title: Parental involvement buffers associations between pump duration and metabolic control among adolescents with type 1 diabetes.
abstract: 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.
authors.affiliation: Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9044, USA. deborah.wiebe@utsouthwestern.edu
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Wiebe
authors.forename: Andrea
authors.initials: A
authors.lastname: Croom
authors.forename: Katherine T
authors.initials: KT
authors.lastname: Fortenberry
authors.forename: Jonathan
authors.initials: J
authors.lastname: Butner
authors.forename: Jorie
authors.initials: J
authors.lastname: Butler
authors.forename: Michael T
authors.initials: MT
authors.lastname: Swinyard
authors.forename: Rob
authors.initials: R
authors.lastname: Lindsay
authors.forename: David
authors.initials: D
authors.lastname: Donaldson
authors.forename: Carol
authors.initials: C
authors.lastname: Foster
authors.forename: Mary
authors.initials: M
authors.lastname: Murray
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Berg
mesh_terms: 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
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human