青少年1型糖尿病患者行为自我控制与血糖水平：家庭冲突和自我管理行为的系列中介作用

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-09-07 DOI:10.1016/j.diabres.2025.112463

Luiza V. Mali , Jamil A. Malik , Janine Sanchez , Jennifer S. Pendley , Caroline Gillenson , Kimberly L. Klages , Amy E. Noser , Lawrence M. Dolan , Alan M. Delamater

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引用次数: 0

摘要

目的探讨家庭冲突（FC）和糖尿病自我管理行为（SMB）在青少年1型糖尿病（T1D）行为自我控制（BSC）与血糖水平关系中的中介作用。我们预测BSC可以直接或间接地通过降低FC和增加SMB来改善血糖水平，无论是横向还是纵向。方法对172例T1D青少年（年龄16岁）进行为期3年的随访。每年采集两次血液样本，在中心实验室进行糖化血红蛋白分析。青少年分别在基线、12、24和36个月完成行为自我控制量表，青少年和父母分别完成糖尿病家庭冲突量表和糖尿病自我管理量表。结果测试了10个独立模型（5个自我报告的FC和SMB， 5个父母报告的FC和SMB），估计每个时间点的纵向（即基线BSC→12个月FC→24个月SMB→30和36个月HbA1c）和横断面串行中介。所有模型均支持显著的序列调节，表明BSC通过降低FC和增加SMB来降低HbA1c。结论sbsc具有影响血糖水平的巨大潜力，因为它与较低的HbA1c直接相关，并有助于通过降低青春期后期的FC和增加SMB来优化血糖水平。

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Behavioral self-control and glycemic levels in youth with type 1 diabetes: serial mediation by family conflict and self-management behaviors

Aims

Examine the mediating roles of family conflict (FC) and diabetes self-management behaviors (SMB) in the relationship between behavioral self-control (BSC) and glycemic levels in adolescents with type 1 diabetes (T1D). We predicted that BSC would improve glycemic levels directly and indirectly by decreasing FC and increasing SMB, both cross-sectionally and longitudinally.

Methods

172 adolescents (M age = 16 years) with T1D were followed for three years at three medical centers. Blood samples were obtained twice yearly and analyzed for HbA1c in a central laboratory. The Behavioral Self-Control Scale was completed by youth, and the Diabetes Family Conflict Scale and Diabetes Self-Management Profile were completed by youth and parents at baseline, 12, 24, and 36 months.

Results

Ten independent models were tested (five for self-reported and five for parent-reported FC and SMB), estimating longitudinal (i.e., baseline BSC → 12-month FC → 24-month SMB → 30 and 36-month HbA1c) and cross-sectional serial mediations for each timepoint. All models supported significant serial mediations indicating that BSC decreases HbA1c through decreased FC and increased SMB.

Conclusions

BSC has substantial potential for influencing glycemic levels as it is directly associated with lower HbA1c and helps to optimize glycemic levels by decreasing FC and increasing SMB during late adolescence.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.