Identification and prediction of group-based glycemic control trajectories during the transition to adolescence
| Autor: | Joseph R. Rausch, Jennifer M. Rohan, Dennis Drotar, Lawrence M. Dolan, Grafton Reeves, Jennifer Shroff Pendley, Alan M. Delamater |
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| Rok vydání: | 2014 |
| Předmět: |
Blood Glucose
Male Adolescent Family Conflict Psychological intervention Child Behavior Article Developmental psychology Executive Function Diabetes mellitus Blood Glucose Self-Monitoring medicine Humans Multicenter Studies as Topic Prospective Studies Child Baseline (configuration management) Prospective cohort study Applied Psychology Glycemic Glycated Hemoglobin Blood glucose monitoring Type 1 diabetes medicine.diagnostic_test medicine.disease Mother-Child Relations Psychiatry and Mental health Diabetes Mellitus Type 1 Logistic Models Caregivers Adolescent Behavior Female Psychology Forecasting Demography |
| Zdroj: | Health Psychology. 33:1143-1152 |
| ISSN: | 1930-7810 0278-6133 |
| DOI: | 10.1037/hea0000025 |
| Popis: | Objective To identify trajectories of glycemic control over a period of 3 years in a pediatric sample of youth diagnosed with Type 1 diabetes transitioning to adolescence. A second aim was to examine a set of modifiable individual and family level baseline predictors of glycemic control group membership. Methods This multisite, prospective study included 239 children and adolescents (ages 9-11 years at baseline) diagnosed with Type 1 diabetes and their caregivers. Glycemic control was based on hemoglobin A1c (HbA1c) collected at 6-month intervals over a period of 3 years. Predictors of glycemic control membership included baseline global executive functioning, diabetes self-management, diabetes-specific family conflict, blood glucose monitoring frequency, and relevant individual and family level covariates. Results Group-based trajectory analyses were used to describe patterns of glycemic control from baseline to 36 months and 3 trajectories were identified: low risk (42.9%), elevated risk (44.6%), and high risk (12.1%) subgroups. Baseline maternal-reported family conflict, blood glucose monitoring frequency, and gender were significant predictors of glycemic control group membership. Higher levels of baseline family conflict, lower frequency of blood glucose monitoring, and female gender were associated with elevated and high-risk group membership. Conclusions These findings underscore the importance of examining trajectories of HbA1c across time. These results suggest that problematic trajectories of glycemic control are evident during the transition to adolescence. Furthermore, there are modifiable individual and family level characteristics that predict group membership and hence could be targeted in interventions to ensure adequate glycemic control is maintained over time and that risks for diabetes-related complications are reduced. |
| Databáze: | OpenAIRE |
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