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

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 (beta 0.13, p <0.05) and amotivation (beta 0.13, p <0.05) toward dietary self-care predicted poor metabolic control. Analyses revealed no gender differences. 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.