title: Patterns of self-management in pediatric type 1 diabetes predict level of glycemic control 2 years later.
abstract: OBJECTIVE
  To determine if 3 distinct self-management patterns (i.e., maladaptive, moderate/mixed, and adaptive) observed at baseline, 1 year, and 2 years in a sample of youth with type 1 diabetes and their caregivers predicted mean differences in adolescent's subsequent glycemic control.
  
  
  METHODS
  This study is a descriptive, multisite, prospective study that examined a sample of youth diagnosed with type 1 diabetes (ages 9-11 years at baseline). Youth and their maternal and paternal caregivers provided information about the youth's self-management patterns at baseline, 1 year, and 2 years using the Diabetes Self-Management Profile structured interview. Glycemic control (hemoglobin A1c: HbA1c) was examined at baseline and 6, 12, 18, and 24 months.
  
  
  RESULTS
  Three distinct self-management patterns were observed at 1 year and 2 years, which were conceptually consistent with previously reported baseline self-management patterns. Youth identified by their maternal caregivers as having adaptive self-management patterns at baseline had better glycemic control across 2 years compared with those in the maladaptive and mixed self-management groups. Similarly, maternal reports suggested that youth with less adaptive self-management patterns generally had worse glycemic control over time and HbA1c values above the American Diabetes Association recommendations. Youth and paternal caregiver reports yielded more variable findings.
  
  
  CONCLUSIONS
  Findings underscore the stability of self-management patterns in pediatric type 1 diabetes and the need for preventive interventions that are tailored to specific patterns of self-management associated with risk for problematic glycemic control.
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. Jennifer.Rohan@cchmc.org
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Rohan
authors.forename: Jennifer Shroff
authors.initials: JS
authors.lastname: Pendley
authors.forename: Alan
authors.initials: A
authors.lastname: Delamater
authors.forename: Lawrence
authors.initials: L
authors.lastname: Dolan
authors.forename: Grafton
authors.initials: G
authors.lastname: Reeves
authors.forename: Dennis
authors.initials: D
authors.lastname: Drotar
mesh_terms: D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D012648:Self Care / Q000523:psychology* / Q000706:statistics & numerical data; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human