Genevieve Maliszewski1,2, Susana R Patton1,2, L Kurt Midyett3, Mark A Clements4. 1. 1 University of Kansas Medical Center, Kansas City, KS, USA. 2. 2 Center for Children's Healthy Lifestyle & Nutrition, Kansas City, MO, USA. 3. 3 St. Luke's Hospital, Kansas City, MO, USA. 4. 4 Children's Mercy Kansas City, Kansas City, MO, USA.
Abstract
OBJECTIVE: Adherence to type 1 diabetes management declines as children enter adolescence. For youth, psychosocial variables including mood and interpersonal relationships play a large role in diabetes maintenance. The current study assessed the unique and interactive roles diabetes family conflict and depression have on insulin bolusing behaviors for youth ages 10-16 years. METHODS: Ninety-one youth-parent dyads completed a survey assessing family conflict and depression. Mean daily blood glucose levels, mealtime insulin bolus scores ( BOLUS), and glycated hemoglobin (HbA1c) were collected from the medical record as outcome variables. RESULTS: Parent-reported diabetes-related family conflict and youths' endorsed depression both significantly predicted insulin bolusing behavior, R2 = .13, F(2, 88) = 6.66, P < .05. The interaction of diabetes family conflict and youth depression played a significant role in youths' bolusing behaviors, above and beyond that which was predicted by conflict and depression separately, R2 = .18, Fchange(1, 87) = 4.63, P < .05. BOLUS was negatively related to youths' hemoglobin A1c, r = -.556, P < .001 and mean daily blood glucose levels, r = -.428, P < .001. CONCLUSIONS: Among depressed youth, mealtime insulin BOLUS scores declined with greater diabetes-related family conflict, while there was no change in BOLUS scores among depressed youth living in families reporting less conflict. Findings underscore the importance of screening for depression and family conflict in youth experiencing or at risk for poor adherence to mealtime insulin and higher HbA1c levels.
OBJECTIVE: Adherence to type 1 diabetes management declines as children enter adolescence. For youth, psychosocial variables including mood and interpersonal relationships play a large role in diabetes maintenance. The current study assessed the unique and interactive roles diabetes family conflict and depression have on insulin bolusing behaviors for youth ages 10-16 years. METHODS: Ninety-one youth-parent dyads completed a survey assessing family conflict and depression. Mean daily blood glucose levels, mealtime insulin bolus scores ( BOLUS), and glycated hemoglobin (HbA1c) were collected from the medical record as outcome variables. RESULTS: Parent-reported diabetes-related family conflict and youths' endorsed depression both significantly predicted insulin bolusing behavior, R2 = .13, F(2, 88) = 6.66, P < .05. The interaction of diabetes family conflict and youth depression played a significant role in youths' bolusing behaviors, above and beyond that which was predicted by conflict and depression separately, R2 = .18, Fchange(1, 87) = 4.63, P < .05. BOLUS was negatively related to youths' hemoglobin A1c, r = -.556, P < .001 and mean daily blood glucose levels, r = -.428, P < .001. CONCLUSIONS: Among depressed youth, mealtime insulin BOLUS scores declined with greater diabetes-related family conflict, while there was no change in BOLUS scores among depressed youth living in families reporting less conflict. Findings underscore the importance of screening for depression and family conflict in youth experiencing or at risk for poor adherence to mealtime insulin and higher HbA1c levels.
Entities:
Keywords:
adolescence; depression; family conflict; insulin bolus; type 1 diabetes mellitus
Authors: Kellee M Miller; Nicole C Foster; Roy W Beck; Richard M Bergenstal; Stephanie N DuBose; Linda A DiMeglio; David M Maahs; William V Tamborlane Journal: Diabetes Care Date: 2015-06 Impact factor: 19.112
Authors: Angela D Liese; Ralph B D'Agostino; Richard F Hamman; Patrick D Kilgo; Jean M Lawrence; Lenna L Liu; Beth Loots; Barbara Linder; Santica Marcovina; Beatriz Rodriguez; Debra Standiford; Desmond E Williams Journal: Pediatrics Date: 2006-10 Impact factor: 7.124
Authors: S K McMahon; F L Airey; D A Marangou; K J McElwee; C L Carne; A J Clarey; E A Davis; T W Jones Journal: Diabet Med Date: 2005-01 Impact factor: 4.359
Authors: Jennifer M Rohan; Bin Huang; Jennifer Shroff Pendley; Alan Delamater; Lawrence Dolan; Grafton Reeves; Dennis Drotar Journal: J Pediatr Psychol Date: 2015-07-07
Authors: Kimberly L Savin; Emily R Hamburger; Alexandra D Monzon; Niral J Patel; Katia M Perez; Jadienne H Lord; Sarah S Jaser Journal: J Fam Psychol Date: 2018-02