Young people with diabetes and their peers

Aims
Peer influences can impact across a range of adolescent behaviours. Type 1 diabetes (T1D) is amongst the most common forms of chronic illness to affect young people in the UK. Self-management is crucial, but managing their T1D is often very difficult for adolescents. It has been suggested that interventions to support young people with T1D could usefully include their friends and peers, but little is known about how peers think about and respond to T1D. This research explored T1D from the perspective of adolescent patients, friends, and peers.

Methods
We conducted dyadic interviews with adolescent diabetes patients aged 13-15 years and a nominated close friend (n=20). We then carried out three focus groups sessions with participants without any necessary prior knowledge of diabetes in a high school setting.

Data were thematically coded and final data interpretations were subject to independent scrutiny from young people the same age as our research participants who assessed the findings in terms of relevance and usefulness from their own perspective.

Results
Limited awareness of T1D amongst their peer group generally and school teaching staff was reported by interview participants. Close friends play a valuable role in recognising the importance of T1D management, whilst also accepting and normalising the condition. Considerable variations in experiences of support provided in relation to T1D in the school environment were reported by all participants, including the extent to which peers were encouraged or even permitted to support patients.

Educational materials designed in response to issues raised in the interviews were piloted in classroom settings. Realistic vignettes developed from the interviews were used to facilitate group discussion. The simple materials were well-received and positively evaluated.

Conclusions
This research highlights the need for greater awareness of T1D in schools amongst teachers and peers, but encouragingly suggests that simple educational sessions can be easily implemented and are well received. There is a lack of standardised school policies in relation to management of T1D. This important aspect of the care pathway should be addressed to ensure there are no barriers to optimal self-management for adolescents in their school environment.