Executive Function Predicting Longitudinal Change in Type 1 Diabetes Management During the Transition to Emerging Adulthood
Executive Function Predicting Longitudinal Change in Type 1 Diabetes Management During the Transition to Emerging Adulthood
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DOI：
10.2337/dc18-0351
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发表时间：
2018-11-01
期刊：
影响因子：
16.2
通讯作者：
Murray, Mary
中科院分区：
文献类型：
--
作者：
Berg, Cynthia A.;Wiebe, Deborah J.;Murray, Mary
目的本研究的目的是检验1)青少年的血糖控制和对1型糖尿病治疗方案的依从性是否在青春期晚期到成年早期的过渡期间恶化，以及2)青少年的执行功能（EF），通过表现和EF自我报告的问题来衡量，是否预测这些变化（在控制一般智力后）。研究设计与方法对患有1型糖尿病的高中毕业生（236例，平均年龄17.74岁）进行每年3个时间点的评估。作为基线，在高中的最后一年，参与者完成了EF问题的自我报告测量和基于表现的EF和一般智力（智商）测量。血糖控制是根据HbA（1c）检测试剂盒收集的结果确定的，青少年报告了他们在所有三个时间点的依从性。结果shba （1c）在三个时间点显著升高，依从性下降。EF表现与基线时的依从性或HbA（1c）无关，也与依从性随时间的变化无关。然而，在控制智商的情况下，更好的EF表现预示着HbA（1c）随时间的缓慢增长（即斜率）。青少年自我报告的EF问题与基线时较差的血糖控制和较差的依从性（即截距）有关，但它们不能预测HbA（1c）或依从性随时间的变化（即斜率）。结论EF测试表现的稳定性可能是在向初成年过渡期间维持较好血糖控制的一种资源。对这种EF能力的评估可能有助于识别在这一转变过程中血糖控制恶化风险最大的个体。
OBJECTIVEThe objective of this study was to examine 1) whether teens' glycemic control and adherence to type 1 diabetes treatment regimen worsen during the transition from late adolescence to emerging adulthood, and 2) whether teens' executive function (EF), as measured by performance and self-reported problems with EF, is predictive of these changes (after controlling for general intelligence).RESEARCH DESIGN AND METHODSHigh school seniors with type 1 diabetes (N = 236; mean age 17.74 years) were assessed at three yearly time points. At baseline, during the senior year of high school, participants completed a self-report measure of problems with EF and performance-based measures of EF and general intelligence (IQ). Glycemic control was determined on the basis of results collected from HbA(1c) assay kits, and teens reported their adherence at all three time points.RESULTSHbA(1c) increased significantly across the three time points and adherence declined. EF performance was not associated with adherence or HbA(1c) at baseline, nor with changes in adherence over time. However, better EF performance predicted slower increases in HbA(1c) over time (i.e., slope) while controlling for IQ. Teens' self-reported problems with EF were associated with worse glycemic control and poorer adherence at baseline (i.e., intercept), but they did not predict changes in either HbA(1c) or adherence over time (i.e., slope).CONCLUSIONSAbilities involved in performance on EF tests may be one resource for maintaining better glycemic control during the transition to emerging adulthood. Assessment of such EF abilities may allow for the identification of individuals who are most at risk for deterioration of glycemic control during this transition.