Predictors of metabolic control among adolescents with diabetes: a 4-year longitudinal study

J Pediatr Psychol. 2009 Apr;34(3):254-70. doi: 10.1093/jpepsy/jsn079. Epub 2008 Jul 30.


Objective: To employ a risk and resistance framework to examine changes in metabolic control over early to middle adolescence.

Methods: We interviewed 70 girls and 62 boys (mean age 12 years) annually for 4 years. Risk and resistance factors, including demographics, disease-related variables, self-care behavior, and psychosocial variables were assessed. Hemoglobin A1c was obtained from medical records.

Results: Multilevel modeling showed metabolic control deteriorated with age. Self-care behavior interacted with age to predict the decline, such that self-care was more strongly related to poor metabolic control for older adolescents. Eating disturbances, depression, and peer relations were related to poor metabolic control, whereas good family relations were related to better metabolic control for girls.

Conclusions: Independent risk factors for poor metabolic control included poor self-care, disturbed eating behavior, depression, and peer relations; parental support was an independent resistance factor for girls. Future research should examine mechanisms by which these relations emerge.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Biomarkers / blood
  • Child
  • Depression* / complications
  • Depression* / psychology
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diabetes Mellitus, Type 1 / psychology*
  • Feeding Behavior* / psychology
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Longitudinal Studies
  • Male
  • Parent-Child Relations
  • Peer Group
  • Risk Assessment
  • Self Care*
  • Surveys and Questionnaires


  • Biomarkers
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human