Objectives

The objective of this study is to examine associations between adolescents' regulation of information about their type 1 diabetes (adolescent disclosure, secrecy), parental knowledge about their adolescent's diabetes management, diabetes outcomes (adherence, HbA1c), and depressive symptoms in Non-Latino White and Latino families.

Methods

In all, 118 adolescents (56 = Latino, 62 = Non-Latino White) completed surveys of disclosure to and secrecy from parents, parental knowledge of adolescent diabetes management, adherence, and depressive symptoms, and mothers completed measures of maternal knowledge and adolescent adherence. Glycemic control was extracted from medical records. Adolescents also completed structured interviews about parental knowledge about their diabetes-related problems.

Results

Interviews revealed that adolescent disclosure is the primary method by which parents gain knowledge about adolescent diabetes management problems. Adolescent disclosure to and secrecy from parents were uniquely associated with diabetes management and depressive symptoms independent of parental knowledge across ethnic groups; maternal reports of knowledge about her adolescent's diabetes care activities were associated with diabetes management independent of adolescent disclosure and secrecy.

Conclusions

Adolescent information management strategies are a primary means by which parents gain knowledge about diabetes, which may facilitate more effective management.

Objectives

This study examined (a) associations of parent-adolescent relationship characteristics and adolescent problem behavior with late adolescents' secrecy from parents about type 1 diabetes management, and (b) whether secrecy was associated with diabetes and psychological outcomes independently of these factors.

Methods

Adolescents (N = 247, Mage = 17.76 years) completed survey measures of diabetes-related secrecy from parents, disclosure, parental acceptance, parental knowledge, and conduct problems. Mothers and adolescents reported on adolescent adherence to diabetes regimens and adolescents reported their depressive symptoms. Glycemic control was obtained from HbA1c test kits.

Results

Adolescent-reported disclosure to parents was uniquely negatively associated with secrecy from parents. Controlling for relationship variables, conduct problems, and sociodemographic and illness-related variables, secrecy from mothers was uniquely associated with poorer glycemic control and secrecy from both parents was associated with lower adherence.

Conclusions

Secrecy about type 1 diabetes management is uniquely associated with diabetes outcomes independent of other relationship characteristics and problem behaviors.

Objective

To examine associations of parent-adolescent relationship quality (parental acceptance and parent-adolescent conflict) with adolescent type 1 diabetes management (adherence and metabolic control) and depressive symptoms in Latinos and Caucasians.

Methods

In all, 118 adolescents and their mothers (56 = Latino, 62 = Caucasian) completed survey measures of parental acceptance, diabetes conflict, adolescent adherence, and adolescent depressive symptoms. Glycemic control was obtained from medical records.

Results

Across ethnic groups, adolescent-reported mother and father acceptance were associated with better diabetes management, whereas mother-reported conflict was associated with poorer diabetes management and more depressive symptoms. Independent of socioeconomic status, Latinos reported lower parental acceptance and higher diabetes conflict with mothers than Caucasians. Ethnicity moderated some associations between relationship quality and outcomes. Specifically, diabetes conflicts with mothers (mother and adolescent report) and fathers (adolescent report) were associated with poorer mother-reported adherence among Caucasians, but not among Latinos.

Conclusions

Parent-adolescent relationship quality differs and may have different relations with diabetes management across Latinos and Caucasians.

Objective

To examine whether individual differences and intraindividual (within-person day-to-day) fluctuations in late adolescents' self-regulation were associated with daily adherence to the type 1 diabetes regimen. 

Methods

 110 school seniors (M age = 17.78 years) and their mothers assessed adolescents' skills underlying self-regulation (executive function, attention, self-control, behavioral inhibition and activation, emotion regulation) and adherence, with glycosylated hemoglobin from medical records. Teens completed daily diaries reporting self-regulation failures surrounding monitoring blood glucose, adherence, and number of blood glucose checks each day for 14 days. 

Results

 Hierarchical Linear Models indicated that better daily adherence was associated with teen and mother reports of better self-regulation skills and teens' reports of fewer daily self-regulation failures. Daily adherence was unrelated to temperamental differences in behavioral inhibition and activation. 

Conclusions

 Results indicate that both individual and intraindividual differences in self-regulation contribute to daily adherence highlighting the importance of daily self-regulatory challenges to adherence.