Abstract
The objective of this study was to test a comprehensive model of biologic (pubertal status), family (communication and conflict),
and psychological influences (behavioral autonomy) on diabetes management and glycemic control in a sample of youth (N = 226) with type 1 diabetes recruited during late childhood/early adolescence (ages 9–11 years). The study design was a prospective,
multisite, multi-method study involving prediction of diabetes management and glycemic control 1 year post-baseline. The primary
outcome measures included diabetes management behaviors based on the Diabetes Self-Management Profile (DSMP) administered
separately to mothers and youth and glycemic control measured by glycated hemoglobin (HbA1c) obtained by blood samples and
analyzed by a central laboratory to ensure standardization. Our hypothesized predictive model received partial support based
on structural equation modeling analyses. Family conflict predicted less adequate glycemic control 1 year later (p < 0.05). Higher conflict predicted less adequate diabetes management and less adequate glycemic control. More advanced pubertal
status also predicted less adequate glycemic control, but behavioral autonomy did not. Family conflict is an important, potentially
clinically significant influence on glycemic control that should be considered in primary and secondary prevention in the
management of type 1 diabetes in youth.
and psychological influences (behavioral autonomy) on diabetes management and glycemic control in a sample of youth (N = 226) with type 1 diabetes recruited during late childhood/early adolescence (ages 9–11 years). The study design was a prospective,
multisite, multi-method study involving prediction of diabetes management and glycemic control 1 year post-baseline. The primary
outcome measures included diabetes management behaviors based on the Diabetes Self-Management Profile (DSMP) administered
separately to mothers and youth and glycemic control measured by glycated hemoglobin (HbA1c) obtained by blood samples and
analyzed by a central laboratory to ensure standardization. Our hypothesized predictive model received partial support based
on structural equation modeling analyses. Family conflict predicted less adequate glycemic control 1 year later (p < 0.05). Higher conflict predicted less adequate diabetes management and less adequate glycemic control. More advanced pubertal
status also predicted less adequate glycemic control, but behavioral autonomy did not. Family conflict is an important, potentially
clinically significant influence on glycemic control that should be considered in primary and secondary prevention in the
management of type 1 diabetes in youth.
- Content Type Journal Article
- Pages 1-12
- DOI 10.1007/s10865-012-9426-0
- Authors
- Dennis Drotar, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Richard Ittenbach, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Jennifer M. Rohan, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Resmi Gupta, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Jennifer Shroff Pendley, Division of Behavioral Health, Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA
- Alan Delamater, Department of Pediatrics, University of Miami, Miami, FL 33136, USA
- Journal Journal of Behavioral Medicine
- Online ISSN 1573-3521
- Print ISSN 0160-7715