The associations of self-care, illness perceptions and psychological distress with metabolic control in Singaporean adolescents with Type 1 Diabetes Mellitus

Abstract

This is the first study to investigate the associations of self-care, illness perceptions and psychological distress with metabolic control in Singaporean adolescents with Type 1 Diabetes Mellitus (T1DM). A cross-sectional sample of 41 adolescents (aged 14–20) completed measures of self-care, illness perceptions and psychological distress. Demographic and medical information were also obtained. Glycated haemoglobin (HbA1c) levels were analysed both as continuous variable to explore dose–effect relationships and as a categorical variable to classify poor versus good metabolic control. A total of 65.9% (n = 27) of the adolescents had poor metabolic control (HbA1c <7.5%). Logistic regression modelling showed that poor metabolic control was associated with lower beliefs in treatment control (OR = 5.51), lower levels of foot care (OR = 3.81) and general diet (OR = 2.44) (total Nagelkerke R square = 78.6%). Similar associations for treatment control beliefs and diet have been noted when modelling HbA1c as a continuous variable. The results highlight the importance of the perceptions of treatment control and dietary self-care in diabetes outcomes for adolescents with T1DM. Future studies are warranted to replicate findings in larger samples and explore longitudinal associations.

Keywords

• self-care
• illness perceptions
• distress
• metabolic control
• adolescents with Type 1 diabetes