Does Gender Moderate the Relations between Shared Responsibility and Health Outcomes among Adolescents with T1D?

Shared responsibility (SR) where both parents and adolescents are involved in diabetes management is optimal for reducing psychological distress and improving diabetes outcomes. Few studies examined whether gender moderates the relations between SR and health outcomes. This study examined whether gender moderates the relations of SR to distress and diabetes outcomes during the transition into adolescence. A secondary analysis of longitudinal study of 132 adolescents with T1D and their parents was conducted. Adolescents were 10 to 14 years, 72 girls and 60 boys. All measures were taken annually for 5 years. Both reported on SR. Adolescents reported on distress (depressive symptoms, anxiety, and anger) and self-care. HbA1c was obtained at the clinic visit. Linear mixed models were used to assess if gender moderates the relations between SR and health outcomes.

Results: Concurrent analyses showed that gender moderated the relation between parent-reported SR and HbA1c (p=.007) and child-reported SR and anger (p=.048). At early adolescence, parent-reported SR was associated with lower HbA1c for girls but higher HbA1c for boys. For middle-stage adolescence, SR was associated with higher HbA1c for girls but lower HbA1c for boys. For older adolescents, SR was associated with lower HbA1c for boys but unrelated to HbA1c for girls. Among young and older adolescents, child-reported SR was associated with less anger for boys but unrelated to anger for girls. At middle-stage adolescence, SR was associated with less anger for girls but more anger for boys.

Conclusion: gender moderated the relations between SR and some aspects of health outcomes during transition adolescence in different patterns. SR was associated with better glycemic control among young girls and older boys, and was associated with less anger among boys in general. Healthcare providers need to consider adolescent’s gender when recommending parental involvement in diabetes management for better health outcomes.