Adolescents’ Experiences of Self-Management and Decision-Making in Type 1 Diabetes Mellitus

Abstract

Background: Adolescents with Type 1 Diabetes Mellitus (T1DM) encounter challenges in managing their condition, which may reduce their confidence and engagement in self-management. This study explored adolescents’ experiences of T1DM self-management, focusing on factors influencing their engagement in self-management practices and healthcare decision-making. Methods: A qualitative study using purposive sampling was conducted via clinical consultations and semi-structured interview. Thirty participants were recruited, comprising 12 adolescents with T1DM, 14 parents, and four healthcare professionals. Data were analysed using Braun and Clarke’s six-phase thematic analysis. Results: Three themes emerged: (a) Knowledge Deficits and Dependence, where limited understanding of diabetes management resulted in reliance on parents and healthcare professionals; (b) Complex Burden of Self-Management, highlighting difficulties in glycaemic control, dietary adherence, and the psychosocial impact of living with T1DM, including social stigma; and (c) Emerging yet Constrained Autonomy, where adolescents demonstrated varying levels of involvement in self-management and decision-making, ranging from passive dependence to increasing independence. These findings suggest that adolescents’ self-management experiences are shaped by the interaction of diabetes-related knowledge, psychosocial challenges, and evolving autonomy. Conclusion: Adolescents’ engagement in T1DM self-management is influenced by their knowledge, psychosocial experiences, and developing autonomy. Developmentally appropriate diabetes education and supportive, adolescent-centred care are essential to strengthen confidence, encourage meaningful participation in decision-making, and promote effective long-term self-management.