Diabetes‐specific self‐esteem, self‐care and glycaemic control among adolescents with Type 1 diabetes

Aims To explore the relationships between diabetes‐specific self‐esteem, self‐care and glycaemic control among diverse adolescents with Type 1 diabetes. Methods Adolescents (aged 13–21 years) diagnosed with Type 1 diabetes for at least one year, receiving care at an urban medical centre, completed a self‐report battery including demographic information, the Diabetes‐Specific Self‐Esteem Scale and Self‐Care Inventory. Glycaemic control (HbA1c) was obtained from medical records at recruitment and one year later. Bivariate correlation and multiple linear regression assessed relationships between the Diabetes‐Specific Self‐Esteem scale, Self‐Care Inventory and HbA1c at baseline and one year. Results Participants included 85 adolescents (15.9 ± 2.1 years; 53% women; 47% Hispanic/Latino). Diabetes‐specific self‐esteem scores did not differ based on patient characteristics but were significantly correlated with baseline self‐care (r = 0.59, P < 0.001) and HbA1c at baseline (r = ‐0.51, P < 0.001) and one year later (r = ‐0.48, P < 0.001). Diabetes‐specific self‐esteem remained a significant correlate of baseline (β = ‐0.41, P < 0.001) and follow‐up HbA1c (β = ‐0.37, P = 0.008) when adjusting for covariates and self‐care. Diabetes‐specific self‐esteem was not significantly associated with change in HbA1c. Conclusions Results suggest that diabetes‐specific self‐esteem is significantly associated with self‐care and glycaemic control among diverse adolescents with Type 1 diabetes. Diabetes‐specific self‐esteem may be more closely related to HbA1c than reports of the frequency of self‐care behaviours, and could represent a useful tool for clinical and research applications. What's new? Prior research supports a diabetes‐specific domain of self‐esteem in adolescents with Type 1 diabetes. Our study evaluated the relationship between diabetes‐specific self‐esteem and diabetes outcomes in a sample of predominantly ethnic minority adolescents with Type 1 diabetes. We identified statistically significant relationships between diabetes‐specific self‐esteem and glycaemic control cross‐sectionally and longitudinally. These relationships were independent of duration of illness, insulin administration and self‐care. Findings highlight the importance of adolescents’ perceptions of their self‐worth in the context of Type 1 diabetes and may be an important factor in identifying adolescents who are at risk of poor self‐care and glycaemic control.