1383-P: Longitudinal Changes in Transition Readiness (TR) in Teens with Type 1 Diabetes (T1D) Are Unrelated to Glycemic Control

Abstract

Aim: During adolescence, teens with T1D increase self-care, anticipating future independence. To assess TR skills (i.e., affective, behavioral, and cognitive preparation to transfer from pediatric to adult care), teens with T1D and parents completed the validated Readiness for Independent Self-Care Questionnaire (RIS-Q). Methods: Teens, ages 13-17, with T1D and parents completed RIS-Q every 6 months over 18 months. Teen and parent reports of teen treatment adherence and self-efficacy were assessed as predictors of TR and A1c with longitudinal mixed models. Results: At entry, teens (N=178, 52% male, 88% white) had mean±SD age 14.9±1.3 years, T1D duration 7.4±3.7 years, 4.9±2.0 BG checks/day, and A1c 8.5±1.0%; 67% were pump users. Teen and parent reported TR increased over time while teen A1c was unchanged (Figure). In multivariate models, teen age, teen reported adherence, and self-efficacy predicted TR (all p<.001). Teen TR did not predict A1c while teen reported adherence, self-efficacy, and BG checks/day predicted A1c (all p<.008). Longitudinal models using parent reports had similar results. Conclusion: Teen TR increased with age and over time but was unrelated to A1c, suggesting a disconnect between teen perceptions of self-care readiness and self-care behaviors. While TR may be important, it is insufficient, highlighting need to improve self-care behaviors and A1c in teens with T1D. Disclosure E.R. Goethals: None. L.K. Volkening: None. P.V. Commissariat: None. D.A. Butler: None. D.E. McGill: 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. Funding National Institutes of Health (R01DK095273, P30DK036836, T32DK007260, K12DK094721); JDRF (2-SRA-2014-253-M-B)