title: Changes in treatment adherence and glycemic control during the transition to adolescence in type 1 diabetes.
abstract: OBJECTIVE
  To test models of unidirectional and bidirectional change between treatment adherence and glycemic control in youth with type 1 diabetes.
  
  
  METHODS
  We conducted a 2-year longitudinal, multisite study of 225 youth with type 1 diabetes recruited at the cusp of adolescence (aged 9-11 years) to describe the mutual influences of glycemic control as measured by HbA(1c) and treatment adherence as measured by blood glucose monitoring frequency (BGMF) during the transition to adolescence.
  
  
  RESULTS
  HbA(1c) increased from 8.2 to 8.6% (P < 0.001) and BGMF decreased from 4.9 to 4.5 checks per day (P < 0.02) during the 2-year period. Changes in the BGMF slope predicted changes in HbA(1c). A change (increase) in HbA(1c) was associated with a change (decrease) in BGMF of 1.26 (P < 0.001) after controlling for covariates.
  
  
  CONCLUSIONS
  The magnitude of the effect of declining treatment adherence (BGMF) on glycemic control in young adolescents may be even greater than declines observed among older adolescents. BGMF offers a powerful tool for targeted management of glycemic control for type 1 diabetes during the critical transition to adolescence.
authors.affiliation: Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Rausch
authors.forename: Korey K
authors.initials: KK
authors.lastname: Hood
authors.forename: Alan
authors.initials: A
authors.lastname: Delamater
authors.forename: Jennifer
authors.initials: J
authors.lastname: Shroff Pendley
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Rohan
authors.forename: Grafton
authors.initials: G
authors.lastname: Reeves
authors.forename: Lawrence
authors.initials: L
authors.lastname: Dolan
authors.forename: Dennis
authors.initials: D
authors.lastname: Drotar
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000295:Adolescent Medicine; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D002648:Child; D002652:Child Behavior / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D011627:Puberty; D016903:Drug Monitoring
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human