Goal conflicts among emerging adults with T1D
Esther Sulkers, Joke Fleer, Henk-Jan Aanstoot, Giesje Nefs
Diabetes Self-Care in Daily Life: a Qualitative Study on Goal Conflict Management in Emerging Adults With Type 1 Diabetes. Can J Diabetes. 2025 Dec 29:S1499-2671(25)00423-X.
Emerging adulthood (18–25 years) is a period marked by increasing independence, social exploration, study, and work. For young people with type 1 diabetes (T1D), this life phase can make it particularly challenging to integrate diabetes self-care into daily routines. Glycaemic outcomes are often suboptimal in this age group, suggesting that the demands of diabetes compete with other important life goals. One key psychological mechanism underlying these challenges is goal conflict: the tension between managing diabetes well and pursuing personally meaningful goals such as socialising, sports, or academic success. This study explores how emerging adults with T1D experience and manage such conflicts in everyday life.
In this qualitative study, 16 emerging adults with T1D from three Diabeter locations (Groningen, Deventer, Amsterdam) participated in semi-structured interviews and completed a three-day diary documenting real-life goal conflict situations. Using directed content analysis informed by goal conflict theory, the researchers examined which life domains most frequently conflicted with diabetes self-care, how participants managed these situations, and how different strategies affected emotional well-being.
Key findings:
- Goal conflicts between diabetes self-care and other life goals occurred frequently, particularly in social situations involving food, alcohol, sports, and leisure activities.
- Participants most often tried to combine goals, using planning, technology, and social support to balance both diabetes and non-diabetes goals.
- When combination was not feasible, they tended to prioritise non-diabetes goals, unless perceived health risks were high.
- Prioritisation strategies were often accompanied by negative emotions such as guilt, frustration, or sadness, whereas successful goal combination was linked to more positive feelings.
The findings suggest that diabetes management in emerging adulthood is not simply a matter of knowledge or motivation, but of continuous negotiation between competing life goals. Understanding these daily dilemmas may help healthcare professionals interpret behaviours that appear inconsistent from a purely biomedical perspective. Discussing goal conflicts explicitly during consultations and supporting self-regulation skills—such as planning, risk assessment, and emotional coping—may facilitate more realistic and sustainable diabetes self-care. The study also highlights the emotional burden associated with prioritisation decisions, underlining the importance of addressing diabetes distress in this age group.
Concluding, the authors state
"For emerging adults, it is a challenge to take good care of their diabetes while also addressing other goals in daily life. Combination and prioritization strategies both play a role in their efforts to deal with these goal conflicts, although the latter often trigger negative emotions." -
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