Self-Management of Type 1 Diabetes During Adolescence

青春期 1 型糖尿病的自我管理

• 批准号: 7266238
• 负责人: Dennis D Drotar
• 金额: $ 48.38万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7266238
• 关键词: Address; Adherence; Adolescence; Adolescent; Behavior Therapy; Behavioral; Blood Glucose; Caring; Chronic Disease; Clinical; Communication; Complications of Diabetes Mellitus; Conflict (Psychology); Cross-Sectional Studies; Data; Deterioration; Development; Diabetes Mellitus; Family; Frequencies; Hand; Hyperglycemia; Hypoglycemia; Individual; Individual Differences; Insulin-Dependent Diabetes Mellitus; Intervention; Lead; Mediator of activation protein; Metabolic Control; Methods; Modeling; Morbidity - disease rate; Outcome; Parents; Pattern; Preventive Intervention; Process; Prospective Studies; Public Health; Range; Research; Risk; Self Management; Testing; Time; base; behavior influence; blood glucose regulation; clinically relevant; clinically significant; design; diabetes management; family influence; follow-up; glycemic control; health care service utilization; improved; predictive modeling; prevent; prospective; psychologic; therapy development; trend; young adult

DESCRIPTION (provided by applicant): 240 young adolescents with Type 1 diabetes (DM1) will be studied in a three year prospective study that will include a comprehensive assessment of family and adolescent behavioral predictors and mediators of self- management, adherence to treatment, and DM1-related morbidity. The proposed study has the following specific aims: 1) to assess individual differences in patterns of self-management and adherence of DM1 from early to middle adolescence; 2) identify family and adolescent behavioral influences on change in self- management and adherence; and 3) to document the consequences of self-management and adherence on blood sugar control, hyperglycemic episodes, and health care utilization. In order to accomplish these aims, a model of family and adolescent influences on self-management and adherence will be tested using data analytic methods that characterize individual trajectories of self-management over time. The following hypotheses will be tested: 1) quality of family communication and family support of diabetes management and autonomy will influence adolescents' behavioral autonomy and autonomy with respect to DM1 self- management and adherence; 2) adolescents who demonstrate adaptive behavioral and diabetes-related autonomy and who are supported in their diabetes management by their parents will be more likely to develop effective, autonomous self-management and adherence; 3) adaptive self-management and adherence to DM1 treatment will enhance blood sugar control, reduce frequency of hypoglycemia, and health care utilization. The proposed study will generate important, clinically relevant scientific data concerning the causes and consequences of self-management of DM1 diabetes during early adolescence. Information from the proposed study will facilitate the development of preventive interventions to address problem patterns of DM1 self-management among young adolescents in order to lessen the deterioration in DM1-related treatment adherence and glycemic control that often occurs during adolescence. The development of targeted interventions based on data from the proposed study will have public health significance for enhancement of blood sugar control and reduction of DM1 related morbidity in adolescents and young adults.

描述（由申请人提供）：将在三年的前瞻性研究中研究240名患有1型糖尿病（DM1）的年轻青少年（DM1），其中包括对家庭和青少年行为预测因素以及自我管理，遵守治疗以及与DM1相关的发病率的全面评估。拟议的研究具有以下具体目的：1）评估从青春期早期至中期DM1的自我管理模式和依从性的个体差异； 2）确定家庭和青少年行为对自我管理和依从性变化的影响； 3）记录自我管理和遵守对血糖控制，高血糖事件和医疗保健利用的后果。为了实现这些目标，将使用数据分析方法来测试家庭和青少年对自我管理和依从性的影响模型，该方法表征了随着时间的推移自我管理的个体轨迹。将检验以下假设：1）家庭交流的质量以及对糖尿病管理和自治的家庭支持的质量将影响青少年在DM1自我管理和依从性方面的行为自治和自治； 2）表现出适应性行为和与糖尿病相关的自主权并得到父母在糖尿病管理中得到支持的青少年更有可能发展有效，自主的自我管理和依从性； 3）自适应自我管理和对DM1治疗的依从性将增强血糖控制，降低低血糖症的频率和医疗保健利用。拟议的研究将产生有关青春期早期DM1糖尿病自我管理的原因和后果的重要的，临床上相关的科学数据。拟议研究的信息将促进预防干预措施的发展，以解决年轻青少年之间DM1自我管理的问题模式，以减少在青少年期间经常发生的与DM1相关的治疗依从性和血糖控制的恶化。基于拟议研究的数据的有针对性干预措施的发展将具有公共健康意义，以增强血糖控制和降低DM1与青少年和年轻人相关的发病率。