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Resilient outcomes linked to diabetes-related strengths in adolescents
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Adolescents with type 1 diabetes who develop strong self-monitoring blood glucose strategies, achieve HbA1c within the target range and report a higher general quality of life have more resilient diabetes outcomes, according to study findings published in Diabetes Care.
Marisa E. Hilliard, PhD, of the section of psychology, department of pediatrics, Baylor College of Medicine and Texas Children’s Hospital in Houston, and colleagues evaluated data from the Diabetes MILES Youth Survey–Australia on 471 adolescents (mean age, 16 years; 62% girls) with type 1 diabetes (mean duration, 7 years; 53% reported using an insulin pump) to determine the associations between diabetes strengths and resilient outcomes in the context of psychological and family risk factors.
Diabetes-related strengths were assessed using the Diabetes Strengths and Resilience Measure for Adolescents (DSTAR-Teen). Participants completed surveys to report on their diabetes-related strengths (depressive/anxiety symptoms, family conflict) and resilience outcomes (self-monitoring blood glucose, general quality of life, HbA1c).
Mean self-reported HbA1c was 8.2%, and 38.7% had HbA1c within the target range. The mean number of SMBG checks per day was 2.1, and a mean of four or more checks per day was reported by 75.7% of participants. Participants reported a mean general quality-of-life rating of 6.8. All three resilient outcomes of SMBG frequency of four or more checks per day, HbA1c of 7.5% and general quality-of-life rating of at least seven were achieved by 26.7% of all participants.
Fewer depressive symptoms, fewer anxiety symptoms and less diabetes family conflict were associated with higher DSTAR-Teen scores and greater strengths were associated with more resilient outcomes.
Participants who reported four or more SMBG checks per day had higher DSTAR-Teen scores compared with those reporting less frequent checks (P < .001). Further, higher DSTAR-Teen scores were found among participants with HbA1c within-target compared with those with HbA1c above target (P < .001) and among those with general quality-of-life scores of at least 7 compared with those with scores less than 7 (P < .001).
“In the context of psychosocial and family risks, strengths appear to play a related but distinct role in self-management, glycemic control and general [quality of life],” the researchers wrote. “Monitoring and building diabetes strengths may support the development of resilience. Measuring youth strengths and discussing them as part of routine medical or psychosocial care may help providers guide youth and families in building on their existing capacities to overcome challenges. ... Resilient outcomes — although not easy to attain in the face of diabetes-related challenges — appear to be achievable. Moreover, even in the context of powerful risk factors at both the individual and family levels, diabetes-related strengths hold a great deal of potential to promote these optimal diabetes outcomes during the vulnerable adolescent years.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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