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

TLDR

The study spanned adolescence (ages 14–17) and emerging adulthood (ages 21–25) across eight waves. The study aimed to identify developmental classes of glycemic control in young type 1 diabetes patients and examine their links to family climate and self‑concept. Participants underwent eight clinical visits for A1C measurement and completed repeated questionnaires on family climate and self‑concept, and latent class growth analysis was applied to classify glycemic trajectories. Latent class growth analysis identified three glycemic control trajectories—optimal, moderate, and deteriorating—whose A1C levels diverged from adolescence into emerging adulthood, with optimal control linked to better family climate and deteriorating control linked to lower positive self‑concept.

Abstract

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.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.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.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.