Continuity and Change in Glycemic Control Trajectories From Adolescence to Emerging Adulthood

Abstract

OBJECTIVE: To determine developmental classes of glycemic control in young people with type 1 diabetes throughout adolescence and emerging adulthood and assess relationships with general family climate and self-concept. RESEARCH DESIGN AND METHODS: In an eight-wave longitudinal study, 72 individuals (37 females) completed questionnaires assessing family climate (at times 1–4) and self-concept (at times 1–4 and 6). Times 1–4 covered adolescence (mean ages were 14–17 years, respectively); times 5–8 covered emerging adulthood (mean ages were 21–25 years, respectively). At each time point, patients visited their physicians to determine A1C values, and questionnaires were sent to the physicians to obtain these values. Latent class growth analysis was used to identify developmental classes of glycemic control. RESULTS: Latent class growth analysis favored a three-class solution, consisting of optimal control (n = 10), moderate control (n = 51), and deteriorating control (n = 11). From time 3 on and especially during emerging adulthood, mean A1C levels were substantially different among the classes. Additional ANOVAs indicated that at times 1, 2, and 4, the optimal control class was characterized by the most optimal family climate, whereas at times 3, 4, and 6, the deteriorating control class was characterized by the lowest score on positive self-concept. CONCLUSIONS: From late adolescence on, a multiformity of glycemic control trajectories emerged, which became more diversified throughout emerging adulthood. Family climate and self-concept in mid-to-late adolescence served as psychosocial markers of these developmental classes.