Relation of stressful life events to metabolic control among adolescents with diabetes: 5-year longitudinal study.
OBJECTIVE
To determine the relation of stressful life events to metabolic control.


METHODS
We interviewed adolescents with Type 1 diabetes (n = 132; average age at enrollment = 12 years) annually for 5 years.


METHODS
Each year we administered measures of stressful life events, psychological distress, and self-care behavior. We downloaded data from blood glucose meters, and obtained measures of metabolic control (hemoglobin A1c) from medical records.


RESULTS
Using longitudinal growth curve modeling, stressful life events predicted greater psychological distress, poorer self-care behavior, and worse metabolic control in both cross-sectional and longitudinal (lagged) analyses. Cross-sectionally, many of these relations were stronger among older than younger adolescents. Self-care behavior partly mediated this association.


CONCLUSIONS
Stressful life events are related to poor metabolic control-especially for older adolescents. A primary mechanism appears to be a lack of good self care. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA. vh2e@andrew.cmu.edu
Vicki S
VS
Helgeson
Oscar
O
Escobar
Linda
L
Siminerio
Dorothy
D
Becker
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D055809:Illness Behavior; D007206:Individuality; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D012648:Self Care / Q000523:psychology*
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human