Nondisclosure of Type 1 Diabetes in Adolescence: A Single-Center Experience

Objective. The aim of this study was to assess the extent of nondisclosure of type 1 diabetes in adolescents and investigate its association with several psychosocial parameters and clinical outcomes.

Research design and methods. This was a cross-sectional study based on data collected from 69 adolescents with type 1 diabetes who were 12–18 years of age and followed at our diabetes clinic. The degree of disclosure, demographics, diabetes management, and psychosocial issues were assessed via questionnaires. Clinical parameters were derived from medical records. Associations between nondisclosure status and clinical and psychosocial study variables were assessed.

Results. Fifty-three participants (77%) reported some extent of nondisclosure. Nondisclosure was associated with low self-esteem, reduced friend support, and increased diabetes-related worries. Nondisclosure was also found to be associated with diminished self-care behaviors related to insulin administration and with elevated A1C.

Conclusion. Our results demonstrate that nondisclosure of type 1 diabetes in adolescents may be more common than initially recognized and is likely associated with unfavorable psychological outcomes and reduced self-care and diabetes management. Our results emphasize the importance of social interactions and disclosure in adolescents and may serve as a potential stepping stone to address other social barriers hindering diabetes management.