Early-onset adult type 2 diabetes, which strikes young adults aged 18-44 years, poses a significant health threat. Adequate self-management requires that young adults perform medical tasks and practice healthy lifestyle behaviors in social situations of everyday life. Few researchers have examined whether these young adults disclose their illness to others and if self-disclosure is linked to diabetes self-management.
A descriptive and exploratory study was designed to answer the following research questions: (1) To what extent do young adults with early onset type 2 diabetes identify instances of illness related self-disclosure during the course of their disease? (2) What is the nature of these instances? and (3) To what extent and how are these instances associated with efforts at self-management? Through a series of in-depth interviews (Rubin & Rubin, 1995), five young adults described their lives since diagnosis. Individual illness timelines were developed from these descriptions and case analyses were completed.
Self-disclosure occurred during all five young adults' illness timelines, particularly at diagnosis, and during times of treatment change, complications, and/or significant life events. The major topics of verbal self-disclosure were expressing feelings about the new diagnosis, telling others "I have diabetes", and telling others about diabetes and treatment. Non-verbal disclosures included specific behaviors such as injecting insulin, testing blood sugar, eating and aspects of one's appearance, such as gaining or losing weight. The majority and most problematic of self-disclosures occurred within the family. In the lives of all five young adults, self-disclosure both enhanced and diminished their efforts at self-management. Through participation in this study, the young adults came to recognize the role of self disclosure in their own lives and in the context of living with diabetes. The findings of this study indicate that for some young adults, self-disclosure was important, and helping them to disclose more effectively may improve self-management. Current theories of diabetes self-management which emphasize self-efficacy, behavioral change, or integration may be enhanced by adding aspects of self-disclosure.
