Naturalistically observed interpersonal problems and diabetes management in older adolescents and young adults with type 1 diabetes

Abstract

Objective

This study investigated the links between naturalistically observed and self-reported interpersonal problems, diabetes management, and glucose levels in older adolescents and young adults with type 1 diabetes.

Design

Sixty-eight older adolescents and young adults (aged 17–20 years) participated in a cross-sectional study that consisted of three home visits and a daily diary segment.

Main Outcome Measures

Participants wore the Electronically Activated Recorder (EAR) for four days to capture interpersonal problems and wore a continuous glucose monitor for blood glucose levels. Researchers also collected HbA1_c values, conducted an interview to assess diabetes management, and collected participant-reported severity of interpersonal problems.

Results

High EAR-observed interpersonal problems were associated with poor diabetes management. Multiple regression analyses revealed that high EAR-observed interpersonal problems continued to explain variance in poor diabetes management after including self-reported interpersonal problems and covariates.

Conclusion

These findings corroborate literature suggesting that negative interactions are associated with type 1 diabetes management. This study is the first to use the EAR to capture naturalistically observed interactions in this population and identify its utility beyond self-reports. These findings highlight the importance of considering naturalistically observed interactions when developing interventions to promote better diabetes management in older adolescents and young adults.

Keywords:

• Type 1 diabetes
• diabetes management
• adolescents
• conflict
• electronically activated recorder

Acknowledgements

Authors acknowledge that the data from this manuscript have been published as an abstract in the July/August 2020 issue of Psychosomatic Medicine for the 78^th Annual Meeting of the American Psychosomatic Society.

Disclosure statement

The authors report no conflicts of interest.

Data availability statement

The data that support the findings of this study are openly available on the Open Science Framework (OSF) at https://doi.org/10.17605/OSF.IO/WMHCY.

Additional information

Funding

This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases under grant number 1DP3DK097717-01 and the National Institute of General Medical Sciences/National Institute of Health under grant R25 GM 058905 – 20.