Introduction
August has been a month of forums, the most recent one bringing together young adults aged 20 years and above.
With 35+ voices in the room, the conversation shifted from basic diabetes words to what it actually means to live with diabetes while building an adult life — navigating work, relationships, family expectations, finances, independence, and the future.
This is also reflected in diabetes guidance. Young adulthood is recognized as a period of significant developmental change, where young people are increasingly expected to take ownership of their health while simultaneously navigating education, employment, relationships, finances, and changing family roles.
So, what happens when adulthood meets diabetes?
The realities of adulthood
Growing into adulthood already comes with questions:What career do I want?Can I afford to live independently?How do I navigate relationships?What does my future look like?
For a young adult living with diabetes, these questions can come with another layer:
Where does diabetes fit into all of this?
The challenge is not always a lack of knowledge about diabetes. Sometimes, it is figuring out how diabetes fits into a life that is changing.
Work and Diabetes
Work was a major source of stress.With the consistent question being do I disclose to employers and colleagues?
One personal story hit to the core is when a participant shared when they need a break to eat, check their glucose, or inject insulin, it feels easier to say they have ulcers than explain that they live with diabetes.
That moment captured something much bigger than diabetes management.
It was about identity, stigma, disclosure and professional ambition.
Young adults should not have to choose between protecting their privacy and receiving reasonable understanding in the workplace.
And this raises an important question:
Can we truly create a discrimination-free work culture for people living with diabetes?
Workplace disclosure is not simply a medical decision. It can involve safety, privacy, stigma, career progression and trust.
Relationships and the Fear of Disclosure
Relationships brought another layer of vulnerability.
Participants spoke openly about disclosure and the fear of rejection.
When is the right time to tell someone you have diabetes?Will they understand?Will they see me differently?What happens when the relationship becomes serious?
And eventually, conversations about marriage, children and the future emerge.
These are not questions that can be answered by a diabetes education leaflet.
They require safe spaces where young adults can talk about the emotional and relational realities of living with a chronic condition.
Psychosocial care in diabetes increasingly recognizes that relationships, emotional wellbeing, communication and autonomy are part of diabetes care ;not separate from it.
Family Dynamics and Independence
Many participants were living independently and making their own healthcare decisions.
Yet family relationships continued to shape their experiences.
Several reflected on the tension between wanting independence and still relying on family support — whether emotional, practical or financial.
This is one of the complexities of young adulthood.
Independence does not necessarily mean doing everything alone.
For someone living with diabetes, becoming independent may mean learning how to make healthcare decisions, communicate needs, manage appointments and supplies, while still knowing when and how to ask for support.
The goal is not to remove family from the picture.
It is to help young adults develop autonomy without isolation.
The Financial Reality
Finances emerged as one of the most relatable discussions of the day:Rent,Food,Transport,Medical appointments,Diabetes supplies,nsurance.
All competing for limited resources.
For many participants, managing diabetes was happening alongside the broader challenge of building an independent life.
This is an important part of the diabetes conversation.
We often ask:
“Are you managing your diabetes?”
But perhaps we also need to ask:
“Can you afford to manage your diabetes?”
Access, affordability and financial security can influence how a young adult experiences diabetes and makes decisions about their care.
Beyond Diabetes Management
As the discussions unfolded, one thing became clear:
The challenges facing young adults living with diabetes are often not about knowledge. They are about navigation.Navigating workplaces, relationships,family expectations,finances,healthcare systems,and ultimately, navigating adulthood itself.
This aligns with the broader direction of international diabetes guidance, which emphasizes that transition into adulthood should not simply mean moving from one clinic to another. It should support the young person’s growing autonomy, psychosocial wellbeing, self-management skills and ability to navigate adult life.
But guidelines can only tell us part of the story.
The voices of young adults tell us what these issues actually look like in everyday life.
That is why spaces for honest conversation matter.
The conversation about building a life while living with diabetes.
And perhaps that is where our conversations about young adults and diabetes need to begin.
References
International Society for Pediatric and Adolescent Diabetes (ISPAD). Clinical Practice Consensus Guidelines: Diabetes in Adolescence / Emerging Adulthood.
International Society for Pediatric and Adolescent Diabetes (ISPAD). Clinical Practice Consensus Guidelines: Psychological Care of Children and Adolescents with Diabetes.
American Diabetes Association. Standards of Care in Diabetes—2026.
