Among people with T1D, adolescents have the poorest adherence and worst glycemic control of any other age group, despite recent advances in treatment and technology. Clinically, adolescents are known to take risks with their diabetes care (e.g., driving without first checking blood glucose), but these risky diabetes behaviors have not been empirically studied. We report psychometric properties of the new 31-item Diabetes-Specific Risk-Taking Inventory (DSRI) for youth 15-18 years old. On the DSRI, youth report the frequency they engaged in 31 diabetes-specific risk-taking behaviors over the past year. We surveyed a national sample of 224 adolescents (participants in the T1Dx registry) (M age=16.4±1.1, 47% female, M A1c=8.3±1.3, 76.8% on insulin pumps) in a cross-sectional design. Participants completed the DSRI as well as measures of adherence, general risk-taking, executive functioning, depressive symptoms, and incidence of severe hypoglycemia and DKA over the past year, using a secure web portal, RedCap. The DSRI demonstrated excellent internal reliability (internal consistency: α=.90; item-total correlations: r range=.21-.64). Construct validity was demonstrated through significant associations (all p<.01) with validated measures: more frequent diabetes-specific risk-taking was related to poorer adherence (r=-.75), greater general risk-taking (r=.57), greater executive dysfunction (r=.34), more depressive symptoms (r=-26), and report of severe hypoglycemia over the past year (r=.22). The DSRI was not associated with DKA. Overall, initial psychometrics suggest the DSRI reliably and validly captures risks that adolescents take with their diabetes care. This self-report measure has the potential to be an innovative and actionable clinical tool that can be used to screen for high risk behaviors that are not routinely assessed in clinical care and inform transition readiness from pediatric to adult care.


R.M. Wasserman: None. S.R. Patton: None. M.A. Clements: Speaker's Bureau; Self; Medtronic. Advisory Panel; Self; Glooko, Inc.. J.H. Finch: None. K. Boschert: None. D.D. Schwartz: None. B. Anderson: Advisory Panel; Self; Sanofi-Aventis.

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