Executive Functioning, Parenting Stress, and Family Factors as Predictors of Diabetes Management in Pediatric Patients with Type 1 Diabetes Using Intensive Regimens

Abstract

The care of youth with type 1 diabetes mellitus (T1DM) has become increasingly complex given the importance of good glycemic control in decreasing the rates of diabetes-related complications. Today, youth with TIDM are more frequently prescribed intensive insulin regimens (i.e. multiple daily injections or insulin pump therapy) which require a great deal of planning, organization, and problem-solving to execute correctly. However, there has been a paucity of research on psychological and family factors that may impact pediatric patients’ diabetes management when using intensive regimens. Seventy-two youth with T1DM on intensive insulin regimens and their caregivers participated in the study, which entailed completing self-report questionnaires, an adherence interview, a parent-report measure of executive functioning, and measurement of glycemic control. Results suggested that although adherence mediated the relation between child executive functioning and glycemic control in youth reporting relatively better adherence, this finding was not supported in youth reporting relatively worse adherence. Regression models including all study variables accounted for large proportions of the variance in glycemic control, although there were differences based on child-reported adherence. Findings from this study provide preliminary information about characteristics associated with outcome for youth with T1DM utilizing intensive insulin regimens.