The relationship between psychosocial factors, self-care behaviors, and metabolic control in adolescents with Type 1 Diabetes

Abstract

Adolescents with Type 1 Diabetes have been shown to experience a number of psychosocial and adjustment issues that impact important health outcomes such as morbidity, quality of life, and longevity. This study examined the associations between psychological factors, self-care behaviors, and metabolic control (HbA1c) in 10-18 year old patients with Type 1 Diabetes (n = 102). Socio-demographic differences were found on most variables. Results of hypothesis testing indicated that both age and psychosocial maturity were generally associated with self-care and metabolic control. Adolescent depression and diabetes-related distress were associated with some of the self-care variables, but not with metabolic control, as previous research suggests. Therefore, it is still unclear whether self-care is a mediator of the relationship between psychological factors and HbA1c. Moderation analyses indicated that psychosocial maturity, but not age, was a significant moderator of the association of diabetes-related psychosocial distress with self-care ability/ independence and metabolic control. This study highlights the complexity of the relationships between psychological factors and both health behaviors and outcomes in this population. Future research should continue to focus on identifying, longitudinally, the causal agents that are related to the associations between depression, diabetes-related psychosocial distress, various components of self-care, and metabolic control. Understanding these associations will help to determine medical and psychological intervention approaches, and help to focus and target intervention on the most salient psychological, social, and behavioral factors.