{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:30:51Z","timestamp":1790087451829,"version":"4.0.1"},"reference-count":34,"publisher":"American Diabetes Association","issue":"2","license":[{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>This was a cross-sectional study based on data collected from 69 adolescents with type 1 diabetes who were 12\u201318 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/ds23-0006","type":"journal-article","created":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T19:00:43Z","timestamp":1701802843000},"page":"124-129","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":1,"title":["Nondisclosure of Type 1 Diabetes in Adolescence: A Single-Center Experience"],"prefix":"10.2337","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1713-0955","authenticated-orcid":false,"given":"Judith","family":"Nir","sequence":"first","affiliation":[{"name":"1The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children\u2019s Medical Center of Israel, Petah Tikva, Israel"},{"name":"2Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Liberman","sequence":"additional","affiliation":[{"name":"1The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children\u2019s Medical Center of Israel, Petah Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Yackobovitch-Gavan","sequence":"additional","affiliation":[{"name":"1The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children\u2019s Medical Center of Israel, Petah Tikva, Israel"},{"name":"2Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drora","family":"Fraser","sequence":"additional","affiliation":[{"name":"3Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheeba, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshe","family":"Phillip","sequence":"additional","affiliation":[{"name":"1The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children\u2019s Medical Center of Israel, Petah Tikva, Israel"},{"name":"2Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tal","family":"Oron","sequence":"additional","affiliation":[{"name":"1The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children\u2019s Medical Center of Israel, Petah Tikva, Israel"},{"name":"2Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2023,12,5]]},"reference":[{"key":"2024051518512532100_B1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/S0140-6736(13)60591-7","article-title":"Type 1 diabetes","volume":"383","author":"Atkinson","year":"2014","journal-title":"Lancet"},{"key":"2024051518512532100_B2","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/S2213-8587(19)30412-7","article-title":"Type 1 diabetes: early life origins and changing epidemiology","volume":"8","author":"Norris","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2024051518512532100_B3","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.jadohealth.2014.03.011","article-title":"Psychosocial burden and glycemic control during the first 6 years of diabetes: results from the SEARCH for Diabetes in Youth study","volume":"55","author":"Hood","year":"2014","journal-title":"J Adolesc Health"},{"key":"2024051518512532100_B4","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.socscimed.2016.06.023","article-title":"To tell or not to tell: a qualitative interview study on disclosure decisions among children with inflammatory bowel disease","volume":"162","author":"Barned","year":"2016","journal-title":"Soc Sci Med"},{"key":"2024051518512532100_B5","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1080\/09540121.2013.764387","article-title":"Disclosure behaviour and experienced reactions in patients with HIV versus chronic viral hepatitis or diabetes mellitus in Germany","volume":"25","author":"Kittner","year":"2013","journal-title":"AIDS Care"},{"key":"2024051518512532100_B6","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.yebeh.2015.07.013","article-title":"To tell or not to tell: a systematic review of the disclosure practices of children living with epilepsy and their parents","volume":"51","author":"Benson","year":"2015","journal-title":"Epilepsy Behav"},{"key":"2024051518512532100_B7","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1023\/A:1024252926930","article-title":"Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women","volume":"26","author":"Kalichman","year":"2003","journal-title":"J Behav Med"},{"key":"2024051518512532100_B8","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.yebeh.2015.12.026","article-title":"Felt and enacted stigma in elderly persons with epilepsy: a qualitative approach","volume":"55","author":"Sleeth","year":"2016","journal-title":"Epilepsy Behav"},{"key":"2024051518512532100_B9","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/dme.13134","article-title":"Disclosure of type 1 diabetes at work among Finnish workers","volume":"34","author":"Hakkarainen","year":"2017","journal-title":"Diabet Med"},{"key":"2024051518512532100_B10","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1093\/jpepsy\/jsv060","article-title":"Secrecy from parents and type 1 diabetes management in late adolescence","volume":"40","author":"Main","year":"2015","journal-title":"J Pediatr Psychol"},{"key":"2024051518512532100_B11","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1037\/0003-066X.55.5.469","article-title":"Emerging adulthood: a theory of development from the late teens through the twenties","volume":"55","author":"Arnett","year":"2000","journal-title":"Am Psychol"},{"key":"2024051518512532100_B12","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1093\/jpepsy\/jst002","article-title":"Emerging adults with type 1 diabetes: a comparison to peers without diabetes","volume":"38","author":"Palladino","year":"2013","journal-title":"J Pediatr Psychol"},{"key":"2024051518512532100_B13","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.2337\/dc07-1249","article-title":"Transitioning from pediatric to adult care: a new approach to the post-adolescent young person with type 1 diabetes","volume":"30","author":"Weissberg-Benchell","year":"2007","journal-title":"Diabetes Care"},{"key":"2024051518512532100_B14","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.2337\/dc06-2197","article-title":"Identification of distinct self-management styles of adolescents with type 1 diabetes","volume":"30","author":"Schneider","year":"2007","journal-title":"Diabetes Care"},{"key":"2024051518512532100_B15","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1080\/24694193.2019.1594453","article-title":"Coping strategies and quality of life of children with type 1 diabetes mellitus: a preliminary