T1D Teens: Good Habits are Critical

This transition time is typically a high-risk period in teen lives with frequent BG excursions due to poor sleep habits, exercise, alcohol, and irregular meals.

The study published in Diabetes Care shows that higher executive function predicts better glycemic control in teenagers with Type 1 Diabetes during the transition period between late adolescence and early adulthood. Executive Function (EF) refers to self-management skills that help us be productive; they include how we manage our emotions, manage our work and time, and respond to changes. It is responsible for how we face and take on challenges. Unlike IQ which is often a measure of intellectual power (ability to solve complex puzzles, etc.), Executive Function has more to do with emotional regulation.

A 2-year longitudinal study involving 220 high school seniors (with a mean age of 17.77) was carried out to determine whether glycemic control and adherence worsen with the transition into adulthood and if Executive Function was predictive of these changes. Participants were assessed (at baseline) for general intelligence (IQ) and performance-based measures of EF. Hemoglobin A1c (HbA1c) was also measured at baseline and throughout the study period using mail-in kits.

The results were that the HbA1c level increased significantly (0.507%/year) while adherence with treatment decreased across all time points. The study further revealed higher IQ was associated with a lower HbA1c level at baseline, and HbA1c level increased more slowly for individuals with higher EF. Some participants self-reported problems with executive function and they had poorer glycemic control and adherence at baseline. These issues, however, did not predict changes in HbA1c or adherence over time.

The participants’ parents all came from a similar socioeconomic background.  Thus, the research cannot be extrapolated to a broader population. Nonetheless, the study showed that emerging adulthood is a high-risk time for diabetes management.