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The Science of Diabetes in Emerging Adulthood
In developmental psychology, young adulthood – sometimes called ‘emerging adulthood’ – occurs between the ages of 18 through the late 20s. These years are when young people take on increasingly more ‘adult-like’ roles and responsibilities.
But no one emerges from a cocoon on their 18th birthday as a butterfly with all the tools and knowledge they need to soar into adulthood.
The confidence people gain in managing adult life comes with time and experience – and it usually evolves over the course of years.
For young adults with type 1 diabetes (T1D), the transition to adulthood – which includes moving out of their parent’s house or beginning their career – inevitably coincides with changes in how they manage T1D, too. Switching to an ‘adult care’ provider. Taking over ordering medical supplies. Navigating complex healthcare systems and insurance plans. And the micromanagement of diabetes decisions both small (When will I have time to eat today?) and large (Which health care plan has the most coverage for what I can afford?).
Challenges of Young Adulthood and Resources to Help
Researchers highlight the challenges of T1D in young adulthood. A lot of research is focused on the numbers: HbA1c levels in young adults are higher compared to older people, and many young adults with T1D experience gaps or delays in medical care.
In a departure from numbers, one study of social barriers discussed the difficulties young adults experienced in their daily lives. Most young adults have much less structure than they did as a child or teen. They are faced – perhaps for the first time – with incorporating T1D management into a workday that may be unpredictable.
Learning to navigate these aspects of adulthood with T1D takes time, but there are resources available that can help.
College Diabetes Network (CDN) provides free resources for young adults – regardless of student status. The You’ve Got This guide has helpful tips on working through daily diabetes management. There also are guides for making a move to college (Off to College), managing diabetes in the workplace (Off to Work), and demystifying the complex world of insurance.
Reminders for Young Adults with T1D
The science behind living with T1D as a young adult highlights an unsurprising fact: it’s hard.
I spoke with Krystle Samai, Vice President of Mission at CDN, and asked how we could empower young people with T1D. She shared an important reminder for when normal T1D management leads to unrelenting high blood glucose and it’s hard to understand the reason why:
“… it’s really easy to be hard on yourself, but taking a step back and saying ’I am high because an important organ in my body doesn’t function properly and I’m doing the very best I can to make up for [an organ] that is supposed to do this for me’ is a good way to offer yourself both kindness and a little perspective.”
My conversation with Krystle inspired some gentle reminders that may be easy to overlook when you’re dealing with the challenges of young adulthood with T1D:
Acknowledge your frustrations and be kind to yourself. T1D sucks. Some days, it sucks more than others. Some days, you’ll be tired of self-advocating. Some days, your blood glucose is going to be less responsive than you’d like. Some days, it’s going to feel like everything is going wrong. But these experiences and the distress you may feel about living with T1D as a young adult are common for a reason. Distress is common because being a young adult is hard. During these times, it is especially important to be kind to yourself and focus on the next step you need to take to make it through the day. And remember that these days won’t be all days. You’ll get through it.
You’re (probably) doing your best in a challenging time. No one manages T1D perfectly. It’s important to remember the difference between your ideal T1D management and your good enough T1D management. If your management choices involve doing something to play the part of a functioning pancreas, then you’re already doing better that the status quo for your body. So, it’s okay when you’re having a rough day to take whatever you’re doing as a win. That’s not to say your choices don’t matter. If you are truly struggling more days than not or if you find yourself getting into emergency situations, then you should re-evaluate and touch base with your diabetes care team. But, if your management keeps you safely moving on to the next day without compromising your immediate health, then your best in your current circumstances is good enough.
You don’t have to navigate T1D in young adulthood alone. There’s a misconception that as an adult you need to manage everything all on your own. Being able to count on others for support is beneficial for T1D management. You’re the person who knows best who is supportive – the people in your life you feel would be there for you if you needed them. Maybe your support comes from your parents, your romantic partner, friends or peers at your college. Maybe it’s an online community where you can meet others with T1D who get it. Having people who you believe are supportive can help to ease the stress that comes with managing T1D in young adulthood. And support doesn’t have to be direct or about diabetes to have a positive impact: one study of adults with T1D found having fun with their romantic partner was associated with feeling like they could more effectively handle daily diabetes stress. Whoever it is and however you connect with them, other people can be a great resource for you. So find them and use them.
Despite the challenges, allow yourself to have fun. When you’re facing hardships, it can be difficult to appreciate the good. But being a young adult is pretty awesome. You’re finding out who you are and what matters to you. You don’t have to have it all figured out at this point, because your adult life is just beginning. And even though having T1D can suck, it’s one part of your life. So don’t forget to enjoy the journey and use this time to start to shape your life into what you want it to be.
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