Key result
Specific cognitive and emotional aspects of self-regulation were significantly correlated with the number of insulin boluses per day (e.g., attentional shift r=-0.36, p<0.05) in adolescents with T1D.
Why the study?
The cognitive and emotional demands of T1D management on developing adolescent self-regulation may contribute to poor glycemic control, but the relationship between specific aspects of self-regulation and T1D outcomes is unclear.
Cross-Sectional (n=56)
Effect estimate: r = -0.36 for attentional shift
p-value: p=<0.05
Specific cognitive and emotional aspects of self-regulation are associated with diabetes management behaviors, such as insulin bolusing, in adolescents with Type 1 Diabetes.
SR deficits may underlie poor glycemic control in T1D adolescents; leaves open whether targeted SR interventions improve outcomes.
Adolescents have the poorest blood sugar control compared to other age groups (Foster et al., 2019). Adolescence is also a period of developing self-regulation (SR) abilities, defined as the ability to manage thoughts, emotions, and actions to achieve a desired outcome (Eisenberg, 2019). The attention, planning, and decision making required for optimal T1D management is both cognitively and emotionally draining on the developing system of adolescents, which may be contributing to difficultly with diabetes management and glycemic control (Duke & Harris, 2014). This project examines the relationship between specific aspects of SR, including executive functions and affect; and T1D outcomes, including diabetes management behaviors and HbA1c. As part of an ongoing clinical trial (NCT03688919), adolescents (13-17 yo) diagnosed with T1D for ≥ 6 months with HbA1c ≥ 7.0 were recruited from diabetes clinics (n = 56). They completed baselines measures of self-regulation including the Behavior Rating Inventory of Executive Functioning, Positive and Negative Affect Schedule for Children, and self-reported diabetes management behaviors. HbA1c was also collected. Parent reported cognitive aspects of SR were negatively related to number of insulin boluses per day, specifically attentional shift, task completion and planning, (r(47)= -.36, -.31, -.33 respectively, all p < .05); however, no association was found between inhibition, self-monitoring, and working memory and diabetes outcomes (p >.05). With regard to emotional aspects of SR, positive affect, including excitement, enthusiasm, pride, determination, and activation (r(47)= .34, .33, .36, .31, .29 respectively, all p < .05) were positively related to number of insulin boluses per day. No aspects of SR were related to blood glucose testing behaviors or HbA1c. SR in adolescents may be an important factor in successful T1D management. With evidence-based approaches, SR may be an optimal target for intervention. Disclosure D. Albright: None. H.O. Riley: None. E. Fredericks: None. J. Sturza: None. S. Lo: None. K.M. Clark: None. J.M. Lee: Advisory Panel; Self; Goodrx. Consultant; Self; T1D Exchange. Research Support; Self; Lenovo. A.L. Miller: None. Funding National Institutes of Health (NCT03688919)
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Albright et al. (2020) conducted a cross-sectional in Type 1 Diabetes (n=56). Self-regulation (executive functions and affect) was evaluated on Diabetes management behaviors (number of insulin boluses per day) and HbA1c (r = -0.36 for attentional shift, p=<0.05). Specific cognitive and emotional aspects of self-regulation were significantly correlated with the number of insulin boluses per day (e.g., attentional shift r=-0.36, p<0.05) in adolescents with T1D.
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