Longitudinal Development and the Influencing Factors of Glycemic Control in Adolescents With Type 1 Diabetes in Taiwan: Gender Differences

Wednesday, 24 July 2013

Wang Ruey-Hsia, PhD
Colledge of Nursing, Kaohsiung Medical University, School of Nursing, Kaohsiung, Taiwan
Lin Kuan-Chia, PhD
National Taipei University of Nursing & Health Sciences, School of Nursing, Taipei, Taiwan

Learning Objective 1: Understand longitudinal development of HbA1c over 18 months in adolescents with type 1 diabetes.

Learning Objective 2: Understand the influence of baseline demographic and psychosocial factors on the longitudinal development of HbA1c in adolescents with type 1 diabetes vis--vis both genders.

Purpose: The purposes of this study were to understand (1) longitudinal development of HbA1c over 18 months, and (2) the influence of baseline demographic and psychosocial factors on the longitudinal development of HbA1c in adolescents with type 1 diabetes vis-à-vis both genders.

Methods: Totally, 178 adolescents aged 13 to 18 years with type1 diabetes participated in an 18-month longitudinal study. At baseline, a structured questionnaire was used to collect demographic data, self-care behaviors, school support, resilience, adolescent- and parent-reported conflict diabetes-specific conflict, parental involvement in diabetes care, and quality of life (life satisfaction, diabetes-related worry, diabetes impact). HbA1c was gathered from medical records every 3 months after the administration of questionnaires. Generalized estimating equations were used to explore the trajectory stability of HbA1c and the influencing factors of the longitudinal development of HbA1c.

Results: The trajectory stability in girls (OR=39.18, 95% CI: 14.99-102.44) was higher than that in boys (OR=9.18, 95% CI: 3.64-23.20). The longitudinal development of HbA1c in girls was more stable than boys. High socioeconomic status (SES) and older age were important predictors of longitudinal development of decreasing HbA1c in boys. Middle SES, better self-care behaviors, low parental report parent-child conflict, and better life satisfaction were important predictors of longitudinal development of decreasing HbA1c in girls.

Conclusion: Intervention to have early good glycemic control in girls might be more cost-benefit than for boys. Improving self-care behaviors, life satisfaction, and decreasing parent child conflict should be emphasized for girls with type 1 diabetes. More studies are needed to discover the contributing psychosocial factors of longitudinal developmental in boys.