Adolescent Disclosure to Parents and Daily Management of Type 1 Diabetes

Delay discounting and parental monitoring in adolescents with poorly controlled type 1 diabetes

“…One mechanism whereby direct parent observation of diabetes tasks may benefit adolescents with poorly controlled diabetes and greater delay discounting is in compensating for decision making patterns that favor immediate rewards over delayed outcomes, such as future health, including better glycemic control. This recommendation is consistent with literature supporting the importance of parental monitoring of diabetes for good diabetes outcomes both across adolescence and into emerging adulthood (Berg et al, 2008, 2016; King et al, 2012; Osborn et al, 2013). Increasing direct parent observation of diabetes tasks might be an additional modifiable target for improving glycemic control in adolescents with poorly controlled type 1 diabetes who evidence greater delay discounting.…”

“…These adolescents will likely require more intensive parent involvement in diabetes management throughout adolescence to provide a structured scaffolding in the transition to more independent care into emerging adulthood. This notion may contrast with an emphasis in many clinical pediatric settings on increasing adolescent independence in their disease management; however, research on late adolescents (ages 17 and 18) with diabetes suggests that while on average levels of parental monitoring have decreased, parental monitoring remains a significant predictor of diabetes outcomes (Berg et al, 2016). Evidence of greater delay discounting, i.e., being overly influenced by the present and heavily “discounting” the future, may be useful as a clinical marker of youths who are at high risk for poor type 1 diabetes outcomes in adolescence, requiring more intensive behavioral and family-based interventions and increased social support.…”

“…The latter indirect parental monitoring aspects, youth disclosure and parent solicitation, are critical to consider in adolescence as youth begin to spend more time away from the home and complete fewer diabetes management behaviors in the presence of a parent. Research finds that higher parental monitoring (direct and indirect) is linked with increased self-efficacy for diabetes management as well as better adherence and glycemic control across adolescence, even after accounting for parent-youth relationship quality (Berg et al, 2008, 2011, 2016; King et al, 2012; Osborn, Berg, Hughes, Pham, & Wiebe, 2013) For example, on days in which parents have greater knowledge of their teen’s diabetes management, teens evidence higher levels of adherence and lower mean daily blood glucose levels (Berg et al, 2016). …”

Modelling individual, parental and peer factors to glycaemic control in adolescents with type 1 diabetes: A prospective study

“…In this study, 81.9% of participants had HbA1c levels higher than 7.5%. This finding echoes previous study findings that more than two‐thirds of adolescents with T1D have poor glycaemic control (Berg et al, ; Chen et al, ). Improving glycaemic control in adolescents with T1D remains an important health issue for nurses.…”

“…Achieving optimal glycaemic control is a challenge for adolescents with T1D. Studies have shown that more than two‐thirds of adolescents with T1D have HbA1c levels higher than 7.5% (Berg et al, ; Chen et al, ). Optimizing glycaemic control in adolescents with T1D is a crucial responsibility of nurses.…”