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 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  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 late 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

Data collection for SMART-1, a multi-site study of children and adolescents with Type 1 Diabetes, is complete. We are now in the process of data collection for SMART-2, which is a follow-up study to SMART-1. We have been re-funded by the National Institutes of Health (NIH; 5R01DK069486-08) to follow the cohort of adolescents and their families for an additional three years. We are continuing to follow adolescents and their families to 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:

Rohan, J.M., Huang, B., Pendley, J., Delamater, A., Dolan, L., Reeves, G., & Drotar, D. Predicting Health Resilience in Pediatric Type 1 Diabetes: A Resilience Model Framework. Journal of Pediatric Psychology. 2015 Oct;40(9):956-67.

Iskander, J.M., Rohan, J.M., Pendley, J., Delamater, A., & Drotar, D. A 3-year Prospective Study of Parent–Child Communication in Early Adolescents with Type 1 Diabetes: Relationship to Adherence and Glycemic Control. Journal of Pediatric Psychology. 2015 Jan-Feb;40(1):109-20.

Wu, Y.P., Rausch, J., Rohan, J.M., Hood, K.K., Pendley, J., Delamater, A., & Drotar, D. Autonomy Support and Responsibility-Sharing Predict Blood Glucose Monitoring Frequency Among Youth With Diabetes. Health Psychology. 2014 Oct;33(10):1224-31.

Rohan, J.M., Rausch, J.R., Shroff Pendley, J., Delamater, A., Dolan, L., Reeves, G., & Drotar, D. Identification and Prediction of Group-Based Glycemic Control Trajectories during the Transition to Adolescence. Health Psychology. 2014 Oct;33(10):1143-52. 

Hilliard, M.E., Rohan, J.M., Rausch, J., Delamater, A., Shroff Pendley, J., & Drotar, D. Patterns and Predictors of Paternal Involvement in Early Adolescents’ Type 1 Diabetes Management over 3 Years. Journal of Pediatric Psychology. 2014 Jan-Feb;39(1):74-83.

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. 2013 Jun;36(3):234-45.

Rohan, J.M., Shroff Pendley, J., Delamater, A., Dolan, D., Reeves, G., & Drotar, D. Patterns of Self-Management in Pediatric Type 1 Diabetes Predict Level of Glycemic Control Two Years Later. Journal of Developmental and Behavioral Pediatrics. 2013 Apr;34(3):186-96.

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. 2013 Mar;20(1):107-13.

Miller, M., Rohan, J.M., Delamater, A., Shroff Pendley, J., Dolan, D., 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. 2013 Jan-Feb;38(1):18-29.

Rausch, J.R., 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 Jun;35(6):1219-24

Sood, E.D., 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 Sep;31(5):571-9.