Self-efficacy Affects Blood Sugar Control Among Adolescents With Type I Diabetes Mellitus
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.
No full text is available. To read the body of this article, please view the PDF online.
aDepartment of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
bDepartment of Pediatric Endocrinology, Taichung Veterans General Hospital, Taichung, Taiwan
cDepartment of Social Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Correspondence to: Dr Bee-Horng Lue, Department of Family Medicine, National Taiwan University Hospital, National Taiwan University, 7 Chung San South Road, Taipei 100, Taiwan
ABSTRACT