General and diabetes-specific stress in adolescents with type 1 diabetes

Diabetes Res Clin Pract. 2017 Aug:130:1-8. doi: 10.1016/j.diabres.2017.05.003. Epub 2017 May 16.

Abstract

Background: Type 1 diabetes (T1D) is one of the most common chronic health conditions in adolescents in the United States. Adherence to the recommended treatment regimen has been reported as a source of stress for adolescents.

Aim: The purpose of this study was to examine the associations among general and diabetes-specific stress and glycemic control (HbA1c), self-management, and diabetes-specific quality of life (QOL) in adolescents with T1D.

Methods: A secondary analysis of baseline data (N=320) from a randomized controlled trial was conducted. Adolescents completed validated measures of general and diabetes-specific stress, self-management, and diabetes-specific QOL. HbA1c levels were obtained from medical records.

Results: Over 50% of the sample scored at or above criteria for high general and diabetes-specific stress. Higher general and diabetes-specific stress was significantly associated with higher HbA1c, poorer self-management activities, and lower diabetes-specific QOL. Diabetes-specific stress accounted for a significant proportion of the variance in HbA1c, while general stress did not. General and diabetes-specific stress accounted for 40% of the variance in diabetes-specific QOL.

Conclusions: General and diabetes-specific stress are common in adolescents with T1D. Healthcare providers must be mindful of the sources of stress that adolescents with T1D face on a daily basis. General stress and diabetes-specific stress should be differentiated and may require different interventions to improve coping and outcomes.

Keywords: Glycemic control; Mental health; Quality of life; Stress; Type 1 diabetes.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Blood Glucose
  • Child
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / psychology*
  • Diabetes Mellitus, Type 1 / therapy
  • Female
  • Humans
  • Male
  • Quality of Life
  • Self Care
  • Stress, Psychological / blood
  • Stress, Psychological / diagnosis*
  • Stress, Psychological / prevention & control

Substances

  • Blood Glucose