Executive function predicting longitudinal change in type 1 diabetes management during the transition to emerging adulthood

Cynthia A. Berg; Deborah J. Wiebe; Yana Suchy; Sara L. Turner; Jonathan Butner; Ascher Munion; Amy Hughes Lansing; Perrin C White; Mary Murray

doi:10.2337/dc18-0351

Executive function predicting longitudinal change in type 1 diabetes management during the transition to emerging adulthood

Cynthia A. Berg, Deborah J. Wiebe, Yana Suchy, Sara L. Turner, Jonathan Butner, Ascher Munion, Amy Hughes Lansing, Perrin C White, Mary Murray

Research output: Contribution to journal › Article › peer-review

33 Scopus citations

Abstract

OBJECTIVE The objective of this study was to examine 1) whether teens’ glycemic control and adherence to type 1 diabetes treatment regimen worsen during the transition from late adolescence to emerging adulthood, and 2) whether teens’ executive function (EF), as measured by performance and self-reported problems with EF, is predictive of these changes (after controlling for general intelligence). RESEARCH DESIGN AND METHODS High school seniors with type 1 diabetes (N = 236; mean age 17.74 years) were assessed at three yearly time points. At baseline, during the senior year of high school, participants completed a self-report measure of problems with EF and performance-based measures of EF and general intelligence (IQ). Glycemic control was determined on the basis of results collected from HbA_1c assay kits, and teens reported their adherence at all three time points. RESULTS HbA_1c increased significantly across the three time points and adherence declined. EF performance was not associated with adherence or HbA_1c at baseline, nor with changes in adherence over time. However, better EF performance predicted slower increases in HbA_1c over time (i.e., slope) while controlling for IQ. Teens’ self-reported problems with EF were associated with worse glycemic control and poorer adherence at baseline (i.e., intercept), but they did not predict changes in either HbA_1c or adherence over time (i.e., slope). CONCLUSIONS Abilities involved in performance on EF tests may be one resource for maintaining better glycemic control during the transition to emerging adulthood. Assessment of such EF abilities may allow for the identification of individuals who are most at risk for deterioration of glycemic control during this transition.

Original language	English (US)
Pages (from-to)	2281-2288
Number of pages	8
Journal	Diabetes care
Volume	41
Issue number	11
DOIs	https://doi.org/10.2337/dc18-0351
State	Published - Nov 1 2018

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Advanced and Specialized Nursing

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10.2337/dc18-0351

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@article{5735746fdb9146e79b8f2de0c24fbcff,

title = "Executive function predicting longitudinal change in type 1 diabetes management during the transition to emerging adulthood",

abstract = "OBJECTIVE The objective of this study was to examine 1) whether teens{\textquoteright} glycemic control and adherence to type 1 diabetes treatment regimen worsen during the transition from late adolescence to emerging adulthood, and 2) whether teens{\textquoteright} executive function (EF), as measured by performance and self-reported problems with EF, is predictive of these changes (after controlling for general intelligence). RESEARCH DESIGN AND METHODS High school seniors with type 1 diabetes (N = 236; mean age 17.74 years) were assessed at three yearly time points. At baseline, during the senior year of high school, participants completed a self-report measure of problems with EF and performance-based measures of EF and general intelligence (IQ). Glycemic control was determined on the basis of results collected from HbA1c assay kits, and teens reported their adherence at all three time points. RESULTS HbA1c increased significantly across the three time points and adherence declined. EF performance was not associated with adherence or HbA1c at baseline, nor with changes in adherence over time. However, better EF performance predicted slower increases in HbA1c over time (i.e., slope) while controlling for IQ. Teens{\textquoteright} self-reported problems with EF were associated with worse glycemic control and poorer adherence at baseline (i.e., intercept), but they did not predict changes in either HbA1c or adherence over time (i.e., slope). CONCLUSIONS Abilities involved in performance on EF tests may be one resource for maintaining better glycemic control during the transition to emerging adulthood. Assessment of such EF abilities may allow for the identification of individuals who are most at risk for deterioration of glycemic control during this transition.",

author = "Berg, {Cynthia A.} and Wiebe, {Deborah J.} and Yana Suchy and Turner, {Sara L.} and Jonathan Butner and Ascher Munion and Lansing, {Amy Hughes} and White, {Perrin C} and Mary Murray",

note = "Funding Information: Acknowledgments. The authors thank the physicians and staff at the Primary Children{\textquoteright}s Hospital Diabetes Program, Mountain Vista Medicine, and Children{\textquoteright}s Medical Center Dallas and the teens and parents who participated in this study. Funding. This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health (grant no. R01 DK092939). C.A.B. and D.J.W. are co–primary investigators on the grant. Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. C.A.B., D.J.W., Y.S., and J.B. designed the study. C.A.B., J.B., and A.M. analyzed data. Y.S., S.L.T., and A.H.L. performed the literature search and acquired data. P.C.W. and M.M. facilitated clinic recruitment. C.A.B., D.J.W., Y.S., S.L.T., J.B., A.M., A.H.L., P.C.W., and M.M. wrote and critically revised the manuscript and approved the manuscript for submission. C.A.B. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Prior Presentation. These data were presented at the 77th Scientific Sessions of the American Diabetes Association, San Diego, CA, 9–13 June 2017. Publisher Copyright: {\textcopyright} 2018 by the American Diabetes Association.",

year = "2018",

month = nov,

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doi = "10.2337/dc18-0351",

language = "English (US)",

volume = "41",

pages = "2281--2288",

journal = "Diabetes care",

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publisher = "American Diabetes Association Inc.",

