Résumé :
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ObjectiveDetriments in quality of life (QOL) may contribute to the common, costly decline in adolescents’ type 1 diabetes management and control, yet we know little about how this might happen.MethodsParticipants were 150 adolescents (age 13–18) with type 1 diabetes and their parents. We constructed a latent QOL variable from a multi-informant, multi-domain assessment when participants entered the study. The QOL variable was examined in relation to prospective assessments of diabetes management (blood glucose monitoring frequency, BGM) and control (hemoglobin A1c). We used an indirect path model to test the links among these variables, using bias-corrected bootstrapping.ResultsPoorer QOL at baseline was indirectly linked with higher A1c at 12 months via less frequent BGM obtained at 6 months (b = -0.01, 95% CI = -0.025, -0.004, p < 0.05). Older age (b = -0.32), longer diabetes duration (b = -0.07), and insulin delivery via injections versus the insulin pump (b = 0.67) were covariates of less frequent BGM, and unmarried caregiver status was associated with higher A1c (b = -0.76), all ps < 0.05.ConclusionsIn this study, poorer QOL acted as a barrier to effective diabetes management, subsequently altering diabetes control.Practice implicationsEfforts to monitor and enhance QOL may hold promise for improving adolescents’ diabetes outcomes in the future.
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