Self-efficacy affects blood sugar control among adolescents with type I diabetes mellitus.
OBJECTIVE
Self-management is crucial to diabetes control. To investigate the effectiveness of self-management in reaching target hemoglobin A1c (HbA1c) level, we conducted a study among Taiwanese adolescents with type 1 diabetes mellitus (DM).


METHODS
Patients aged 12-20 years with type 1 DM participated in an annual integrated DM care clinic at a medical center in Taiwan. All patients completed a questionnaire that included demographic data and self-efficacy measured by the Perceived Diabetes Self-Management Scale (PDSMS) in February 2008. Laboratory tests were also done at the same visit. The target HbA1c was < 7.0% in accordance with the general standard of the American Diabetes Association for patients with type 1 DM. Logistic regression analysis was used to explore the relationship between age, sex, duration of diabetes, PDSMS score, and HbA1c level.


RESULTS
Fifty-two patients were enrolled. The mean age was 16.0 +/- 2.4 years, and mean HbA1c level was 8.6 +/- 1.6%. Pearson correlation analysis showed a positive correlation between body mass index and preprandial blood sugar level (r = 0.297, p < 0.05). Negative correlations were found between PDSMS scores and duration of diabetes (r = -0.365, p < 0.01) as well as HbA1c level (r = -0.295, p < 0.05). Logistic regression analysis demonstrated that sex and PDSMS scores significantly influenced glycemic control. In multivariate logistic regression analysis, patients with higher PDSMS scores were 1.63 times (95% confidence interval = 1.03-2.59) more likely to reach target diabetes control after adjustment for other variables. Male patients also had a higher probability (odds ratio = 19.80, 95% confidence interval = 1.34-291.93) of reaching target diabetes control.


CONCLUSIONS
This study demonstrates that adolescents with type 1 DM and higher self-efficacy, especially males, have a higher probability of reaching target diabetes control.
Chih
An-Hsuan
AH
Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Jan
Chyi-Feng
CF
Shu
San-Ging
SG
Lue
Bee-Horng
BH
D000293:Adolescent; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000628:therapy; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D020377:Self Efficacy; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013624:Taiwan; D016896:Treatment Outcome; D055815:Young Adult
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin