Journal of the Formosan Medical Association
Volume 109, Issue 7 , Pages 503-510, July 2010

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

  • An-Hsuan Chih

      Affiliations

    • Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • ,
  • Chyi-Feng Jan

      Affiliations

    • Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • ,
  • San-Ging Shu

      Affiliations

    • Department of Pediatric Endocrinology, Taichung Veterans General Hospital, Taichung, Taiwan
  • ,
  • Bee-Horng Lue

      Affiliations

    • Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
    • Department of Social Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Bee-Horng Lue, Department of Family Medicine, National Taiwan University Hospital, National Taiwan University, 7 Chung San South Road, Taipei 100, Taiwan

Received 2 March 2009; received in revised form 26 November 2009; accepted 1 December 2009.

Background/Purpose

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.

Key Words:  adolescents , blood sugar , hemoglobin A1c , self-efficacy , type 1 diabetes mellitus

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PII: S0929-6646(10)60084-8

doi:10.1016/S0929-6646(10)60084-8

Journal of the Formosan Medical Association
Volume 109, Issue 7 , Pages 503-510, July 2010