51-LB: Young Adults with T1DM: Is Fear a Mediator between Self-Efficacy and Quality of Life?

It has been reported that the many demands of young adulthood in addition to the complex treatment regimen required to manage T1DM impacts quality of life (QoL). It has also been stated in the literature that self-efficacy (SE), fear of complications (FOC) and fear of hypoglycemia (FOH) are predictive of quality of life. However, is fear a mediator in the relationship between SE and QoL? The literature to no extent has reported on whether FOC and FOH mediate the relationship between SE and QoL. Therefore, the aim of this study was to determine if fear mediates the relationship between SE and QoL in young adults with T1DM. This descriptive, cross-sectional study examined SE among young adults with T1DM. The subjects included 201 young adults (age: 27.4 ± 5; gender: 163(F) 38 (M); A1C: 7.4 ± 1.5%; age of diagnosis: 14 ± 8 years). The subjects completed a general health survey and six self-report instruments accessed via the web including the Diabetes Knowledge Test (DKT), Hypoglycemia Fear Scale (HFS), the Fear of Complications Questionnaire (FCQ), Self-Efficacy for Diabetes Self-Management (SEDM), the Diabetes Behavior Rating Scale (DBRS), the Diabetes Quality of Life Measure (DQoL). This study explored the relationship between SE and QoL and found the FOC and FOH significantly mediated the relationship between SE and QoL (p<.000). This study suggests that although the higher ones SE is, the higher the reported QoL is, FOC and FOH impact this relationship when present. The young adults in this study reported a high level of fear centered around complications from their diabetes as well as fear of hypoglycemia in trying to maintain tight glucose control. Therefore, it is important for researchers and clinicians working to improve QoL in young adults to consider mediating factors such as FOC and FOH when designing interventions aimed to impact QoL.