How do children and adolescents understand their diabetes?

While adults have the cognitive skills to understand and process information about a diagnosis of diabetes, children and young people (CYP) can only understand and process medical explanations if they fit with their level of development. The way information is processed throughout development moves from primitive, circular, concrete and egocentric reasoning to more abstract and logical views. The changes in adolescence and move towards independence can pose a challenge as children and families try to find a balance between the appearance of normality and adhering to a condition which can create a significant burden. Young people often wish diabetes away in their desire to be 'normal' and as a result sacrifice self-management behaviours to fit in with others. Young people acknowledge that mastery of the skills involved in diabetes self-management is an integral part of accepting the illness and incorporating it into a new identity. Finding ways that enable these self-management skills to 'fit' in personal and social settings can enable the young person to become comfortable with their life as a person with diabetes. There is also a dilemma for many as to the extent to which they choose to share this aspect of their lives with others. The goal for all of us is to help CYP realise that there is so much more to them than diabetes. A sound support system, including parents, family members, peers, health care providers, and school nurses can reduce burden, diminish stigma and create a more positive attitude towards diabetes efficacy. Copyright (c) 2019 John Wiley & Sons. Practical Diabetes 2019; 36 (4): 117-120