# Association of HbA1C and comfort with diabetes self-management among adolescents and young adults with type 1 diabetes

## TL;DR

This study found that higher self-reported comfort with diabetes management among teens and young adults with type 1 diabetes is linked to worse blood sugar control, suggesting comfort alone is not enough to ensure good outcomes.

## Contribution

The study reveals a novel association between self-reported comfort with diabetes tasks and higher HbA1c levels in adolescents and young adults with T1D.

## Key findings

- Participants generally reported high comfort with diabetes management tasks, regardless of race or insurance type.
- Higher self-reported comfort was associated with higher HbA1c levels after controlling for demographic and clinical factors.
- The findings highlight the need for continued support during the transition from pediatric to adult diabetes care.

## Abstract

Adolescents and young adults (AYA) living with type 1 diabetes (T1D) are a vulnerable demographic at risk for sub-optimal glycemic outcomes at a time when they are taking over their diabetes management. The purposes of this study were to examine levels of self-reported comfort with diabetes management tasks among AYA living with T1D and to describe the relationships among comfort levels, sociodemographic factors, and HbA1c.

During a routine diabetes care visit, AYA aged 15–23 years old living with T1D received a transition survey to self-assess their comfort level with different diabetesmanagement tasks.

Among 161 participants who completed the survey (median age 17 years, median diabetes duration 7 years, 82.3% White, 40.9% female, 66.5% with private insurance, and median HbA1c 8.8%), comfort with diabetes management tasks was generally rated highly (median overall comfort level of 4.5 out of 5), irrespective of race or insurance type. Regression analysis revealed that higher self-reported comfort level with diabetes management tasks was associated with a higher HbA1c (p = 0.006), after controlling for age, sex, race, insurance type, and diabetes duration.

These findings suggest that self-reported comfort with independently managing T1D may not be a sufficient metric in assessing AYA patients’ need for further intervention to optimize glycemic outcomes as they transition from pediatric to adult diabetes care, and highlights the importance of continuity of care to support diabetes management during this transitional period.