There are many emotional and physical changes that occur during the developmental stage of adolescents. �During adolescence, the most important developmental processes are the building of an inward sense of a new, adult body image, discovering sexual identity, and becoming independent� (Newman & Newman, as cited in Kyngas & Hentinen, 1995, p. 729).

The transitional stages of an adolescent may actually be detrimental for the young person�s health. According to Fleming, Bernie, & Gillibrand (2002), �adolescents have unique health needs, which impact upon their transition from children�s health care services into adult health care services� (p. 560). In fact, research has shown that there is evidence of marked deterioration of metabolic control during the teenage years (Fleming et al., 2002). Not only are these individuals having to manage a chronic illness but they are also having to adapt to the changes associated with becoming an adult. �The overwhelming changes in the first phase of the young-adult period (including graduation form high school, moving away from home, beginning new educational directions, and beginning work to be self-supporting) are often a distraction from the demands of managing diabetes� (Wolpert & Anderson, 2001, p. 1513). The second phase of adolescents as documented by Wolpert & Anderson (2001) is described as the crucial time and opportunity for the health provider to intervene and influence regular self-care that will promote health and well being.

Being seen as different by one�s peers may be very difficult to accept during a time of emotional confusion. �Adolescents with diabetes must establish an identity separate from their parents, while coming to terms with being different from peers at a time in their lives when being the same is important� (Curtin, as cited in Christian & D�Auria, 1999, p. 256). In relation to identity Wichowski & Kubsch (1997) noted that �perceptions of self have tremendous influence in determining behavior� (p. 549). Therefore, an individuals psychological well being may in fact affect adherence to a self-care regimen.

Kyngas, H., & Hentinen, M. (1995). Meaning attached to compliance with self-care, and coalitions for compliance among young diabetics. Journal of Advanced Nursing, 21, 729-736.

Kyngas, H., & Rissanen, M. (2001). Support as a crucial predictor of good compliance of adolescents with a chronic disease. Journal of Clinical Nursing, 10, 767- 775.

Bryden, K.S., Peveler, R.C., Stein, A., Neil, A., Mayou, R.A., & Dunger, D.B. (2001). Clinical and psychological course of diabetes form adolescence to young adulthood. Diabetes Care, 24, 1536-1540.

Fleming, E., Bernie, C., & Warren, G. (2002). The transition of adolescents with diabetes from the children�s health care service into the adult health service. Journal of Clinical Nursing, 11, 560-568. Karlsen, B., Bru, E., & Hanestad, B.R. (2002). Self-reported psychological well-being and disease-related strains among adults with diabetes. Psychology and Health, 17, 459-473.

Wolpert, H.A., & Anderson, B.J. (2001). Young adults with diabetes: Need for a new treatment paradigm. Diabetes Care, 24, 1513-1514.