Abstract:
Adolescents and Young Adults (AYAs) with Type 1 Diabetes Mellitus (T1DM) experience psychological challenges that extend beyond metabolic control. This review synthesizes qualitative evidence to examine how mental health, biographical disruption, embodiment, and illness narratives shape the lived experience of AYAs with T1DM. A structured search of PubMed, Scopus, and Web of Science identified 15 qualitative studies published in English or Spanish over the past decade. Thematic synthesis was conducted across seven domains: psychological burden, identity, adaptation, social experience, barriers to care, diabetes technology, and participant recommendations. Across studies, participants reported emotional turbulence, anxiety, fear of hypoglycemia, and distress related to both anticipated and experienced complications. Identity concerns frequently outweighed perceived biomedical risk, with notable gendered differences in illness experience. Daily life was characterized by constant vigilance and efforts to reclaim normalcy. Social experiences included stigma, peer misunderstanding, and feelings of surveillance, while family and close relationships provided critical emotional support. Automated insulin delivery systems were associated with reduced cognitive and emotional burden and increased independence; however, access was uneven, shaped by economic, educational, and healthcare system factors. These findings demonstrate that T1DM in adolescence and young adulthood constitutes a profound disruption of biography, embodiment, and mental well-being, consistent with Charmaz’s chronic illness framework. Limited integration of mental health care within diabetes services constrains recognition of psychosocial needs and may contribute to suboptimal outcomes. Addressing biographical disruption requires culturally responsive, developmentally informed, and relationally grounded interventions that integrate mental health into routine diabetes care.
Keywords: Type 1 diabetes; mental health; adolescence; biographical disruption; qualitative research
