# The relationship between perceived executive function and self-reported self-management behaviour in adults with type 1 diabetes

## TL;DR

This study shows that adults with type 1 diabetes who feel they have better executive function manage their condition more effectively, especially in diet, monitoring, and activity.

## Contribution

The study links perceived executive function to specific diabetes self-management behaviors using mixed methods.

## Key findings

- Stronger perceived executive function significantly predicts better self-management in adults with type 1 diabetes.
- Perceived executive function correlates with adherence to dietary behavior, glucose monitoring, and physical activity.
- Qualitative analysis highlights challenges like planning and flexibility, and strategies like routines to reduce cognitive load.

## Abstract

This mixed-method study examined whether and how perceived executive function (EF) is linked to self-reported self-management in 173 people diagnosed with Type 1 diabetes (T1D) during adulthood, combining a cross-sectional survey with thematic analysis of 11 interviews. Stronger global EF significantly predicted better self-management (B = −0.04, t(165) = 4.15; p < 0.001) after controlling for demographic factors. Stronger perceptions of EF correlated with better self-reported adherence to dietary behaviour, glucose monitoring and physical activity, but not medication-taking or cooperation with healthcare teams. Qualitative interviews identified key challenges in self-management requiring stronger EF including planning behaviours, maintaining attention and vigilance over time and responding flexibly to changing demands. Strategies which reduce demands on EF, such as establishing routines and delegating control of tasks, helped to improve self-management. Adults with perceived EF impairments may struggle to effectively manage T1D, suggesting supportive interventions should aim to reduce the cognitive demands of self-management.