title: Longitudinal trajectories of metabolic control across adolescence: associations with parental involvement, adolescents' psychosocial maturity, and health care utilization.
abstract: OBJECTIVE
  To predict trajectories of metabolic control across adolescence from parental involvement and adolescent psychosocial maturity, and to link metabolic control trajectories to health care utilization.
  
  
  METHODS
  Two hundred fifty-two adolescents (M age at study initiation = 12.5 years, SD = 1.5, range = 10-14 years) with type 1 diabetes (54.4% female, 92.8% Caucasian, length of diagnosis M = 4.7 years, SD = 3.0, range = 1-12 years) participated in a 2-year longitudinal study. Metabolic control was gathered from medical records every 3 months. Adolescents completed measures of self-reliance (functional autonomy and extreme peer orientation), self-control (self-control and externalizing behavior), and parental involvement in diabetes care (acceptance, monitoring, and frequency of help). At the end of the study, mothers reported health care utilization (diabetes-related emergency room visits and hospitalizations) over the past 6 months.
  
  
  RESULTS
  Latent class growth analyses indicated two distinct trajectories of metabolic control across adolescence: moderate control with slight deterioration (92% of the sample; average HbA1c = 8.18%) and poor control with rapid deterioration (8% of the sample; average HbA1c of 12.09%). Adolescents with poor and rapidly deteriorating metabolic control reported lower paternal monitoring and frequency of help with diabetes management, lower functional autonomy, and lower self-control than others. Those with poor and rapidly deteriorating metabolic control were 6.4 times more likely to report diabetes-related emergency room visits, and 9.3 times more likely to report diabetes-related hospitalizations near the end of the study.
  
  
  CONCLUSIONS
  Parental involvement and adolescents' psychosocial maturity predict patterns of deteriorating metabolic control across adolescence and could be targeted for intervention.
authors.affiliation: University of Utah, Salt Lake City, UT, USA. pam.king@psych.utah.edu
authors.forename: Pamela S
authors.initials: PS
authors.lastname: King
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Berg
authors.forename: Jonathan
authors.initials: J
authors.lastname: Butner
authors.forename: Linda M
authors.initials: LM
authors.lastname: Drew
authors.forename: Carol
authors.initials: C
authors.lastname: Foster
authors.forename: David
authors.initials: D
authors.lastname: Donaldson
authors.forename: Mary
authors.initials: M
authors.lastname: Murray
authors.forename: Michael
authors.initials: M
authors.lastname: Swinyard
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Wiebe
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010290:Parents; D010349:Patient Compliance / Q000523:psychology*; D000297:Psychology, Adolescent; D012648:Self Care / Q000523:psychology*