The relation between metabolic control (HbA1c) and achievement (grade point average [GPA]) was examined over a period of 2.5 years (every 6 months) employing a dynamical systems approach that allowed for the examination of whether HbA1c was associated with change in subsequent GPA and vice versa. Metabolic control tends to deteriorate (i.e., with higher HbA1c reflecting poorer metabolic control) during adolescence. It was hypothesized that these higher levels of HbA1c would limit subsequent increases in GPA. The sample included 252 adolescents (Mbaseline age = 12.49 years, SD = 1.53; 53.6% female) with Type 1 diabetes. Mothers' report and school records provided information on relevant demographics and GPA; medical records provided values of HbA1c. Two simultaneous coupled change equations (i.e., examining current values in 1 variable associated with changes in the other) controlling relevant risk indicators (i.e., age, sex, disease duration, insulin delivery method, IQ) revealed higher levels of HbA1c limited increases in GPA. Higher levels of GPA, however, were not associated with change in HbA1c except for 2 instances where moderation existed by disease duration and IQ. Higher GPA was associated with slower increases in HbA1c over time for youth with shorter disease duration and lower IQ. These results affirm the importance of maintaining good metabolic control to facilitate adequate school performance across the adolescent years. Further, the results suggest that factors related to school achievement may protect adolescents who are newly diagnosed or who have low cognitive ability from subsequent deterioration in metabolic control. (PsycINFO Database Record

Background

Type 1 diabetes management involves self- and social-regulation, with past research examining components through individual differences unable to capture daily processes.

Purpose

Dynamical systems modeling was used to examine the coordinative structure of self- and social-regulation (operationalized as parental-regulation) related to daily diabetes management during late adolescence.

Methods

Two hundred and thirty-six late adolescents with type 1 diabetes (M age = 17.77 years, SD = .39) completed a 14-day diary reporting aspects of self- (e.g., adherence behaviors, cognitive self-regulation failures, and positive and negative affect) and parental-regulation (disclosure to parents, knowledge parents have, and help parents provide).

Results

Self-regulation functioned as one coordinative structure that was separate from parental-regulation, where mothers and fathers were coordinated separately from each other. Mothers' perceived helpfulness served as a driver of returning adolescents back to homeostasis.

Conclusions

The results illustrate a dynamic process whereby numerous facets of self- and social-regulation are coordinated in order to return diabetes management to a stable state.

OBJECTIVE : To examine how adolescents' daily disclosure to parents about type 1 diabetes management may foster a process whereby parents gain knowledge and are viewed as helpful in ways that may aid diabetes management.  METHODS:  A total of 236 late adolescents (M age = 17.76) completed a 14-day diary where they reported daily disclosure to, and solicitation from, their parents, how knowledgeable and helpful parents were, and their self-regulation failures and adherence; blood glucose was gathered from meters.  RESULTS:  Multilevel models revealed that adolescent disclosure occurred in the context of greater parent solicitation and face-to-face contact and was positively associated with adolescents' perceptions of parental knowledge and helpfulness. Disclosure to mothers (but not to fathers) was associated with better diabetes management (fewer self-regulation failures, better adherence).  CONCLUSIONS:  Adolescent disclosure may be an important way that parents remain knowledgeable about diabetes management and provide assistance that serves to support diabetes management.

Objective

To examine how adolescents’ daily disclosure to parents about type 1 diabetes management may foster a process whereby parents gain knowledge and are viewed as helpful in ways that may aid diabetes management.

Methods

A total of 236 late adolescents (M age = 17.76) completed a 14-day diary where they reported daily disclosure to, and solicitation from, their parents, how knowledgeable and helpful parents were, and their self-regulation failures and adherence; blood glucose was gathered from meters.

Results

Multilevel models revealed that adolescent disclosure occurred in the context of greater parent solicitation and face-to-face contact and was positively associated with adolescents’ perceptions of parental knowledge and helpfulness. Disclosure to mothers (but not to fathers) was associated with better diabetes management (fewer self-regulation failures, better adherence).

Conclusions

Adolescent disclosure may be an important way that parents remain knowledgeable about diabetes management and provide assistance that serves to support diabetes management.