Self-care and glycemic control in adolescents with type I diabetes

This study assesses the concurrence of adolescent- and parent-reported adherence to the medical regimen among youth with type I diabetes. Relationships between diabetes self-care and metabolic control were also examined. Adolescents'(n = 111) and their mothers' reports of adolescents' self-management of the diabetes regimen were examined for prediction to glycosylated hemoglobin (HgbA,,) levels obtained at concurrent and subsequent clinic visits. Adolescents' and parents' reports were correlated with each other, and correlations with HgbA(1c) were as high as .4 1. Self- and parent-reported adherence to more complex aspects of the regimen (i.e., keeping blood glucose at appropriate levels) was the strongest correlate of HgbA,c. In multivariate analyses, adolescent report predicted 30% and parent report explained 19% of the variance in concurrent HgbA,c. Self- and parent report of the adolescents' self-management may be show reliable indicators of the adolescents' self-care behaviors. As such they may be useful as indices for assessing the effectiveness of interventions to improve the management of the diabetic regimen among adolescents. In addition, aspects of diabetes management that involve higher level cognitive skills appear to be more effective in maintaining good HgbA,, than variables that involve simply complying with physician directives. These findings emphasize the importance of education and graded practice with complex tasks and decision making in relation to diabetes management.