Evidence-Based Practice on Adolescents' Self-Management of Diabetes: Are They Able To Do So Effectively?

Bridges, Dakima, and Joyce Conley

Diabetes mellitus is becoming a growing endocrine disorder of children with peak incidence in early adolescence. Over 186000 people under the age of 20 was diagnosed with type 1or 2 diabetes in 2007. Satisfactory and consistent self-management of diabetes is important to prevent the many complications associated with the disease. Children diagnosed with diabetes require different standards of care from that of an adult. There are a significant amount of emotional needs that ought to be addressed while clinicians develop their plan of care. More importantly, parental support and supervision over the plan of care is crucial when helping the child to eventually achieve independence over their disease management when capable.

The purpose of reviewing literature about adolescents managing their diabetes is to help bring a better understanding of what these children struggle with, while helping clinicians to better meet their needs when providing treatment. The clinical question studied is: How do adolescents diagnosed with diabetes (type 1 or 2) cope with issues of self-management? An in depth search regarding literature on this subject was conducted. Databases used to gather information was CINAHL, PubMed Clinical Queries, and Cochrane Reviews searching articles older than 2004. In total, eleven articles were found but only seven were appropriate for review. There was a significant amount of data on adolescent-parent relationships and how the nature of these relationships influences disease management outcomes. One research article was found regarding data on cultural influences and if culture is an influencing factor concerning adolescents‟ management of diabetes.

The research showed notably strained adolescent-parent relationships. The studies showed a considerable amount of adolescents vying for autonomy and parents uneasy about relinquishing that freedom in the studies presented. The studies reviewed showed a need for clinicians to create and implement behavioral, as well as medical interventions to enhance the adolescent‟s ability to self-manage their diabetes better. More importantly, these behavioral interventions could also help teach parents how and when to give their adolescent autonomy; and not worry about the end result of doing so.