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T1 - Executive function predicting longitudinal change in type 1 diabetes management during the transition to emerging adulthood

AU - Berg, Cynthia A.

AU - Wiebe, Deborah J.

AU - Suchy, Yana

AU - Turner, Sara L.

AU - Butner, Jonathan

AU - Munion, Ascher

AU - Lansing, Amy Hughes

AU - White, Perrin C

AU - Murray, Mary

N1 - Funding Information: Acknowledgments. The authors thank the physicians and staff at the Primary Children’s Hospital Diabetes Program, Mountain Vista Medicine, and Children’s Medical Center Dallas and the teens and parents who participated in this study. Funding. This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health (grant no. R01 DK092939). C.A.B. and D.J.W. are co–primary investigators on the grant. Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. C.A.B., D.J.W., Y.S., and J.B. designed the study. C.A.B., J.B., and A.M. analyzed data. Y.S., S.L.T., and A.H.L. performed the literature search and acquired data. P.C.W. and M.M. facilitated clinic recruitment. C.A.B., D.J.W., Y.S., S.L.T., J.B., A.M., A.H.L., P.C.W., and M.M. wrote and critically revised the manuscript and approved the manuscript for submission. C.A.B. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Prior Presentation. These data were presented at the 77th Scientific Sessions of the American Diabetes Association, San Diego, CA, 9–13 June 2017. Publisher Copyright: © 2018 by the American Diabetes Association.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - OBJECTIVE The objective of this study was to examine 1) whether teens’ glycemic control and adherence to type 1 diabetes treatment regimen worsen during the transition from late adolescence to emerging adulthood, and 2) whether teens’ executive function (EF), as measured by performance and self-reported problems with EF, is predictive of these changes (after controlling for general intelligence). RESEARCH DESIGN AND METHODS High school seniors with type 1 diabetes (N = 236; mean age 17.74 years) were assessed at three yearly time points. At baseline, during the senior year of high school, participants completed a self-report measure of problems with EF and performance-based measures of EF and general intelligence (IQ). Glycemic control was determined on the basis of results collected from HbA1c assay kits, and teens reported their adherence at all three time points. RESULTS HbA1c increased significantly across the three time points and adherence declined. EF performance was not associated with adherence or HbA1c at baseline, nor with changes in adherence over time. However, better EF performance predicted slower increases in HbA1c over time (i.e., slope) while controlling for IQ. Teens’ self-reported problems with EF were associated with worse glycemic control and poorer adherence at baseline (i.e., intercept), but they did not predict changes in either HbA1c or adherence over time (i.e., slope). CONCLUSIONS Abilities involved in performance on EF tests may be one resource for maintaining better glycemic control during the transition to emerging adulthood. Assessment of such EF abilities may allow for the identification of individuals who are most at risk for deterioration of glycemic control during this transition.

AB - OBJECTIVE The objective of this study was to examine 1) whether teens’ glycemic control and adherence to type 1 diabetes treatment regimen worsen during the transition from late adolescence to emerging adulthood, and 2) whether teens’ executive function (EF), as measured by performance and self-reported problems with EF, is predictive of these changes (after controlling for general intelligence). RESEARCH DESIGN AND METHODS High school seniors with type 1 diabetes (N = 236; mean age 17.74 years) were assessed at three yearly time points. At baseline, during the senior year of high school, participants completed a self-report measure of problems with EF and performance-based measures of EF and general intelligence (IQ). Glycemic control was determined on the basis of results collected from HbA1c assay kits, and teens reported their adherence at all three time points. RESULTS HbA1c increased significantly across the three time points and adherence declined. EF performance was not associated with adherence or HbA1c at baseline, nor with changes in adherence over time. However, better EF performance predicted slower increases in HbA1c over time (i.e., slope) while controlling for IQ. Teens’ self-reported problems with EF were associated with worse glycemic control and poorer adherence at baseline (i.e., intercept), but they did not predict changes in either HbA1c or adherence over time (i.e., slope). CONCLUSIONS Abilities involved in performance on EF tests may be one resource for maintaining better glycemic control during the transition to emerging adulthood. Assessment of such EF abilities may allow for the identification of individuals who are most at risk for deterioration of glycemic control during this transition.

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JO - Diabetes care

JF - Diabetes care

IS - 11

ER -

Executive function predicting longitudinal change in type 1 diabetes management during the transition to emerging adulthood

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