Aim: In childhood, there is gradual transition of T1D tasks from parents to youth. To assess acquisition of self-care by age, we examined parent report of responsibility across task domains in youth ages 5-18 years.

Methods: Parents of youth with T1D completed the Diabetes Family Responsibility Questionnaire using 3 response options (mainly parent, shared, mainly youth) across 5 T1D domains: Nutrition, Monitoring, Insulin, Communication, and Health Surveillance. Analyses included 3 age groups: 5-10 (Elementary School [ES]), 11-14 (Early Adolescence [EA]), and 15-18 (Late Adolescence [LA]).

Results: Youth (N=148, 50% male) were 12.9±3.2 [X±SD] years, with T1D duration 6.2±3.6 years; 60% pump treated, BG checks 5.6±2.9 X/day, A1c 8.4±1.3%. Parents were 84% mothers, 92% white, 83% married, and 63% college educated. Parent report of youth self-care varied by age and task (Figure). Youth self-care increased as age and T1D duration increased (p<.001). Self-care in Nutrition began in ES, followed by Monitoring and Insulin in EA, and Communication in LA. Health Surveillance (e.g., sick day care) remained mainly under parent care for majority in ES, EA, and LA. In all youth, more parent involvement was related to lower A1c (p<.03).

Conclusion: Recognizing and supporting youth during acquisition of self-care, especially for Nutrition, BG Monitoring, and Insulin, may help to prevent glycemic deterioration later in childhood/adolescence.

R.O. La Banca: None. L.K. Volkening: None. L.M. Laffel: Advisory Panel; Self; Lilly Diabetes, Novo Nordisk A/S, Roche Diabetes Care, Sanofi. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Dexcom, Inc., Janssen Pharmaceuticals, Inc., UpToDate.


National Institutes of Health (P30DK036836)

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