Monaghan Maureen, Helgeson Vicki, Wiebe Deborah
Children`s National Health System, Washington, DC, USA.
Curr Diabetes Rev. 2015;11(4):239-50. doi: 10.2174/1573399811666150421114957.
Type 1 diabetes has traditionally been studied as a chronic illness of childhood. However, young adulthood is a critical time for the development and integration of lifelong diabetes management skills, and research is starting to identify unique challenges faced by youth with diabetes as they age into adulthood. Most young adults experience multiple transitions during this unstable developmental period, including changes in lifestyle (e.g., education, occupation, living situation), changes in health care, and shifting relationships with family members, friends, and intimate others. Young adults with type 1 diabetes must navigate these transitions while also assuming increasing responsibility for their diabetes care and overall health. Despite these critical health and psychosocial concerns, there is a notable lack of evidence-based clinical services and supports for young adults with type 1 diabetes. We review relevant evolving concerns for young adults with type 1 diabetes, including lifestyle considerations, health care transitions, psychosocial needs, and changes in supportive networks, and how type 1 diabetes impacts and is impacted by these key developmental considerations. Specific avenues for intervention and future research are offered.
1型糖尿病传统上被视为一种儿童慢性疾病。然而,青年期是培养和整合终身糖尿病管理技能的关键时期,并且研究开始识别糖尿病青少年步入成年期后面临的独特挑战。在这个不稳定的发育阶段,大多数青年会经历多种转变,包括生活方式的改变(如教育、职业、生活状况)、医疗保健的变化以及与家庭成员、朋友和亲密他人关系的转变。患有1型糖尿病的青年在应对这些转变的同时,还必须对自己的糖尿病护理和整体健康承担越来越多的责任。尽管存在这些关键的健康和社会心理问题,但对于患有1型糖尿病的青年,明显缺乏基于证据的临床服务和支持。我们回顾了与1型糖尿病青年相关的不断演变的问题,包括生活方式考量、医疗保健过渡、社会心理需求以及支持网络的变化,以及1型糖尿病如何影响这些关键的发育考量因素以及如何受到这些因素的影响。还提供了具体的干预途径和未来研究方向。