Abstract
Purpose
The aim of the study was to establish whether suboptimal self-management explains the relationship between stressful life events and hemoglobin A1c (HbA1c) in adolescents with type 1 diabetes and whether these relationships differ across race/ethnicity.
Methods
Participants were 6,368 adolescents enrolled in the U.S. T1D Exchange registry. The outcome, HbA1c, was chart-based; predictors and covariates were self-reported. Moderated mediation was tested using Mplus, adjusting for gender, age, insulin treatment modality, and socioeconomic status.
Results
Higher frequency of missed insulin doses and lower frequency of daily self-monitoring of blood glucose partially explained the relationship between past-year stressful life events and higher HbA1c. Mediation by self-monitoring of blood glucose was detected for those who identified as white non-Hispanic and Hispanic, but not for those who identified as African American.
Conclusions
In adolescents, there is some evidence for a behavioral mechanism in the stressor–HbA1c relationship. African American youth may be more resilient against some detrimental behavioral effects of stressors.
The aim of the study was to establish whether suboptimal self-management explains the relationship between stressful life events and hemoglobin A1c (HbA1c) in adolescents with type 1 diabetes and whether these relationships differ across race/ethnicity.
Methods
Participants were 6,368 adolescents enrolled in the U.S. T1D Exchange registry. The outcome, HbA1c, was chart-based; predictors and covariates were self-reported. Moderated mediation was tested using Mplus, adjusting for gender, age, insulin treatment modality, and socioeconomic status.
Results
Higher frequency of missed insulin doses and lower frequency of daily self-monitoring of blood glucose partially explained the relationship between past-year stressful life events and higher HbA1c. Mediation by self-monitoring of blood glucose was detected for those who identified as white non-Hispanic and Hispanic, but not for those who identified as African American.
Conclusions
In adolescents, there is some evidence for a behavioral mechanism in the stressor–HbA1c relationship. African American youth may be more resilient against some detrimental behavioral effects of stressors.
| Original language | English |
|---|---|
| Pages (from-to) | 282-285 |
| Journal | Journal of Adolescent Health |
| Volume | 67 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2020 |