Meldman, L.S. (1987, Summer). Diabetes as experienced by adolescents. Adolescence, XXII(86), 433-44.

OVERVIEW

Diabetic control is difficult. It requires a balance of daily insulin injections, following a consistent diet plan, regular exercise, daily blood testing, and regular timing in coordinating all of these important factors. What happens to a diabetic adolescent when one adds to these disciplines a body dealing with puberty and accompanying hormonal changes, a groping for a new independence, and a natural rebellion toward anything controlling? The impact on a young person can be stressful and painful. "Many adolescents are accustomed to instant gratification of their needs; however, the adolescent with diabetes must practice self-control and delay gratification."

Various studies cited in the article show that diabetic adolescents experience anxiety and fear about their future health and current and future relationships. Also, adolescent diabetics often suffer from a poor self-image due to feelings of being different, guilt, increased responsibility and stress, hopelessness, shame, anxiety, and frustration. Self-destruction is a common behavior among adolescents with diabetes, and developmental conflicts combined with adjustment to the disease may result in rebellion, with diabetes used as a weapon against authority and a way of expressing hostility.

In addition to Meldman’s research, she reports on a series of self-conducted interviews at a diabetic summer camp. Participants included twelve diabetics ranging in ages from 15 to 18. Her interviews focused on diabetes self-management and factors that interfere with diabetic management. The three themes emerged from the analysis: psychosocial, developmental, and clinical.

Psychosocial themes address acceptance, one’s view of diabetes, informing others, and guilt/blame. On the surface, the diabetics seem accepting of and positive about their disease. Yet, most deal with significant guilt about their lack of control, judging themselves critically by their daily blood sugars and feeling remorseful for not following their daily regime.

Developmental themes speak to independence, peer support, and diabetic control. Most have a great need to be independent in caring for themselves, appreciate peer support (and wish for it when it is unavailable), and generally share experiences about their lack of control of their diabetes.

Clinical themes address difficulties and coping strategies. Major difficulties include avoiding sweets and sticking to a well-balanced diet, and difficulty in daily blood testing and insulin reaction. " ‘The repetition gets old you know,’ " responded one participant. Emotional instability also made it hard to maintain control. One stated, " ‘There is not enough time for myself. Diabetes is too much to think of.’ "

QUESTIONS FOR REFLECTION AND DISCUSSION

1. Do the diabetic adolescents with whom you work exhibit any of the aforementioned frustrations? Explain.
2. Why is there a need to understand of the needs of diabetic youth?
3. How can a person without diabetes sympathize and understand an adolescent living with diabetes?
4. How can a youth worker help an adolescent diabetic who is experiencing difficult times?

IMPLICATIONS

1. A surprising conclusion of this study is that, overall, diabetics are fairly ambivalent about their condition.
2. To help an adolescent diabetic live fully and responsibly with their disease, one should walk with them. Allow and encourage them to express and define their feelings.