In a recent review of research on paediatric chronic illness, Glasgow and Anderson163 called for a number of conceptual issues to be addressed in future research. With the vast majority of research being conducted on the family, they 'recommend that greater attention be paid to the social context' in which the adolescent lives. In particular, La Greca164'165 noted the paucity of research on the role and influence of the adolescent's peer group at a time when friendships develop and peer influence becomes increasing important. Studies have shown that peers and friends are an important source of emotional support for adolescents with diabetes55'59'148'166. However, it is not just the supportive behaviour of adolescents that is important. Kyngas and colleagues147 report that some adolescents have friends who seem to dominate their lives, sometimes tempting them to break their treatment regimens and make self-management difficult. Friends can be both supportive and unsupportive, and may serve to help with some aspects of the regimen and yet hinder others167.

Dunning168 reported on a range of adolescents' self-management behaviours, and found that 66% reported skipping insulin injections to fit in socially. Jacobson and colleagues86 found that 55% of adolescent newly-diagnosed diabetics did not talk about their diabetes with their friends, and 35% thought that their friends would like them better if they did not have diabetes. Simonds and colleagues78 and Bobrow and colleagues93 also found that adolescent diabetics were sensitive to being different, and felt that they were treated differently because of their diabetes. Meldman166 reports that many adolescent diabetics found that having diabetes made it difficult to be spontaneous and socially acceptable, expressing fears that at parties or restaurants, having to go and take an insulin injection may result in others thinking they were drug addicts. As well as having to deal with the social pressures associated with being part of a peer group, adolescent diabetics may be more sensitive to feeling different from their peers. Additionally, Meldman found that young people were afraid of being identified as 'freaks' or 'weird' by their peers. The adolescent diabetic is aware of these pressures and states that peer support is important, 'those who did not have it wanted it, and those who had it appreciated it'166.

Despite these descriptive studies, only a few studies have explored the relationship between the adolescents' peer support and their diabetes management or psychological adjustment. La Greca and colleagues148 reported that peer support was associated with self-care, but this relationship did not remain after controlling for family support. However, this study did not consider the negative aspects of peer relationships, which is a key component of the social relationships, particularly in adolescence169. However, including the negative aspects of peer relations may not be the key to understanding the importance of peers for young people with diabetes55'59. Rather, as postulated by Wallander and Varni170, adolescents need both supportive family and supportive friends if they are going to integrate diabetes management into their daily lives. This is supported by a 6 month prospective study of adolescents, where neither family or friend support alone predicted self-care behaviour, but the combination of the two did55.

In addition to providing support for self-management, the emotional support provided by friends is likely to be associated with well-being in adolescents with a chronic illness164. Two studies of adolescents with diabetes55'132 found that lower peer support was associated with poorer psychological adjustment. However, the data from a prospective study again supports the need for both supportive family and friends for optimal adjustment58. In addition, in a study looking at adjustment across several chronic conditions, it was the presence of both family and friend support that was predictive of better psychological outcomes170. From the limited research to date, it would seem that the social aspects of diabetes are important for adolescents, and that they are highly likely to put their social worlds before their diabetes management21. This conflict between social and diabetes pressures may also be important determinants of their emotional well-being, and therefore, diabetes care teams should strive to work alongside young people so that they can enable them to manage their diabetes but not at cost of their social life.

Supplements For Diabetics

Supplements For Diabetics

All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.

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