title: [Adolescence and type 1 diabetes: self-care and glycemic control].
abstract: BACKGROUND
  Type 1 diabetes is one of the most frequent chronic diseases in children and adolescents. Self-care support is a crucial aspect of the medical care provided to adolescent patients with type 1 diabetes. In the perspective of health promotion, which seeks to empower people to become the actors of their own health, self-care may be operationalized in three dimensions: psychosocial life, general health, and disease. We looked at the process of autonomization in adolescents 13-15 years of age, and hypothesized that their level of glycemic control (HbA1c) would be related to their perceived level of self-care.
  
  
  METHODS
  We conducted an exploratory study through 32 in-depth interviews with adolescents aged 13-15 years. The data collected was analyzed quantitatively and qualitatively, based on the annual mean HbA1c level.
  
  
  RESULTS
  Significantly higher scores of perceived self-care were associated with levels of HbA1c ≤ 7.5% (P=0.038). Overall, adolescents with good glycemic control reported greater autonomy and complexity in self-care behaviors in all three dimensions of self-care. Moreover, our results show that adolescents with poor glycemic control tend to restrict the definition of self-care to its medical dimension and to exclude the psychosocial dimension.
  
  
  CONCLUSIONS
  Our study confirms the hypothesis of a relation between HbA1c and the self-reported level of self-care in adolescents with type 1 diabetes. Moreover, it emphasizes the need to better respond to the young patients' psychosocial needs, in order to improve the long-term follow-up of adolescents with type 1 diabetes.
authors.affiliation: Diabétologie pédiatrique, hôpital Necker-Enfants-Malades (NEM), 149, rue Sèvres, 75015 Paris, France. julie.pelicand@uclouvain.be
authors.forename: J
authors.initials: J
authors.lastname: Pelicand
authors.forename: M
authors.initials: M
authors.lastname: Maes
authors.forename: D
authors.initials: D
authors.lastname: Charlier
authors.forename: I
authors.initials: I
authors.lastname: Aujoulat
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012648:Self Care
chemical_list: D001786:Blood Glucose