Journal of the Formosan Medical Association (Jul 2010)

Self-efficacy Affects Blood Sugar Control Among Adolescents With Type I Diabetes Mellitus

  • An-Hsuan Chih,
  • Chyi-Feng Jan,
  • San-Ging Shu,
  • Bee-Horng Lue

DOI
https://doi.org/10.1016/S0929-6646(10)60084-8
Journal volume & issue
Vol. 109, no. 7
pp. 503 – 510

Abstract

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Self-management is crucial to diabetes control. To investigate the effectiveness of self-management in reaching target hemoglobin A1c (HbA1c) level, we conducted a study among Taiwanese adolescents with type 1 diabetes mellitus (DM). Methods: Patients aged 12–20 years with type 1 DM participated in an annual integrated DM care clinic at a medical center in Taiwan. All patients completed a questionnaire that included demographic data and self-efficacy measured by the Perceived Diabetes Self-Management Scale (PDSMS) in February 2008. Laboratory tests were also done at the same visit. The target HbA1c was < 7.0% in accordance with the general standard of the American Diabetes Association for patients with type 1 DM. Logistic regression analysis was used to explore the relationship between age, sex, duration of diabetes, PDSMS score, and HbA1c level. Results: Fifty-two patients were enrolled. The mean age was 16.0 ± 2.4 years, and mean HbA1c level was 8.6 ± 1.6%. Pearson correlation analysis showed a positive correlation between body mass index and preprandial blood sugar level (r = 0.297, p < 0.05). Negative correlations were found between PDSMS scores and duration of diabetes (r = −0.365, p < 0.01) as well as HbA1c level (r = −0.295, p < 0.05). Logistic regression analysis demonstrated that sex and PDSMS scores significantly influenced glycemic control. In multivariate logistic regression analysis, patients with higher PDSMS scores were 1.63 times (95% confidence interval = 1.03–2.59) more likely to reach target diabetes control after adjustment for other variables. Male patients also had a higher probability (odds ratio = 19.80, 95% confidence interval = 1.34–291.93) of reaching target diabetes control. Conclusion: This study demonstrates that adolescents with type 1 DM and higher self-efficacy, especially males, have a higher probability of reaching target diabetes control.

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