Longitudinal trajectories of metabolic control across adolescence: Associations with parental involvement, adolescents' psychosocial maturity, and health care utilization

Pamela S. King, Cynthia A. Berg, Jonathan Butner, Linda M. Drew, Carol Foster, David Donaldson, Mary Murray, Michael Swinyard, Deborah J. Wiebe

Research output: Contribution to journalArticle

55 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)491-496
Number of pages6
JournalJournal of Adolescent Health
Volume50
Issue number5
DOIs
StatePublished - May 2012

Keywords

  • Adolescents
  • Glycemic control
  • hba1c
  • Health care utilization
  • Hospitalization
  • Latent class growth analysis
  • Longitudinal
  • Metabolic control
  • Parental involvement
  • Psychosocial maturity
  • Type 1 diabetes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health

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