Modelling individual, parental and peer factors to glycaemic control in adolescents with type 1 diabetes: A prospective study

Abstract Aim To construct a model addressing the pathways from baseline diabetes distress, attribution of peer reactions, parenting style and 3‐month self‐management to 6‐month glycated haemoglobin levels in adolescents with type 1 diabetes. Design A prospective design was adopted. Methods A total of 177 adolescents aged 10–19 with type 1 diabetes were enrolled from four hospitals in Taiwan. Diabetes distress, attribution of peer reactions and parenting style were collected at baseline, self‐management was collected at the third month and glycated haemoglobin levels were collected at the sixth month. Data were collected from May 2015–June 2016. Results Baseline diabetes distress and 3‐month self‐management directly affected 6‐month glycated haemoglobin levels. Baseline attribution of peer reactions directly affected baseline diabetes distress and 3‐month self‐management; also, it indirectly affected 6‐month glycated haemoglobin levels through 3‐month self‐management. Baseline parenting style directly affected baseline diabetes distress, baseline attribution of peer reactions, 3‐month self‐management and 6‐month glycated haemoglobin levels; it also indirectly affected 6‐month glycated haemoglobin levels through baseline diabetes distress and 3‐month self‐management. Conclusion A model simultaneously incorporating individual, parental and peer factors to glycaemic control in adolescents with type 1 diabetes has been constructed. Improving diabetes distress and self‐management should be essential strategies to improve glycaemic control in adolescents with type 1 diabetes. Encouraging adolescents with type 1 diabetes to communicate openly with peers about diabetes care and educating their parents to provide more responsive and autonomy‐encouraging parenting style might be vital strategies to improve diabetes distress, 3‐month self‐management and glycaemic control. Impact Individual, parental and peer factors should be simultaneously considered to improve glycaemic control in adolescents with type 1 diabetes. Nurses should evaluate these factors to tailor interventions improving glycaemic control in adolescents with type 1 diabetes.