Autonomy support and responsibility-sharing predict blood glucose monitoring frequency among youth with diabetes.
OBJECTIVE
Adolescence poses a number of special challenges for youth and their families managing the Type 1 diabetes medical regimen. Little is known on how family and youth factors and management of the regimen change over the course of early adolescence and predict adherence to the regimen during this developmental period.


METHODS
Youth with Type 1 diabetes (n = 239) and their maternal caregivers completed measures of diabetes-specific autonomy support, diabetes-related family conflict, regimen responsibility, and blood glucose monitoring frequency (BGMF) at 4 timepoints over a 3-year period.


RESULTS
Autonomy support and BGMF significantly decreased over time and responsibility for the diabetes regimen shifted from the caregiver toward youth over time. Significant changes in perceived family conflict over time differed depending on the reporter. Baseline BGMF, changes in caregiver autonomy support, and changes in responsibility for the regimen significantly predicted changes in BGMF over time.


CONCLUSIONS
This study documents changes in autonomy support, youth responsibility for the diabetes regimen, and BGMF during the transition into early adolescence. Higher levels of caregiver autonomy support preserve BGMF during a developmental period in which BGMF typically deteriorates.
Center for Treatment Adherence and Self-Management.
Yelena P
YP
Wu
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.
Joseph
J
Rausch
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.
Jennifer M
JM
Rohan
Madison Clinic for Pediatric Diabetes, Division of Endocrinology, Department of Pediatrics, University of California.
Korey K
KK
Hood
Division of Behavioral Health, Alfred I. duPont Hospital for Children.
Jennifer S
JS
Pendley
Department of Pediatrics, University of Miami.
Alan
A
Delamater
Center for Treatment Adherence and Self-Management.
Dennis
D
Drotar
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D015190:Blood Glucose Self-Monitoring / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology* / Q000628:therapy; D054541:Family Conflict / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009034:Mother-Child Relations; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D026684:Personal Autonomy; D014481:United States
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human