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Characterization of youth goal setting in the self‐management of type 1 diabetes and associations with HbA1c: The Flexible Lifestyle Empowering Change trial
Author(s) -
Cristello Sarteau Angelica,
Crandell Jamie,
Seid Michael,
Kichler Jessica C,
Maahs David M,
Wang Jessica,
MayerDavis Elizabeth
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13099
Subject(s) - medicine , type 2 diabetes , type 1 diabetes , diabetes mellitus , endocrinology
Youth with type 1 diabetes (T1D) commonly do not meet HbA1c targets. Youth‐directed goal setting as a strategy to improve HbA1c has not been well characterized and associations between specific goal focus areas and glycemic control remain unexplored. Objective To inform future trials, this analysis characterized intended focus areas of youth self‐directed goals and examined associations with change in HbA1c over a 18 months. Methods We inductively coded counseling session data from youth in the Flexible Lifestyle Empowering Change Intervention (n = 122, 13‐16 years, T1D duration >1 year, HbA1c 8‐13%) to categorize intended goal focus areas and examine associations between frequency of goal focus areas selected by youth and change in HbA1c between first and last study visit. Results We identified 13 focus areas that categorized youth goal intentions. Each session where youth goal setting concurrently incorporated blood glucose monitoring (BGM), continuous glucose monitoring (CGM), and insulin dosing was associated with a 0.4% (95% CI: −0.77, −0.01; P = .03) lower HbA1c at the end of intervention participation. No association was observed between HbA1c and frequency of sessions where goal intentions focused on BG only (without addressing insulin or CGM) (β: 0.07; 95% CI: −0.07, 0.21; P = .33) nor insulin dosing only (without addressing BGM or CGM) (β: 0.00; 95% CI: −0.11, 0.10; P = .95). Conclusions Findings exemplify how guiding youth goal development and combining multiple behaviors proximally related to glycemic control into goal setting may benefit HbA1c among youth with T1D. More research characterizing optimal goal setting practices in youth with T1D is needed.