Self-Efficacy Linked with Greater Diabetes Control in Adolescents
A recent study found that there was a significant relationship between self-efficacy for disease control and the level of glycemic control.
Adolescents with higher levels of self-efficacy have improved health outcomes and more control over their type 1 diabetes, according to a new study published in the International Journal of Psychology.1 The authors said the study findings support using interventions which promote self-efficacy in this patient population.
Self-Efficacy Linked with Greater Diabetes Control in Adolescents / Africa Studio - stock.adobe.com
Over 300000 children and adolescents in the United States have type 1 diabetes, which makes it one of the most prevalent chronic diseases in this age group.2 Because type 1 diabetes requires daily management, many pediatric patients experience a shock when being diagnosed that can impact development. However, research has shown self-efficacy—which is defined as personal confidence in one’s ability to cope with specific situations—can influence healthy behaviors.
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“There is positive evidence that self-efficacy beliefs alone change evolutive development and influence healthy behaviors acquired by the individual in several applied domains, many of them in the field of preventive or primary care,” the authors wrote. “Diabetes management requires behavioral change in the performance of daily self-care activities, and therefore, high levels of self-efficacy have been related to correct diabetes self-care.”
Investigators from the University of Salamanca and the University of Córdoba conducted a study to analyze the impact of domain-specific self-efficacy for type 1 diabetes control in children and adolescents and its relationship with different indicators of glycemic control over time. The study cohort included 205 patients between the ages of 6 and 18 years who had type 1 diabetes and currently used a continuous glucose monitor (CGM).
Participants took a descriptive, randomized longitudinal survey during 4 routine reviews with a physician every 6 months between January 2022 and September 2023. Measurements were also taken at reviews, including assessments of glycemic control and self-efficacy for diabetes management. Glycemic control was determined by CGM reports and self-efficacy for diabetes was determined by the Self-Efficacy for Diabetes Self-Management (SEDM-SF) questionnaire, which asks about perceived self-assurance in 10 situations related to diabetes management.
The study found that there was a significant relationship between self-efficacy for disease control and the level of glycemic control. Self-efficacy had a significantly positive relationship with the percentage of time that the CGM device was active and the time that glucose was in range in adolescents. However, in children under the age of 14, self-efficacy beliefs did not show a direct relationship with the biomedical indicators. In adolescents, the effect of self-efficacy on glycemic indicators remained significant after 6 months.
Additionally, adolescents had worse glycemic adjustment compared to children. Investigators said this is likely due to a gradual transfer of disease management from parents to adolescents as they get older. They added that intervention programs should address diabetes management and lifestyle habits necessary for health promotion in this population.
“Overall, our results show how in adolescents, the maintenance of high confidence in the ability to manage type 1 diabetes can help adolescents persevere in the face of adversity and strive to follow clinical indications and thus maintain glycemic control indicators within healthy parameters over time,” the authors concluded. Network analyses between self-efficacy items and biomedical indicators allowed us to create recommendations for targeting interventions for adolescents in two directions: adhering to both medical indications for insulin control and healthy behavioral patterns around food choices and physical exercise.”
READ MORE: Diabetes Resource Center
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