Type 1 diabetes (T1D) and type 2 diabetes (T2D) affect greater than 200,000 individuals under the age of 20 in the United States [1]. The yearly incidence of T1D and T2D is rising, with a 1.9 and 4.8% increase, respectively [2]. Similarly, the incidence of prediabetes, where an individual has elevated blood sugar levels but not at the severity of T2D, is rapidly increasing in adolescents in the United States, approaching 18–24% of the adolescent and young adult population (AYA) [3]. AYA with prediabetes are at significantly increased risk of developing T2D, defined as HbA1c blood concentration 6.5% or above [4].

Both T1D and T2D present with hyperglycemia. However, the underlying pathophysiology between these two diagnoses is different. T1D is an autoimmune disorder in which individuals do not produce insulin, and have lifelong insulin dependency [5]. T2D is a multifactorial disorder in which individuals have impaired insulin secretion and insulin resistance, which can be reduced or reversed with lifestyle modifications and medications [4]. In individuals with prediabetes, there are clinical indicators of impaired glucose tolerance and hyperglycemia, but not at the same clinical threshold of T2D; like T2D, prediabetes is reversible with lifestyle modifications [4].

Management of all forms of diabetes requires integration of significant lifestyle changes, such as titration of diet and exercise, and depending on the disease type and severity, use of daily oral and/or injectable medications [6]. For AYA, integration of these significant lifestyle changes can be disruptive, stressful, and a source of emotional distress and family conflict [7]. AYA with diabetes are even more likely to experience stress, anxiety, depression, and eating disorders than their peers without diabetes [[8], [9], [10], [11], [12], [13], [14], [15]].

Psychosocial comorbidities, especially anxiety and depressive symptoms, are highly prevalent during adolescence and young adulthood due to the nature of this rapidly changing developmental period [16,17]. The additional stressors related to managing a chronic condition worsens the normative psychosocial comorbidities that occur at high rates during these developmental periods [18,19]. These psychosocial comorbidities, in turn, negatively impact diabetes self-management, disease outcomes, and quality of life (QOL). As such, strategies that help improve psychosocial comorbidities are critical to improving diabetes outcomes in AYA.

Mindfulness is a type of meditation that emphasizes presence and awareness of one's emotions including attention, emotional self-regulation, and bodily sensations [[20], [21], [22]]. Practicing mindfulness has been found to alter the structure and function of several regions of the brain, indicating the profound and lasting impact of the practice [21,23]. Mindfulness training improves coping with social, biological, and psychosocial domains of diabetes in adults [24]. In adults with diabetes, mindfulness interventions have been shown to improve psychosocial outcomes, including depression, and improve diabetes self-management, including glycemic control [25]. Mindfulness is a feasible and acceptable intervention in adult populations with T1D, T2D, and prediabetes [[26], [27], [28]]. In AYA, with and without chronic medical conditions, mindfulness interventions are feasible, acceptable, and improve stress, anxiety, and depression [[29], [30], [31]].

Given the increasing incidence of diabetes and prediabetes in AYA and the high prevalence of psychosocial comorbidities during these vulnerable developmental periods, targeted interventions are required. Although mindfulness has been found to be effective in improving psychosocial comorbidities in adults with diabetes, there is a paucity of literature in AYA with diabetes. The purpose of this integrative review is to examine and synthesize the extant literature on mindfulness in AYA with T1D, T2D, or prediabetes.