Continuity and change in glycemic control trajectories from adolescence to emerging adulthood: relationships with family climate and self-concept in type 1 diabetes.
OBJECTIVE
To determine developmental classes of glycemic control in young people with type 1 diabetes throughout adolescence and emerging adulthood and assess relationships with general family climate and self-concept.


METHODS
In an eight-wave longitudinal study, 72 individuals (37 females) completed questionnaires assessing family climate (at times 1-4) and self-concept (at times 1-4 and 6). Times 1-4 covered adolescence (mean ages were 14-17 years, respectively); times 5-8 covered emerging adulthood (mean ages were 21-25 years, respectively). At each time point, patients visited their physicians to determine A1C values, and questionnaires were sent to the physicians to obtain these values. Latent class growth analysis was used to identify developmental classes of glycemic control.


RESULTS
Latent class growth analysis favored a three-class solution, consisting of optimal control (n = 10), moderate control (n = 51), and deteriorating control (n = 11). From time 3 on and especially during emerging adulthood, mean A1C levels were substantially different among the classes. Additional ANOVAs indicated that at times 1, 2, and 4, the optimal control class was characterized by the most optimal family climate, whereas at times 3, 4, and 6, the deteriorating control class was characterized by the lowest score on positive self-concept.


CONCLUSIONS
From late adolescence on, a multiformity of glycemic control trajectories emerged, which became more diversified throughout emerging adulthood. Family climate and self-concept in mid-to-late adolescence served as psychosocial markers of these developmental classes.
Luyckx
Koen
K
Department of Psychology, Center for Developmental Psychology, Catholic University Leuven, Leuven, Belgium. koen.luyckx@psy.kuleuven.be
Seiffge-Krenke
Inge
I
D000293:Adolescent; D017668:Age of Onset; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D005190:Family; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D010287:Parent-Child Relations; D012649:Self Concept; D035781:Siblings; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
D001786:Blood Glucose; D006442:Glycated Hemoglobin