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Type 1 Diabetes Mellitus in Adolescents


While type 2 diabetes associated with middle-aged and older patients is of more frequent occurrence, type 1 diabetes is rarer and predominates among younger people. The fact that type 1 is not so common implies difficulties in collecting data. However, in recent times, researchers give attention to this problem more often. As a part of the growing interest, qualitative studies are often conducted. The article by Scholes, Mandleco, Roper, Dearing, Dyches, & Freeborn (2013) is an example of such studies. The authors explore how young persons with type I diabetes live their lives and perceive their illness depending on the level of metabolic control (HbA1c). The purpose of the present paper is to analyze the research focusing on the following elements: problem statement, study purpose and research question, literature review, and theoretical framework.

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Problem Statement

The article concerns young people with type 1 diabetes mellitus (T1DM) and their perception of their lives and illness. The authors consider adolescence as one of the most challenging developmental stages for a person characterized by physiological and psychological changes. Since blood glucose levels and adherence to treatment regimens tend to deteriorate, T1DM becomes a complicating factor (Greening as cited in Scholes et al., 2013).

Nowadays, this clinical problem is pressing: some adolescents show responsibility and comply with treatment instructions, but others undergo hardship. However, it is emphasized that whether patients with high and low levels of metabolic control do not regard their state in the same manner is unknown: little research has explored these patient categories separately and concentrated on the young people’s self-perception. As a result, medical professionals assist adolescents with T1DM less effectively. Thus, the authors explain young individuals’ difficulties by the gap in knowledge about the influence of blood glucose levels on socializing.

Purpose and Research Question

According to the article, the study was a stage within a larger research dealing with the adaptation of family members to treating a child or adolescent with T1DM. In the paper under analysis, the aim is to investigate if young people with higher and lower levels of metabolic control of TD1M hold different perceptions of their lives and disease (Scholes et al., 2013). In this context, the research provides answers to the questions whether patients with high-HbA1cs levels are more optimistic about the future clinical outcome and whether adolescents with low-HbA1cs levels are less responsible for diabetes management. As these questions are directly connected with the real-life situations, they are related to the problem.

The qualitative method used is audio-recorded in-depth interviewing. Four main topics were covered: family, surrounding persons’ attitude, self-management, and behavior. The interviewees could freely share their routine daily experience and personal opinions about living with T1DM; only clarifying questions were sometimes present. Different researchers conducted the interview and analyzed the results. Thus, the method is appropriate to find the answers to the research question.

Literature Review

The authors use a wide range of works concerning the sphere of T1DM in adolescents as well as more general research and statistics on morbidity and mortality rates, disease incidence, and social aspects of diabetes mellitus. A substantial part of literature deals with family issues and parent-adolescent communication. Overall, the reference list contains current sources, although the authors used a few books and articles published in the last century. Most sources are qualitative studies dated by the last five years; older papers are also relevant because they help understand how adolescents’ perception has changed in the course of time and what obstacles were present.

The authors underline the main weakness of the previous studies: as a rule, they concentrated on adolescents with T1DM irrespectively to their HbA1cs levels. They summarize what has already been achieved in T1DM treatment and put this information into a special section where the research findings and implications for practice are given. This structure is instrumental in building the logical argument.

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Theoretical Framework

The authors argue that the results of their research were checked for accuracy according to the qualitative methodology, and the interview themes were identified through inductive analysis (Scholes et al., 2013). They also mention the theory of crisis: perceptual differences are explained by the level of support and care that a person in a crisis state receives (Aguilera as cited in Scholes et al., 2013). However, the specific perspective from which the study was designed is not the focus. The researchers develop neither a framework nor diagram. It can be explained by the fact that this investigation is the part of the larger study.


To sum it up, the paper exemplifies the qualitative study concerning type I diabetes in adolescents with different levels of metabolic control. The authors use appropriate academic sources that help elicit the up-to-date knowledge and gaps in research, but do not concentrate on developing a theoretical framework. They aim at discovering differences between adolescents with high- and low- HbA1c levels in terms of optimism and self-care responsibility. The authors used interviewing and draw a conclusion that patients with high- HbA1c level tend to be more buoyant and concern about their health to a greater extent than adolescents with low- HbA1c level.


Scholes, C., Mandleco, B., Roper, S., Dearing, K., Dyches, T., & Freeborn, D. (2013). A qualitative study of young people’s perspectives of living with type 1 diabetes: Do perceptions vary by levels of metabolic control? The Journal of Advanced Nursing, 69(6), 1235-1247.

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