Parental involvement buffers associations between pump duration and metabolic control among adolescents with type 1 diabetes.
OBJECTIVE
To examine pump duration associations with adolescents' metabolic control and whether parental involvement moderated this association.


METHODS
This study used a cross-sectional sample of 10- to 14-year-olds with diabetes (N = 252, 53.6% female) and parents' reported parental involvement; HbA1c was obtained from medical records. Half (50.8%) were on an insulin pump (continuous subcutaneous insulin infusion, CSII), with the remainder prescribed multiple daily injections (MDI).


RESULTS
Adolescents on CSII displayed better HbA1c than those on MDI. A curvilinear association revealed that participants on CSII for <2 years showed a positive pump duration-HbA1c association, while those on CSII longer showed no association. Parental involvement interacted with pump duration to predict HbA1c. Pump duration was associated with poorer HbA1c only when parents were relatively uninvolved.


CONCLUSIONS
Within the limitations of a cross-sectional design, data suggest that adolescents on CSII have better HbA1c than those on MDI, but may experience a period of deterioration that can be offset by parental involvement.
Wiebe
Deborah J
DJ
Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9044, USA. deborah.wiebe@utsouthwestern.edu
Croom
Andrea
A
Fortenberry
Katherine T
KT
Butner
Jonathan
J
Butler
Jorie
J
Swinyard
Michael T
MT
Lindsay
Rob
R
Donaldson
David
D
Foster
Carol
C
Murray
Mary
M
Berg
Cynthia A
CA
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D015918:Infusion Pumps, Implantable; D007332:Insulin Infusion Systems; D016014:Linear Models; D008297:Male; D016487:Parenting; D010349:Patient Compliance; D012648:Self Care; D014481:United States
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human