Self-efficacy affects blood sugar control among adolescents with type I diabetes mellitus

J Formos Med Assoc. 2010 Jul;109(7):503-10. doi: 10.1016/S0929-6646(10)60084-8.


Background/purpose: Self-management is crucial to diabetes control. To investigate the effectiveness of self-management in reaching target hemoglobin A1c (HbA1c) level, we conducted a study among Taiwanese adolescents with type 1 diabetes mellitus (DM).

Methods: Patients aged 12-20 years with type 1 DM participated in an annual integrated DM care clinic at a medical center in Taiwan. All patients completed a questionnaire that included demographic data and self-efficacy measured by the Perceived Diabetes Self-Management Scale (PDSMS) in February 2008. Laboratory tests were also done at the same visit. The target HbA1c was < 7.0% in accordance with the general standard of the American Diabetes Association for patients with type 1 DM. Logistic regression analysis was used to explore the relationship between age, sex, duration of diabetes, PDSMS score, and HbA1c level.

Results: Fifty-two patients were enrolled. The mean age was 16.0 +/- 2.4 years, and mean HbA1c level was 8.6 +/- 1.6%. Pearson correlation analysis showed a positive correlation between body mass index and preprandial blood sugar level (r = 0.297, p < 0.05). Negative correlations were found between PDSMS scores and duration of diabetes (r = -0.365, p < 0.01) as well as HbA1c level (r = -0.295, p < 0.05). Logistic regression analysis demonstrated that sex and PDSMS scores significantly influenced glycemic control. In multivariate logistic regression analysis, patients with higher PDSMS scores were 1.63 times (95% confidence interval = 1.03-2.59) more likely to reach target diabetes control after adjustment for other variables. Male patients also had a higher probability (odds ratio = 19.80, 95% confidence interval = 1.34-291.93) of reaching target diabetes control.

Conclusion: This study demonstrates that adolescents with type 1 DM and higher self-efficacy, especially males, have a higher probability of reaching target diabetes control.

MeSH terms

  • Adolescent
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism*
  • Child
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / therapy
  • Educational Status
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Logistic Models
  • Male
  • Self Efficacy*
  • Sex Factors
  • Surveys and Questionnaires
  • Taiwan
  • Treatment Outcome
  • Young Adult


  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin