Relation of stressful life events to metabolic control among adolescents with diabetes: 5-year longitudinal study.

Objective: To determine the relation of stressful life events to metabolic control. Design: We interviewed adolescents with Type 1 diabetes (n = 132; average age at enrollment = 12 years) annually for 5 years. Measures: Each year we administered measures of stressful life events, psychological distress, and self-care behavior. We downloaded data from blood glucose meters, and obtained measures of metabolic control (hemoglobin A1c) from medical records. Results: Using longitudinal growth curve modeling, stressful life events predicted greater psychological distress, poorer self-care behavior, and worse metabolic control in both cross-sectional and longitudinal (lagged) analyses. Cross-sectionally, many of these relations were stronger among older than younger adolescents. Self-care behavior partly mediated this association. Conclusion: Stressful life events are related to poor metabolic control—especially for older adolescents. A primary mechanism appears to be a lack of good self care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)