Self-Management Strategies in Emerging Adults With Type 1 Diabetes.
Elora Majumder, Fran R Cogen, Maureen Monaghan
PMID 26861574WHAT IT FOUND
Emerging adults with type 1 diabetes relied less on parents but reported better problem solving and communication over the first year after high school.
Their A1c rose and glucose monitoring fell.
Key findings
01Subscale scores changed over 12 months: Collaboration with Parents decreased from 9.45 to 6.85, and Diabetes Problem Solving increased from 16.00 to 17.20.
02Glycemic control worsened over 12 months: A1c increased from 8.00% to 8.50%, and BG monitoring decreased from 3.95 to 3.24 checks/day.
03Diabetes Problem Solving predicted A1c at 12 months after accounting for baseline A1c, family income, and insulin regimen.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Attrition was about 19%, and only participants with complete data at all three time points were analysed, so higher-risk youth may be underrepresented. The sample was mostly Caucasian and from high socioeconomic status families, and few participants entered full-time employment, so the results may not generalise to lower-income or non-white emerging adults. The follow-up period was only 1 year, which is short for a transition that may continue longer. Effect sizes were modest. This was an observational study of self-report and chart data, not a tested intervention, so it cannot show that teaching problem solving improves glycemic control.
Declared interests
The supplied text lists NIH extramural research support. It does not include a conflicts-of-interest statement.
The easy way to misread this
Do not read the problem-solving finding as proof that teaching problem solving improves A1c. This was an observational study, not a tested intervention, so it cannot show that the association causes better control.