Predictors of Glycemic Control in Adolescents of Various Age Groups With Type 1 Diabetes

Lee, Shu‐Li; Lo, Fu‐Sung; Lee, Yann-Jinn; Chen, Bai-Hsiun; Wang, Ruey‐Hsia

doi:10.1097/jnr.0000000000000096

Cited by 8 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lastly, dividing participants into smaller age segments may have revealed different patterns of interactions between psychosocial variables and outcomes that did not appear in our models, as others have found age to act as a moderator of the family functioning-adherence-metabolic control associations [ 76 ], and that developmental needs and reliance on caregivers vary greatly throughout the course of adolescence [ 77 ].…”

Section: Discussionmentioning

confidence: 99%

Multi-informant path models of the influence of psychosocial and treatment-related variables on adherence and metabolic control in adolescents with type 1 diabetes mellitus

et al. 2018

View full text Add to dashboard Cite

BackgroundWe assessed the associations between metabolic control and adherence and a broad range of adolescent and family characteristics (e.g., gender, family structure), treatment-related variables (e.g., disease duration, treatment modality), and psychosocial factors (e.g., symptoms of depression and anxiety, parental support, self-efficacy) in a nationwide study of Danish adolescents (age 12–17 years) with type 1 diabetes mellitus (T1DM).MethodsSixty-four percent of invited families participated by completing a survey and providing a blood sample. Two path models of associations between generic and diabetes-related family factors, adolescent self-efficacy, emotional difficulties, and metabolic control and adherence were tested, one for adolescents and one for caregivers. Demographic variables were included as covariates.ResultsBoth path models demonstrated a satisfying model fit. In both models, metabolic control was associated with adherence, age, and T1DM duration. In the adolescent model, metabolic control was also related to treatment modality, single-parent household, caregiver non-support, and anxiety, whereas in the caregiver model metabolic control was associated with family conflict and caregiver support. In both models, adherence was related to age, duration, treatment modality, family conflict, caregiver support, family functioning, and emotional difficulties of the adolescent. In the adolescent model, adherence was also related to adolescent self-efficacy, whereas in the caregiver model adherence was associated with adolescent gender and caregiver non-support and support. Adolescent self-efficacy, emotional well-being, and difficulties related to adolescent/caregiver interaction appeared to be particularly important, as indicated by their stronger association with adherence and/or metabolic control.ConclusionThe results highlight the value of applying a multi-informant approach to address the psychosocial well-being of adolescents with diabetes in a large national sample. Self-efficacy, emotional, and family-related difficulties are important aspects to address in both clinical care and future research regarding adolescents with T1DM.

show abstract

Section: Discussionmentioning

confidence: 99%

Multi-informant path models of the influence of psychosocial and treatment-related variables on adherence and metabolic control in adolescents with type 1 diabetes mellitus

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The Epidemiology of Diabetes Interventions and Complications study, the long-term follow-up of the Diabetes Control and Complications Trial, reported a higher likelihood of microvascular and macrovascular disease in adolescents who had up to 6 years of suboptimal diabetes control (7). Furthermore, poor diabetes self-management behaviors and associated chronic suboptimal glycemic control can persist into adulthood (8)(9)(10).…”

mentioning

confidence: 99%

Flash Continuous Home Glucose Monitoring to Improve Adherence to Self-Monitoring of Blood Glucose and Self-Efficacy in Adolescents With Type 1 Diabetes

et al. 2020

View full text Add to dashboard Cite

Adolescents with type 1 diabetes face self-management challenges that make it difficult for them to achieve good glycemic control. In our population of adolescents with poorly controlled type 1 diabetes, the use of continuous glucose monitoring (CGM) improved patients’ glycemic time in range (TIR) and identified hypoglycemia more frequently than with intermittent self-monitoring of blood glucose throughout a 4-week interval. However, the adolescents were unable to synthesize this information to problem-solve or reduce the frequency of hypoglycemic events. Setting SMART (specific, measurable, achievable, relevant, and time-bound) diabetes management goals and providing intensive diabetes education and support could increase adolescents’ TIR and prevent hypoglycemia.

show abstract

“…Differences were observed regarding how instruments were described in original studies and how these instruments were used in later studies. For example, in some later studies various subsets and adapted and/or updated items were generated that differed from the original tool [4,6,10,38,39,41,43,45,47,68,71,81,83,88,89,92,94,95,97,[102][103][104]107] or response options were added (i.e., "not applicable", "someone else" or "no one in the home") [5,47,63,83]. Contrary to original instructions of the DFRQ [8], in one study responders were requested to report per item which family member had most responsibility instead of who takes or initiates responsibility [47].…”

Section: Use Of Instruments Across Included Studiesdeviations From Or...mentioning

confidence: 99%

“…For none of the instruments costs were reported [8,40,50,52,58,78,84,91,100,107,[110][111][112]. Next to the language in which the questionnaire was developed, a few scales were (partly) translated into different languages in later studies (i.e., DRCS: Chinese [71]; DFRQ: Spanish [61] and presumably in the languages in the 19 countries involved in the study of Cameron et al 2008 [10]). q Mothers of children using pen therapy completed the DIS; Mothers of children using pump therapy completed the CSII-Use survey.…”

Section: Feasibilitymentioning

confidence: 99%

A Systematic Review of Instruments Measuring the Division of Care Responsibilities between Children with Type 1 Diabetes and their Parents

Aalders

Nefs

Hartman

et al. 2023

CDR

View full text Add to dashboard Cite

Background: The division of care responsibilities between parents and children with type 1 diabetes, and an optimal transfer of responsibilities from parent to child over time are assumed to be key for optimal diabetes outcomes during childhood and adolescence. However, an overview of instruments assessing this division as well as their psychometric qualities is currently lacking. Objective: To 1) identify all existing instruments, 2) evaluate their psychometric properties, and 3) provide an overview of scoring methods. Methods: Pubmed and PsycINFO were searched using an a priori defined search string. Peer-reviewed studies in English using an instrument assessing the division of diabetes care responsibilities between children (6-18 years) and parents were included. In total, 84 of 725 articles qualified, covering 62 unique samples. Results: Thirteen questionnaires were identified. The Diabetes Family Responsibility Questionnaire (DFRQ) was most frequently used across studies. Instructions, content and number of tasks, response options, and scoring methods varied across questionnaires. Recent studies often adapted questionnaires, contributing to the heterogeneity across measures. Overall, reporting and quality of psychometric properties was suboptimal. Conclusion: The division of diabetes care responsibilities can be operationalized with various instruments, each having its strengths and weaknesses but all with limited psychometric support. To measure the division of diabetes care responsibilities more adequately, an updated version of the popular DFRQ or a new scale needs to be developed and evaluated.

show abstract

Predictors of Glycemic Control in Adolescents of Various Age Groups With Type 1 Diabetes

Cited by 8 publications

References 0 publications

Multi-informant path models of the influence of psychosocial and treatment-related variables on adherence and metabolic control in adolescents with type 1 diabetes mellitus

Multi-informant path models of the influence of psychosocial and treatment-related variables on adherence and metabolic control in adolescents with type 1 diabetes mellitus

Flash Continuous Home Glucose Monitoring to Improve Adherence to Self-Monitoring of Blood Glucose and Self-Efficacy in Adolescents With Type 1 Diabetes

A Systematic Review of Instruments Measuring the Division of Care Responsibilities between Children with Type 1 Diabetes and their Parents

Contact Info

Product

Resources

About