Objectives: This study explored perceptions, experiences, and outcomes associated with the choice of insulin therapies among pediatric patients with type 1 diabetes mellitus (T1D). Methods: This study included 20 adolescents (8 male and 12 female) with T1D, with a mean age of 15.05 ± 0.91 years, a mean diabetes duration of 5.19 ± 1.2 years, and a mean most recent HbA1c of 7.03 ± 0.16%. Ten of the participants were using an insulin pump (n = 10) and another 10 had either refused (n = 7) or discontinued (n = 3) insulin pump therapy. A qualitative inductive method was employed, using in-depth individual interviews. The interview material was transcribed verbatim and grounded theory was used to analyze the verbal material. Results: Four main thematic categories were identified from the narrations that captured both common and divergent perceptions of insulin pump users versus non-users: (1) adjusting to the lifelong diagnosis, (2) exposing diabetes versus hiding it, (3) becoming autonomous and integrating insulin pump therapy into daily life, and (4) worrying over the pump. The third theme, capturing autonomy and integration, surfaced as the core thematic category of this study. Conclusions: This grounded theory study revealed that, by using insulin pump therapy, adolescent T1D patients can enhance their autonomy and facilitate the integration of insulin treatment into their life. This study identified processes that inform diabetes education and contribute to ameliorating gaps in the uptake and maintenance of pump therapy in pediatric care.

Objectives: Families play a pivotal role in the care of adolescents with chronic illnesses, such as type 1 diabetes (T1D). This study’s aim was to evaluate family functioning in families of adolescents with T1D and to assess its relationship with metabolic control. Methods: Fifty-eight adolescents and young adults diagnosed with T1D, aged 14–21 years, and 116 healthy adolescents (controls) matched for age, gender and socioeconomic status were included in this study. The participants’ mean age was 15.9 years (±1.6 years). The demographics and family functioning were reported by the participants. The McMaster Family Assessment Device (FAD) measured family functioning across six dimensions. Results: In problem-solving and behavioral involvement, T1D adolescents self-reported similar scores to healthy controls. On the contrary, in the domains of communication (p = 0.048), family roles (p = 0.045), affective responsiveness (p = 0.048), affective involvement (p = 0.043) and general functioning (p = 0.044), the T1D group scored lower than the controls, indicating better family functioning. Furthermore, within the T1D group, better metabolic control, assessed by glycated hemoglobin (HbA1c), was associated with a trend toward improved affective responsiveness, although this did not reach statistical significance (p = 0.091). Conclusions: Our findings highlight the importance of family functioning among adolescents with T1D and point toward distinct family processes that can be addressed in the context of routine care to enhance wellbeing and facilitate T1D management.