title: Changes in executive functioning and self-management in adolescents with type 1 diabetes: a growth curve analysis.
abstract: OBJECTIVE
  To investigate the relation of changes in executive functioning to changes in diabetes self-management in a 2-year prospective study of a sample of youth aged 9-11 years at baseline (n = 239) with type 1 diabetes and their maternal caregivers.
  
  
  METHODS
  Youth and maternal caregivers completed the Diabetes Self-Management Profile (DSMP) at baseline, 12 months, and 24 months. Maternal caregivers completed the Behavioral Rating Inventory of Executive Functioning (BRIEF) at the same time points to assess global executive functioning, and the domains of behavioral regulation and metacognition.
  
  
  RESULTS
  Youth reported self-management decreased over time (p < .01) while behavioral regulation (e.g., the child's ability to shift cognitive set and moderate emotions and behaviors via emotional control) increased (p < .05). Changes in behavioral regulation significantly predicted rate of change in youth-reported self-management (p < .01). Global executive functioning and metacognition (e.g., the child's ability to monitor, initiate, plan, organize, and sustain future-oriented problem solving and working memory) did not change over time and did not predict changes in self-management. Moreover, executive functioning and self-management did not predict changes in HbA1c.
  
  
  CONCLUSIONS
  Positive changes in behavioral regulation may enhance self-management of type 1 diabetes during the transition to adolescence.
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. megan.miller_2@cchmc.org
authors.forename: Megan M
authors.initials: MM
authors.lastname: Miller
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Rohan
authors.forename: Alan
authors.initials: A
authors.lastname: Delamater
authors.forename: Jennifer
authors.initials: J
authors.lastname: Shroff-Pendley
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dolan
authors.forename: Grafton
authors.initials: G
authors.lastname: Reeves
authors.forename: Dennis
authors.initials: D
authors.lastname: Drotar
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D004644:Emotions; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012648:Self Care