There are many emotional and physical changes that occur during the developmental stage of adolescents. “During adolescence, the most important developmental processes are the building of an inward sense of a new, adult body image, discovering sexual identity, and becoming independent” (Newman & Newman, as cited in Kyngas & Hentinen, 1995, p. 729).

The transitional stages of an adolescent may actually be detrimental for the young person’s health. According to Fleming, Bernie, & Gillibrand (2002), “adolescents have unique health needs, which impact upon their transition from children’s health care services into adult health care services” (p. 560). In fact, research has shown that there is evidence of marked deterioration of metabolic control during the teenage years (Fleming et al., 2002). Not only are these individuals having to manage a chronic illness but they are also having to adapt to the changes associated with becoming an adult. “The overwhelming changes in the first phase of the young-adult period (including graduation form high school, moving away from home, beginning new educational directions, and beginning work to be self-supporting) are often a distraction from the demands of managing diabetes” (Wolpert & Anderson, 2001, p. 1513). The second phase of adolescents as documented by Wolpert & Anderson (2001) is described as the crucial time and opportunity for the health provider to intervene and influence regular self-care that will promote health and well being.

Being seen as different by one’s peers may be very difficult to accept during a time of emotional confusion. “Adolescents with diabetes must establish an identity separate from their parents, while coming to terms with being different from peers at a time in their lives when being the same is important” (Curtin, as cited in Christian & D’Auria, 1999, p. 256). In relation to identity Wichowski & Kubsch (1997) noted that “perceptions of self have tremendous influence in determining behavior” (p. 549). Therefore, an individuals psychological well being may in fact affect adherence to a self-care regimen.

Kyngas, H., & Hentinen, M. (1995). Meaning attached to compliance with self-care, and coalitions for compliance among young diabetics. Journal of Advanced Nursing, 21, 729-736.

Kyngas, H., & Rissanen, M. (2001). Support as a crucial predictor of good compliance of adolescents with a chronic disease. Journal of Clinical Nursing, 10, 767- 775.

Bryden, K.S., Peveler, R.C., Stein, A., Neil, A., Mayou, R.A., & Dunger, D.B. (2001). Clinical and psychological course of diabetes form adolescence to young adulthood. Diabetes Care, 24, 1536-1540.

Fleming, E., Bernie, C., & Warren, G. (2002). The transition of adolescents with diabetes from the children’s health care service into the adult health service. Journal of Clinical Nursing, 11, 560-568. Karlsen, B., Bru, E., & Hanestad, B.R. (2002). Self-reported psychological well-being and disease-related strains among adults with diabetes. Psychology and Health, 17, 459-473.

Wolpert, H.A., & Anderson, B.J. (2001). Young adults with diabetes: Need for a new treatment paradigm. Diabetes Care, 24, 1513-1514.