ABSTRACT
PURPOSE: The purpose of this study is to characterize daily diabetes self-care behaviors and to evaluate associations among self-care behaviors, psychosocial adjustment, and glycemic control in an understudied sample of emerging adults with type 1 diabetes. METHODS: Forty-nine emerging adults (65% women; ages 18-26 years) completed 2 diabetes interviews to assess self-care behaviors and self-report measures of psychosocial adjustment. Glycemic control was assessed via hemoglobin A1C. RESULTS: Diabetes self-care behaviors varied widely and were largely suboptimal; only a small percentage of participants demonstrated self-care behaviors consistent with national and international recommendations. Psychosocial adjustment was within normal limits and was unrelated to frequency of self-care behaviors in this sample. Mean glycemic control (8.3%) was higher than the recommended A1C level (< 7.0%) for this age group. Use of intensive (e.g., multiple daily injections or pump) insulin regimens was related to better glycemic control. CONCLUSIONS: The majority of emerging adults in this sample did not engage in optimal daily diabetes self-care. Intensive insulin therapy was associated with better glycemic control without corresponding psychosocial distress. Diabetes care behaviors could be improved in this age group, and emerging adults may benefit from targeted education and behavioral support to enhance diabetes self-management and optimize health outcomes.
Subject(s)
Blood Glucose Self-Monitoring/standards , Blood Glucose/metabolism , Diabetes Mellitus, Type 1/blood , Glycated Hemoglobin/metabolism , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Self Care , Adaptation, Psychological , Adult , Blood Glucose Self-Monitoring/psychology , Cross-Sectional Studies , Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/psychology , District of Columbia/epidemiology , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Medication Adherence , Motor Activity , Patient Education as Topic , Quality of Life , Self Care/psychology , Surveys and Questionnaires , Young AdultABSTRACT
OBJECTIVE: Longitudinal research shows that pediatric type 1 diabetes can result in verbal memory difficulties, yet the role of memory in the daily management of this or any other chronic illness has not been evaluated. METHODS: Verbal memory measures from two well-standardized tests were administered to 224 youths with type 1 diabetes, aged 9 to 17. Twenty-four-hour recall interviews conducted separately with mothers and their children assessed diabetes care behaviors. RESULTS: Rote verbal memory predicted blood glucose testing frequency for adolescents but not for preadolescents; and when combined with ethnicity, socioeconomic status, and age, rote verbal memory accounted for 27.6% of the variance, p <.001. Quantitative verbal working memory--along with ethnicity, socioeconomic status, and age, p <.01--accounted for 33.7% of the variance in predicting carbohydrate calories for older adolescents. CONCLUSIONS: Memory, in addition to demographic factors, is a significant predictor of some of the central self-care behaviors involved in diabetes management. However, memory only predicts diabetes management for older adolescents, who have greater self-care responsibility.
