Dietary Self-Care in Adolescents with Type 1 Diabetes: Report from the Juvenile Diabetes and Dietary Study

Abstract

ABSTRACT OBJECTIVE: This study had 3 aims: a) to examine the relationships between metabolic control, self-perceptions of dietary self-care, types of motivation and parental autonomy support toward dietary self-care in adolescents with type 1 diabetes; b) to explore gender differences in the above variables; and c) to verify the extent to which types of motivation and autonomy support from parents predict metabolic control and dietary self-care. METHODS: A consecutive series of 289 adolescent patients with type 1 diabetes, aged 11 to 17 years, was recruited from 2 pediatric diabetes outpatient clinics in the province of Quebec between January and December 2003. RESULTS: Metabolic control was found to be suboptimal, with mean glycated hemoglobin levels of 8.5% (SD 1.6). Dietary recommendations were generally carried out for autonomous reasons: that is, for the satisfaction and pleasure of eating healthfully (mean 3.62, SD 1.0, range 1–5) or because these activities were valued or considered important (mean 4.35, SD 0.8, range 1–5). Results also showed that the more adolescents performed these activities because they felt controlled or were amotivated, the more they presented poor dietary self-care and metabolic control. Similarly, regression analysis revealed that controlled regulation (s 0.13, p CONCLUSION: Minimizing sources of pressure to pursue dietary self-care could be a promising avenue for improving dietary self-care in adolescents with type 1 diabetes.