Relationships with Peers and Health Care Providers.

As adolescents mature and spend time away from parents, additional relationships become important for diabetes management. Research on peer support during adolescence suggests friends both help and hinder diabetes management during adolescence. We have examined how late adolescents and emerging adults develop diabetes-specific support from friends. Disclosing about their diabetes and teaching friends what to do in emergencies appears an effective strategy to promote T1D self- management across the first year after high school.

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Although understudied, health care providers are also important resources for T1D management, given their long-standing, personal relationships with both adolescents and parents. We have found that health care providers may influence family processes (e.g., by conveying messages to both adolescent and parent about the importance of maintaining parental involvement in diabetes management) and self-regulation mechanisms (e.g., patient-centered communication predicts longitudinal increases in adolescents’ perceptions of competence, promoting T1D management). We recently found that patient- centered relationships with health care providers shift and influence diabetes management as adolescents transition out of pediatric care and establish new relationships with adult care providers in emerging adulthood.