Self-care needs and obstacles of adolescents with type 1 diabetes: a narrative review

Type 1 diabetes is the most common metabolic disorder in children. This disease is associated with a range of potential complications, including developmental and endocrine abnormalities, acute events such as diabetic ketoacidosis, as well as long-term microvascular and macrovascular complications. Effective self-management is considered the cornerstone in controlling this chronic condition. The responsibility for self-care may be assigned to adolescents who have not yet fully accepted their diagnosis, which can negatively impact their adherence to self-care practices. Therefore, the purpose of this narrative review study is to identify the self-care needs of adolescents living with T1D based on the review and analysis of the findings of previous studies. This study is a narrative review. The population of interest includes all studies published between 2013 and 2024 addressing the self-care needs and glycemic control issues of adolescents living with T1D. Relevant articles were retrieved from the databases PubMed, ScienceDirect, Scopus, and Web of Science and The keywords “self-care,” “self-care needs,” “type 1 diabetes,” “blood glucose control,” and “adolescents” were used with MeSH terms in combination within the titles, abstracts, and keyword sections. In the first stage of the search, a total of 7973 articles were found. After removing similar and unrelated articles based on the inclusion and exclusion criteria, 15 articles remained for review. In the analysis phase, the findings extracted from each article were recorded and, based on their content, concepts related to self-care in adolescents living with T1D were extracted. These concepts were classified into two main areas: “self-care needs” and “self-care barriers.” The study results were generally categorized into two groups: self-care needs in diabetes and barriers to self-care in diabetes. The most significant self-care needs identified included dietary management, physical activity and exercise, recognition of blood glucose emergencies and appropriate responses, acquisition of knowledge about insulin, family support for adolescents, the development of independence from parents, peer support, the necessity of disease-related education, support from healthcare professionals, and attention to spiritual needs.Barriers to self-care included concealing the disease from friends, insufficient education, fear of needles, treatment costs, lack of resources, issues with teachers, denial of the disease, and conflicts with parents. A review of the research findings reveals an urgent need for self-care activities across multiple areas to reduce the burden of diabetes-related disease. Also, physicians play an important role and bear responsibility in facilitating and promoting self-care. Barriers to self-care are factors that hinder adolescents or parents from accessing, receiving, and utilizing comprehensive, patient-centered, coordinated, accessible, and high-quality care.