. In
adolescent-dominant self-management, youth independently managed their diabetes. Half of the dyads reported that there
were sometimes conflicts over food and blood glucose testing. Understanding the nature of sharing self-management
responsibilities, the nature of conflict in carrying out such responsibilities, and the pattern of self-management may help nurses
provide more targeted assistance to youth with diabetes and to their parents.
n 2006 Elsevier Inc. All rights reserved.

NE IN EVERY 400–500 children and ado- and fat metabolism (Boland

Boland & Grey, 2000
2000). The
O lescents in the United States has type I
diabetes (American
American Diabetes Association, 2004
2004).
goal of diabetes treatment is to keep blood glucose
levels within normal range because both hypogly-
The incidence of type I diabetes is rising, cemia and hyperglycemia carry short-term and
especially in children under 5 years (Juvenile
Juvenile long-term health risks and potential complications
Diabetes Research Foundation, 2004
2004). In type I (Boland
Boland & Grey, 2000
2000). Low glycosylated hemo-
diabetes, the pancreas produces little or no insulin globin (HbA1c) levels have been shown to delay
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