Adolescents' Experiences of Transition to Self-Management of Type 1 Diabetes: Systematic Review and Future Directions.
Paula Leocadio, Carol Kelleher, Eluska Fernández and 1 others
PMID 37927049WHAT IT FOUND
Adolescents with type 1 diabetes sometimes let glucose rise to fit in, despite parents and health care professionals pushing for A1C targets.
The review suggests interdependence and rehearsal, not full independence, may ease transition to self-management.
Key findings
01Adolescents described wanting to fit in with peers, and some allowed blood glucose to rise during social or practical demands, while family and health care expectations often focused on A1C targets.
02The review framed transition as relational autonomy and interdependence: adolescents wanted ownership but still needed ongoing guidance, shared responsibility, and gradual rehearsal rather than abrupt full independence.
03Continuous glucose monitoring and parental access to data were described as both reassuring and intrusive, and the review could not say whether they help or hinder transition.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The search was restricted to English-language studies, so non-English experiences were not captured. The review protocol was not registered. The included studies used very different designs and populations, so the themes describe experiences rather than tested effects. No included study reported health care professionals' perspectives, even though the search aimed to include them. Most studies did not separate which self-management tasks were done by adolescents and which were done by parents or caregivers. Background information such as A1C, age at diagnosis, family composition, socioeconomic status, and insurance coverage was not available in all studies. The review did not link the themes to measured clinical outcomes, so it cannot say what improved diabetes control or quality of life.
Declared interests
No relevant conflicts of interest were declared. Funding came from Cork University Hospital Charity, with additional support from university departments.
The easy way to misread this
Do not read this as evidence that interdependence, rehearsal, or reduced parental monitoring improves diabetes outcomes. The review reports themes from adolescents' and families' experiences; it did not test an intervention or show changes in A1C or quality of life.