• SMART Project

    Illness Management in Children and Young Adults with Type 1 Diabetes

    This study will analyze patterns of self-management and adherence to type 1 diabetes (DM1) during early adolescence and will identify salient predictors of self-management and treatment adherence. This three-year study will generate scientific data concerning causes and consequences of self-management of DM1 during early adolescence. Such information could facilitate development of interventions that target problematic patterns of self-management among young adolescents, thus reducing chances of deterioration in their self-management, treatment adherence and metabolic control. Cincinnati Children’s Hospital Medical Center is the central coordinating site for this three-site study, which also includes the University of Miami Diabetes Research Institute in Miami, FL, and the Nemours Clinic in Wilmington, DE.

    Study Goals

    We will accomplish the following specific aims with this study: 

      1. Describe individual differences and group trends, in patterns of change, in DM1 self-management and treatment adherence from early to middle adolescence
      2. Identify family and individual influences on self-management and treatment adherence
      3. Assess consequences of self-management and treatment adherence patterns on blood sugar control, hypoglycemic episodes and healthcare utilization

    Current Progress

    We recently finished the third and final year of data collection for this study (N = 239 patients and their families). We are in the process of writing manuscripts that describe our research findings from baseline to three years (see below). We also are in the process of applying for a continuation research grant and recently received bridge funding to meet with our all of our enrolled patients and their families at their next routine medical visit(s). The continuation grant will allow us to continue to follow our current cohort of adolescents who were recruited to participate in the study so that we can gain additional information about their adherence and self-management as they transition to older adolescence.

    We have published the following papers from this data set with hopefully more to come in the near future:

    1. McNally K, Rohan, J.M., Shroff Pendley, J., Delamater, A., & Drotar, D.Executive functioning, treatment adherence, and glycemic control in children with type 1 diabetes. Diabetes Care. 2010. 33(6):1159-62. PMID:20215458.
    2. Rohan JM, Delamater, A., Shroff Pendley, J., Dolan, D., Reeves, G., & Drotar, D.Identification of self-management patterns in pediatric type 1 diabetes using cluster analysis. Pediatric Diabetes. 2011;12:611-8. PMID:21446925.
    3. Hilliard M, Rohan, J., Carle, A., Shroff-Pendley J., Delamater, A. & Drotar, D. Fathers' involvement in preadolescents' diabetes adherence and glycemic control. Journal of Pediatric Psychology. 2011;36:911-22. PMID:21515643.
    4. Rausch JR, Hood, K.K., Delamater, A., Shroff Pendley, J., Rohan, J.M., Reeves, G., Dolan, L., & Drotar, D. Changes in treatment adherence and glycemic control during the transition to adolescence in type 1 diabetes. Diabetes Care. 2012; 35: 1219-1224. PMID: 22474040.
    5. Sood ED, Shroff Pendley, J., Delamater, A., Rohan, J.M., Pulgaron, E., Drotar, D. Mother-father informant discrepancies regarding diabetes management: Associations with diabetes-specific family conflict and glycemic control. Health Psychology. 2012; 31(5): 571-579. PMID: 22823070.
    6. Drotar D, Ittenbach, R., Rohan, J.M., Gupta, R., Shroff Pendley, J., & Delamater, A. Diabetes management and glycemic control in youth with type 1 diabetes: Test of a predictive model. Journal of Behavioral Medicine. 2012. In Press. PMID: 22569775.
    7. Ittenbach, R.F., Cassedy, A.E., Rohan, J.M., Delamater, A., Shroff Pendley, J., Hood, K.K., Harris, M.A., Drotar, D. Diabetes Self-Management Profile Short Form: A Preliminary Report. Journal of Clinical Psychology in Medical Settings. 2012. In Press. PMID: 22825286.
    8. Miller M, Rohan, J.M., Delamater, A., Pendley, J.S., Dolan, L., Reeves, G., & Drotar, D. Changes in executive functioning and self-management in adolescents with type 1 diabetes: A growth curve analysis. Journal of Pediatric Psychology. 2012. In press. PMC Journal – In Process.
  • mom and daughter.