Executive functioning, treatment adherence, and glycemic control in children with type 1 diabetes

Kelly McNally, Jennifer Rohan, Jennifer Shroff Pendley, Alan Delamater, Dennis Drotar, Kelly McNally, Jennifer Rohan, Jennifer Shroff Pendley, Alan Delamater, Dennis Drotar

Abstract

Objective: The primary aim of the study was to investigate the relationship among executive functioning, diabetes treatment adherence, and glycemic control.

Research design and methods: Two hundred and thirty-five children with type 1 diabetes and their primary caregivers were administered the Diabetes Self-Management Profile to assess treatment adherence. Executive functioning was measured using the Behavior Rating Inventory of Executive Functioning and glycemic control was based on A1C.

Results: Structural equation modeling indicated that a model in which treatment adherence mediated the relationship between executive functioning and glycemic control best fit the data. All paths were significant at P < 0.01.

Conclusions: These results indicate that executive functioning skills (e.g., planning, problem-solving, organization, and working memory) were related to adherence, which was related to diabetes control. Executive functioning may be helpful to assess in ongoing clinical management of type 1 diabetes.

Figures

Figure 1
Figure 1
Hypothesized alternative models of the relationship between executive functioning, treatment adherence, and glycemic control. A: Glycemic control mediating the relationship between adherence and executive functioning. B: Adherence mediates the relationship between executive functioning and glycemic control.
Figure 2
Figure 2
Structural model with treatment adherence mediating the relationship between executive functioning and glycemic control. Standardized path coefficients are shown. DSMP-P, Diabetes Self-Management Profile, parent interview; DSMP-C, Diabetes Self-Management Profile, child interview. **P < 0.01.

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Source: PubMed

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