Self-Management Strategies in Emerging Adults With Type 1 Diabetes.

INTRODUCTION We examined changes in self-management behaviors after high school graduation in a cohort of emerging adults with type 1 diabetes. METHODS Sixty-four emerging adults reported on diabetes self-management behaviors at three time points over a 1-year period. Glycemic control and blood glucose monitoring frequency data were collected from the medical chart. RESULTS Collaboration with parents decreased, diabetes problem-solving and communication increased, and glycemic control worsened during the first year after high school (p < .05). Problem solving appeared to be protective against worsening glycemic control; higher baseline diabetes problem solving significantly predicted better glycemic control at the 1-year follow-up. DISCUSSION Emerging adults demonstrate increased independence in diabetes problem solving and communication with health care providers in the year after high school. Problem-solving skills may help emerging adults adapt type 1 diabetes self-care in response to unpredictable schedules after high-school, and promoting these skills may prevent deteriorations in glycemic control during this risky period.

[1]  D. Dunger,et al.  Clinical and psychological course of diabetes from adolescence to young adulthood: a longitudinal cohort study. , 2001, Diabetes care.

[2]  Joyce M Lee,et al.  The Promise and Peril of Mobile Health Applications for Diabetes and Endocrinology , 2013, Pediatric diabetes.

[3]  J. Arnett Emerging adulthood. A theory of development from the late teens through the twenties. , 2000, The American psychologist.

[4]  R. Whittemore,et al.  Self-Management in Early Adolescence and Differences by Age at Diagnosis and Duration of Type 1 Diabetes , 2014, The Diabetes educator.

[5]  M. Sadler,et al.  Validation of a structured interview for the assessment of diabetes self-management. , 2000, Diabetes care.

[6]  R. Whittemore,et al.  Self-Management as a Mediator of Family Functioning and Depressive Symptoms With Health Outcomes in Youth With Type 1 Diabetes , 2014, Western journal of nursing research.

[7]  K. Knafl,et al.  Determining Content Validity of a Self-Report Instrument for Adolescents Using a Heterogeneous Expert Panel , 2007, Nursing research.

[8]  Donna S. Eng,et al.  Mobile Health Applications for Diabetes and Endocrinology: Promise and Peril? , 2013 .

[9]  Aesha Drozdowski,et al.  Standards of medical care in diabetes. , 2004, Diabetes care.

[10]  D. Neumark-Sztainer,et al.  Emerging Adulthood and College‐aged Youth: An Overlooked Age for Weight‐related Behavior Change , 2008, Obesity.

[11]  Shelagh A. Mulvaney,et al.  Development and validation of the diabetes adolescent problem solving questionnaire. , 2014, Patient Education and Counseling.

[12]  M. S. Kirkman,et al.  Type 1 Diabetes Through the Life Span: A Position Statement of the American Diabetes Association , 2014, Diabetes Care.

[13]  J. Fortenberry,et al.  Initial findings: primary diabetes care responsibility among emerging adults with type 1 diabetes post high school and move out of parental home. , 2013, Child: care, health and development.

[14]  K. Knafl,et al.  A New Self-Report Measure of Self-Management of Type 1 Diabetes for Adolescents , 2009, Nursing research.

[15]  A. Peters,et al.  Let’s Empower and Prepare (LEAP): Evaluation of a Structured Transition Program for Young Adults With Type 1 Diabetes , 2015, Diabetes Care.

[16]  E. Storch,et al.  Validity and reliability of an adolescent and parent rating scale of type 1 diabetes adherence behaviors: the Self-Care Inventory (SCI). , 2009, Journal of pediatric psychology.

[17]  S. Crawford,et al.  Self-management of Type 1 Diabetes Across Adolescence , 2011, The Diabetes educator.

[18]  A. Peters,et al.  Diabetes Care for Emerging Adults: Recommendations for Transition From Pediatric to Adult Diabetes Care Systems , 2011, Diabetes Care.

[19]  R. Hamman,et al.  The SEARCH for Diabetes in Youth Study: Rationale, Findings, and Future Directions , 2014, Diabetes Care.

[20]  Jasmin Divers,et al.  Prevalence of Diabetes in U.S. Youth in 2009: The SEARCH for Diabetes in Youth Study , 2014, Diabetes Care.

[21]  David V. Power,et al.  Standards of Medical Care in Diabetes: Response to position statement of the American Diabetes Association , 2006 .

[22]  Kathleen A Knafl,et al.  Changing patterns of self-management in youth with type I diabetes. , 2006, Journal of pediatric nursing.

[23]  D. Dunger,et al.  Poor prognosis of young adults with type 1 diabetes: a longitudinal study. , 2003, Diabetes care.

[24]  L. Laffel,et al.  Transition to Adult Care for Youth with Type 1 Diabetes , 2012, Current Diabetes Reports.

[25]  Neil R. Powe,et al.  Association of Social Problem Solving With Glycemic Control in a Sample of Urban African Americans With Type 2 Diabetes , 2006, Journal of Behavioral Medicine.

[26]  D. Cicchetti,et al.  The transition to adulthood as a critical juncture in the course of psychopathology and mental health , 2004, Development and Psychopathology.

[27]  S. Corathers,et al.  Health-System-Based Interventions to Improve Care in Pediatric and Adolescent Type 1 Diabetes , 2015, Current Diabetes Reports.