Patterns of self-management in pediatric type 1 diabetes predict level of glycemic control 2 years later

Jennifer M. Rohan, Jennifer Shroff Pendley, Alan Delamater, Lawrence Dolan, Grafton Reeves, Dennis Drotar

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

OBJECTIVE: To determine if 3 distinct self-management patterns (i.e., maladaptive, moderate/mixed, and adaptive) observed at baseline, 1 year, and 2 years in a sample of youth with type 1 diabetes and their caregivers predicted mean differences in adolescent's subsequent glycemic control. METHODS: This study is a descriptive, multisite, prospective study that examined a sample of youth diagnosed with type 1 diabetes (ages 9-11 years at baseline). Youth and their maternal and paternal caregivers provided information about the youth's self-management patterns at baseline, 1 year, and 2 years using the Diabetes Self-Management Profile structured interview. Glycemic control (hemoglobin A1c: HbA1c) was examined at baseline and 6, 12, 18, and 24 months. RESULTS: Three distinct self-management patterns were observed at 1 year and 2 years, which were conceptually consistent with previously reported baseline self-management patterns. Youth identified by their maternal caregivers as having adaptive self-management patterns at baseline had better glycemic control across 2 years compared with those in the maladaptive and mixed self-management groups. Similarly, maternal reports suggested that youth with less adaptive self-management patterns generally had worse glycemic control over time and HbA1c values above the American Diabetes Association recommendations. Youth and paternal caregiver reports yielded more variable findings. CONCLUSIONS: Findings underscore the stability of self-management patterns in pediatric type 1 diabetes and the need for preventive interventions that are tailored to specific patterns of self-management associated with risk for problematic glycemic control.

Original languageEnglish (US)
Pages (from-to)186-196
Number of pages11
JournalJournal of Developmental and Behavioral Pediatrics
Volume34
Issue number3
DOIs
StatePublished - Apr 1 2013

Keywords

  • cluster analysis
  • glycemic control
  • pediatrics
  • self-management
  • type 1 diabetes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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