Longitudinal trajectories of metabolic control across adolescence: Associations with parental involvement, adolescents' psychosocial maturity, and health care utilization
Open accessAbstract
Purpose To predict trajectories of metabolic control across adolescence from parental involvement and adolescent psychosocial maturity, and to link metabolic control trajectories to health care utilization.Methods Two hundred fifty-two adolescents (M age at study initiation = 12.5 years, SD = 1.5, range = 10-14 years) with type 1 diabetes (54.4% female, 92.8% Caucasian, length of diagnosis M = 4.7 years, SD = 3.0, range = 1-12 years) participated in a 2-year longitudinal study. Metabolic control was gathered from medical records every 3 months. Adolescents completed measures of self-reliance (functional autonomy and extreme peer orientation), self-control (self-control and externalizing behavior), and parental involvement in diabetes care (acceptance, monitoring, and frequency of help). At the end of the study, mothers reported health care utilization (diabetes-related emergency room visits and hospitalizations) over the past 6 months.Results Latent class growth analyses indicated two distinct trajectories of metabolic control across adolescence: moderate control with slight deterioration (92% of the sample; average HbA1c = 8.18%) and poor control with rapid deterioration (8% of the sample; average HbA1c of 12.09%). Adolescents with poor and rapidly deteriorating metabolic control reported lower paternal monitoring and frequency of help with diabetes management, lower functional autonomy, and lower self-control than others. Those with poor and rapidly deteriorating metabolic control were 6.4 times more likely to report diabetes-related emergency room visits, and 9.3 times more likely to report diabetes-related hospitalizations near the end of the study.Conclusions Parental involvement and adolescents' psychosocial maturity predict patterns of deteriorating metabolic control across adolescence and could be targeted for intervention.
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Adolescence is a period when sub-optimal type 1 diabetes treatment engagement and glycemia can begin to occur and low parental involvement can exacerbate these outcomes.
“Adolescence is a period when sub-optimal type 1 diabetes treatment engagement and glycemia can begin to occur and low parental involvement can exacerbate these outcomes [10].”
From A nonrandomized pilot of a group, video-based telehealth intervention to reduce diabetes distress in parents of youth with type 1 diabetes mellitus (2022) · cites this paper as [10]
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- Authors
- King, P. S., Berg, C. A., Butner, J., Drew, L. M., Foster, C., Donaldson, D., Murray, M., Swinyard, M., & Wiebe, D. J.
- Affiliations
- University of Utah (US)
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- King, Pamela S.
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2012-05
- Volume
- 50
- Issue
- 5
- Pages
- 491-496
- ISSN
- 1054-139X (ISSN-L)
- PMC
- PMC4403632
- OpenAlex
- W2086310077
- Cited by
- 94
- References
- 32
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 8 · 2022: 6 · 2021: 5 · 2020: 6 · 2019: 8 · 2018: 5 · 2017: 20 · 2016: 7 · 2015: 5 · 2014: 11 · 2013: 3 · 2012: 1
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Adolescent Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01dk063044-06)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK0630-44)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- type 1 diabetes, adolescents, metabolic control, HbA1c trajectories, parental involvement, psychosocial maturity, functional autonomy, self-control, health care utilization, diabetes-related hospitalization, emergency department visits, diabetes self-management
- MeSH terms
- Adolescent, Psychology, Adolescent, Child, Diabetes Mellitus, Type 1, Female, Humans, Longitudinal Studies, Male, Parent-Child Relations, Parents, Patient Compliance, Self Care, Parenting, Adolescent Development
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