Effects of Body Image and Self-Concept on the Management of Type 1 Diabetes Mellitus in Adolescents and Young Adults: A Systematic Review

Abstract

Background: Adolescence and young adulthood are critical periods during which psycho-emotional factors can significantly influence disease management and increase the risk of complications. This systematic review aims to examine the impact of body image, self-image, self-perception, and other psycho-emotional variables on the management of type 1 diabetes mellitus (T1DM) in this population. Methods: This review follows the Cochrane Handbook, PRISMA 2020 guidelines and the JBI Checklist for Systematic Reviews and Research Syntheses. A comprehensive search was conducted across both general and discipline-specific databases (PubMed, Web of Science, Scopus, Embase, CINAHL, APA PsycInfo, APA PsycArticles) between March and April 2025. The inclusion criteria focused on studies involving adolescents with T1DM that addressed relevant emotional or psychological aspects. Methodological quality was assessed using JBI tools. Data extraction was performed independently by four reviewers, with discrepancies resolved by consensus. A total of 25 studies met the inclusion criteria. Results: Body image concerns were found to be highly prevalent among adolescents and young adults with T1DM, and were associated with adverse outcomes such as disordered eating behaviors and suboptimal glycemic control. Gender differences were consistently reported, with adolescent girls and young women displaying greater body dissatisfaction and engaging more frequently in risky weight management practices, including insulin omission. Other factors, such as self-perception, diabetes-specific stress, and identity formation, also played significant roles in treatment adherence and psychosocial adaptation. Notably, this review reveals a lack of interventions specifically designed to address the psychological dimensions of T1DM. Conclusions: Body image and self-concept exert a substantial influence on T1DM management in adolescents and young adults, affecting both glycemic outcomes and psychosocial well-being. There is a pressing need for gender-sensitive and developmentally appropriate interventions that address body image, self-concept, and disease acceptance. Future research should prioritize longitudinal designs and the development and evaluation of targeted psycho-emotional support strategies.

Keywords: adolescents; body image; disease management; glycemic control; self-concept; type 1 diabetes mellitus; young adults.

Figure 1

PRISMA flowchart.