Glycemic Control in Youth with Type 1 Diabetes: Family Predictors and Mediators

OBJECTIVE: This study examined predictive and mediated relationships among youth perception of critical parenting, Child Behavior Checklist Externalizing Subscale (CBCL) externalizing problem scores, adherence, and (hemoglobin A(1c) HbA(1c)), in youth with type 1 diabetes from low socioeconomic status families. METHODS: Caregiver/youth dyads (n = 120) completed diabetes specific measures of family functioning regarding diabetes management and structured adherence interviews. Parents completed the CBCL, while assays of youth HbA(1c) were performed. Analyses were conducted using hierarchical linear regression. RESULTS: Combined measures predicted 44% of the variance in HbA(1c). Adherence partially mediated critical parenting and HbA(1c), while critical parenting and adherence mediated CBCL externalizing problem scores and HbA(1c). CBCL externalizing problem scores did not mediate critical parenting and HbA1(c). CONCLUSIONS: The presence of youth perceptions of critical parenting and youth externalizing behavior problems may interfere with adherence, leading to increases in HbA(1c).