Supplementary file 2_Living with early-onset type 2 diabetes in young adulthood: a narrative review of lived experience and implications for developmentally appropriate care.docx

Although many challenges of living with T2DM are shared across adulthood, diagnosis during young adulthood may shape how this condition is perceived, prioritised and managed during a formative stage of life. This narrative review aimed to synthesize how adults diagnosed with T2DM between 18 and 39 years of age experience, understand and manage their condition, and the implications for developmentally appropriate clinical care.</p>Methods<p>We conducted a structured narrative review of English-language qualitative, mixed-methods and observational quantitative studies identified in PubMed, MEDLINE (via Ovid) and EMBASE (via Ovid) from database inception to 31 August 2025.

Direct evidence from adults diagnosed at 18 to 39 years was prioritised. Studies of adults aged ≥18 years with youth-onset T2DM were used as closely related supporting evidence, and broader adult T2DM studies as contextual evidence. Study selection, extraction and appraisal followed predefined procedures, with reporting informed by SANRA.</p>Results<p>Recurring themes included difficulty integrating diabetes into identity, stigma, competing work and family demands, material hardships, family and sociocultural influences and healthcare services perceived as not aligned with young adults’ priorities.