study","volume":"42","author":"Mulyasari","year":"2019","journal-title":"Compr Child Adolesc Nurs"},{"key":"2024051518512532100_B16","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s12160-016-9825-5","article-title":"Stress and coping predicts adjustment and glycemic control in adolescents with type 1 diabetes","volume":"51","author":"Jaser","year":"2017","journal-title":"Ann Behav Med"},{"key":"2024051518512532100_B17","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.1186\/s12889-023-16573-z","article-title":"Coping and adaptation strategies among young persons living with type 1 diabetes and their caregivers: textual and photovoice analyses","volume":"23","author":"Owusu","year":"2023","journal-title":"BMC Public Health"},{"key":"2024051518512532100_B18","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.pec.2019.08.019","article-title":"Diabetes disclosure strategies in adolescents and young adult with type 1 diabetes","volume":"103","author":"Pihlaskari","year":"2020","journal-title":"Patient Educ Couns"},{"key":"2024051518512532100_B19","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1111\/pedi.12932","article-title":"Identity and treatment adherence in predominantly ethnic minority teens and young adults with type 1 diabetes","volume":"21","author":"Commissariat","year":"2020","journal-title":"Pediatr Diabetes"},{"key":"2024051518512532100_B20","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1093\/jpepsy\/17.5.633","article-title":"Applying stigma theory to epilepsy: a test of a conceptual model","volume":"17","author":"Westbrook","year":"1992","journal-title":"J Pediatr Psychol"},{"key":"2024051518512532100_B21","doi-asserted-by":"crossref","DOI":"10.1515\/9781400876136","volume-title":"Society and the Adolescent Self Image.","author":"Rosenberg","year":"1965"},{"key":"2024051518512532100_B22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF00898416","article-title":"Measures of perceived social support from friends and from family: three validation studies","volume":"11","author":"Procidano","year":"1983","journal-title":"Am J Community Psychol"},{"key":"2024051518512532100_B23","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1177\/014572179101700219","article-title":"A modified quality-of-life measure for youths: psychometric properties","volume":"17","author":"Ingersoll","year":"1991","journal-title":"Diabetes Educ"},{"key":"2024051518512532100_B24","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1046\/j.1365-2648.2001.01717.x","article-title":"Persons with insulin-dependent diabetes mellitus: acceptance and coping ability","volume":"33","author":"Richardson","year":"2001","journal-title":"J Adv Nurs"},{"key":"2024051518512532100_B25","doi-asserted-by":"crossref","first-page":"S230","DOI":"10.2337\/dc23-S014","article-title":"14. Children and adolescents: Standards of Care in Diabetes\u20142023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"key":"2024051518512532100_B26","doi-asserted-by":"crossref","first-page":"S148","DOI":"10.2337\/dc19-S013","article-title":"13. Children and adolescents: Standards of Medical Care in Diabetes\u20142019","volume":"42","author":"American Diabetes Association","year":"2019","journal-title":"Diabetes Care"},{"key":"2024051518512532100_B27","doi-asserted-by":"crossref","first-page":"e019764","DOI":"10.1136\/bmjopen-2017-019764","article-title":"Concealment of type 1 diabetes at work in Finland: a mixed-method study","volume":"8","author":"Hakkarainen","year":"2018","journal-title":"BMJ Open"},{"key":"2024051518512532100_B28","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1177\/014572179402000305","article-title":"Situational obstacles to adherence for adolescents with diabetes","volume":"20","author":"Schlundt","year":"1994","journal-title":"Diabetes Educ"},{"key":"2024051518512532100_B29","doi-asserted-by":"crossref","first-page":"818","DOI":"10.2337\/diacare.29.04.06.dc05-1828","article-title":"Attributions of adolescents with type 1 diabetes in social situations: relationship with expected adherence, diabetes stress, and metabolic control","volume":"29","author":"Hains","year":"2006","journal-title":"Diabetes Care"},{"key":"2024051518512532100_B30","doi-asserted-by":"crossref","first-page":"751","DOI":"10.2337\/dc09-1746","article-title":"Self-efficacy, problem solving, and social-environmental support are associated with diabetes self-management behaviors","volume":"33","author":"King","year":"2010","journal-title":"Diabetes Care"},{"key":"2024051518512532100_B31","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1097\/00004703-200604000-00003","article-title":"Self-efficacy, outcome expectations, and diabetes self-management in adolescents with type 1 diabetes","volume":"27","author":"Iannotti","year":"2006","journal-title":"J Dev Behav Pediatr"},{"key":"2024051518512532100_B32","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1089\/dia.2018.0384","article-title":"State of type 1 diabetes management and outcomes from the T1D Exchange in 2016\u20132018","volume":"21","author":"Foster","year":"2019","journal-title":"Diabetes Technol Ther"},{"key":"2024051518512532100_B33","doi-asserted-by":"crossref","first-page":"133","DOI":"10.2337\/dc20-0257","article-title":"A decade of disparities in diabetes technology use and HbA1c in pediatric type 1 diabetes: a transatlantic comparison","volume":"44","author":"Addala","year":"2021","journal-title":"Diabetes Care"},{"key":"2024051518512532100_B34","doi-asserted-by":"crossref","first-page":"e1171","DOI":"10.1542\/peds.2009-0207","article-title":"Association between adherence and glycemic control in pediatric type 1 diabetes: a meta-analysis","volume":"124","author":"Hood","year":"2009","journal-title":"Pediatrics"}],"container-title":["Diabetes Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/spectrum\/article-pdf\/37\/2\/124\/759916\/diaspectds230006.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/spectrum\/article-pdf\/37\/2\/124\/759916\/diaspectds230006.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T18:51:49Z","timestamp":1715799109000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/spectrum\/article\/37\/2\/124\/153934\/Nondisclosure-of-Type-1-Diabetes-in-Adolescence-A"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,5]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,12,5]]},"published-print":{"date-parts":[[2024,4,1]]}},"URL":"https:\/\/doi.org\/10.2337\/ds23-0006","relation":{},"ISSN":["1040-9165","1944-7353"],"issn-type":[{"value":"1040-9165","type":"print"},{"value":"1944-7353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,5]]}}}