Integrative Review of the Transitions of Emerging Young Adults with Type 1 Diabetes

Monday, 9 November 2015

Jennifer Saylor, PhD, MSN, BSN, RN, APRN-BC
School of Nursing, University of Delaware, Newark, DE, USA

Background/Purpose: Approximately three million Americans have type 1 diabetes, which is the most common childhood metabolic disease. Transitional events among emerging adults from late adolescence to late twenties may cause physiological and psychological difficulties, especially for those with type 1 diabetes. Although research is more prevalent in the early and mid-adolescent age groups, there is a dearth in the literature among the emerging adults age group. This vulnerable population undergoes a critical transitional time with an overwhelming sense of developing independence. This critical phase may impact the trajectory of type 1 diabetes management not only physiologically, but also psychologically throughout one’s lifespan. This integrative literature review evaluates the current state of the science of emerging adults with type 1 diabetes during transitional events.

Methods: A comprehensive multi-step literature search (published 1994–2014) of transition, type 1 diabetes, and young adults, which indexed in the CINAHL, Pubmed, PsychINFO and Cochrane databases was performed. A sample of 36 research and non-research reports met the inclusion criteria. All 36 articles were included in the review. A systematic and iterative approach was used to extract and reduce the data to draw conclusions.

Results: This analysis revealed that the most crucial transitional events among emerging adults with type 1 diabetes are those that promote independence, including attending college, leaving parents’ home, obtaining new employment, and transferring from a pediatric to adult care. Stress was a common theme among emerging adults, especially those in college with erratic eating, sleeping, and course schedules. Balancing college living and diabetes management is essential but non-existent in the literature.

Conclusions & Implications: Despite the small sample sizes and descriptive research methods, this review suggests some barriers and facilitators for transitioning emerging young adults with type 1 diabetes. Further research including interventional studies of educating emerging young adults is essential to aid in the transition to college, which may improve diabetes management and quality of life.