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Journal of Pediatric Psychology Advance Access originally published online on July 30, 2008
Journal of Pediatric Psychology 2009 34(3):254-270; doi:10.1093/jpepsy/jsn079
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Predictors of Metabolic Control among Adolescents with Diabetes: A 4-Year Longitudinal Study *

Vicki S. Helgeson, PhD1, Linda Siminerio, PhD2, Oscar Escobar, MD3 and Dorothy Becker, MBBCh3

1Carnegie Mellon University, 2University of Pittsburgh Medical Center, and 3Children's Hospital of University of Pittsburgh Medical Center

All correspondence concerning this article should be addressed to Dr Vicki S. Helgeson, Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA. E-mail: vh2e{at}andrew.cmu.edu


  Abstract

Objective To employ a risk and resistance framework to examine changes in metabolic control over early to middle adolescence. Methods We interviewed 70 girls and 62 boys (mean age 12 years) annually for 4 years. Risk and resistance factors, including demographics, disease-related variables, self-care behavior, and psychosocial variables were assessed. Hemoglobin A1c was obtained from medical records. Results Multilevel modeling showed metabolic control deteriorated with age. Self-care behavior interacted with age to predict the decline, such that self-care was more strongly related to poor metabolic control for older adolescents. Eating disturbances, depression, and peer relations were related to poor metabolic control, whereas good family relations were related to better metabolic control for girls. Conclusions Independent risk factors for poor metabolic control included poor self-care, disturbed eating behavior, depression, and peer relations; parental support was an independent resistance factor for girls. Future research should examine mechanisms by which these relations emerge.

Key words: adolescence; diabetes; metabolic control.

*Portions of this article have been presented at the 2007 Meeting of the Society of Behavioral Medicine.

Received February 6, 2008; revision received July 8, 2008; accepted July 8, 2008


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