3 - Coping with Diabetes: A Longitudinal Study

Summary

In this book the challenges of coping with chronic illness are examined, with the focus on one illness in particular, namely, insulin-dependent diabetes mellitus (IDDM), which is also known as diabetes mellitus type I or juvenile-onset diabetes. Diabetes is a comparatively frequently occurring chronic disease in adolescence and exhibits the typical aspects of a chronic illness as detailed in chapter 1. The manifestation of diabetes confronts patients and their families with a flood of questions, and the demands on the adolescent's understanding, self-discipline, and responsibilities are very high. The medical treatment regimen is relatively burdensome, and the consequences of not following physicians' instructions may be severe and even life-threatening. Consequently, compliance and adherence are highly relevant aspects to be considered in assessing the coping process. An analysis of coping processes, however, must be embedded in the context of the adolescent's family and extended social environment. Furthermore, the adolescent's overall developmental progression needs to be taken into account.

After the main medical features of diabetes have been described, a preliminary model for understanding the relationships among variables involved in the process of coping with a chronic illness is outlined. This model may serve as a guide in the discussions of the theoretical questions related to coping. Then, a 4-year longitudinal study of diabetic adolescents and their families, which aimed to integrate medical, developmental, psychosocial, and family dynamics perspectives, is presented.