Diabetes conflict outstrips the positive impact of self-efficacy on youth adherence and glycemic control in type 1 diabetes

Abstract

Objective: To examine whether self-efficacy buffers the deleterious consequences of diabetes-specific family conflict on self-monitoring blood glucose (SMBG) and HbA1c in youth with type 1 diabetes mellitus (T1DM). Methods: A total of 129 youth with T1DM (aged 10–16 years) completed measures of diabetes-specific family conflict and self-efficacy for diabetes management, and their blood glucose meter data and HbA1c were extracted from the electronic medical record. We preformed moderation analyses to examine whether self-efficacy moderated the association that diabetes-specific family conflict had with SMBG and HbA1c. We used simple slopes analyses to probe significant interactions. Results: Our results indicated that self-efficacy moderated the association that diabetes-specific family conflict had with SMBG and HbA1c. The pattern of these findings showed that high self-efficacy buffered the negative impact of diabetes conflict on HbA1c. However, benefits of high self-efficacy for more frequent SMBG was only apparent in the context of low diabetes-specific family conflict. Conclusions: Study findings highlight the interactive relationship between diabetes-specific family conflict and self-efficacy in relation to SMBG and glycemic control. These findings suggest that family functioning and youth’s self-efficacy are promising intervention targets for families having trouble with SMBG and HbA1c.

Adherence to insulin pump treatment declines with increasing age in adolescents with type 1 diabetes mellitus

“…The involvement of the parents during adolescence can have a positive effect on adherence to therapy and on the development of adequate self‐management in the adolescent patient. Conversely, parental psychological control with pressure on and coercion of the adolescent is associated with poorer adherence . The few studies assessed adherence to blood glucose measurements and showed that parental support led to more daily measurements .…”

“…Earlier studies suggest that the interaction between the adolescent with type 1 diabetes and his or her parents is a key determinant of the adolescent's adherence to insulin therapy. Interaction factors that improve adherence include support, supervision and assistance from parents, working towards supported autonomy for the adolescent patient…”

Diabetes camp still matters: Relationships with diabetes‐specific distress, strengths, and self‐care skills

“…It is possible that this final association could be mediated by parent perception of youth being less independent in their diabetes self‐care. Moreover, higher adolescent self‐efficacy is associated with lower A1c despite level of family conflict . Finding ways (such as through camp participation) to improve parent perceptions of youth independence and efficacy may facilitate positive medical and psychosocial outcomes.…”

Impacto psicosocial de la diabetes mellitus tipo 1 en niños, adolescentes y sus familias. Revisión de la literatura

“…Sin embargo, para otras familias se transforma en una carga terrible si además se enfrentan a otros problemas como pobreza, desempleo, falta de tiempo o tener otros miembros con enfermedades crónicas 5 . El impacto en la vida familiar se reconoce con un factor que afecta el cuidado de la DMT1, ya sea interfiriendo en la capacidad de monitoreo de los padres o creando un ambiente hostil 2,25 . Incluso las familias con niños de muy poca edad pueden llegar al aislamiento social debido al miedo, sobre todo al de hipoglicemia.…”