Ready or not? Greater readiness for independent self‐care predicts better self‐management but not HbA1c in teens with type 1 diabetes

Objective Prior to the transfer from paediatric to adult health care transition, teens with type 1 diabetes seek increasing independence in diabetes self‐care while parent involvement in care decreases. Yet, few teens attain glycaemic targets. This study aimed to assess changes in perceived readiness for independent self‐care in teens with type 1 diabetes over 18 months, from both teens' and parents' perspectives, and to evaluate its predictive value for diabetes self‐management and haemoglobin A1c (HbA1c). Research design and methods At baseline, 6, 12 and 18 months, 178 teens with type 1 diabetes (mean ± SD age 14.9±1.3 years; HbA1c 8.5 ± 1.0% (69 ± 11 mmol/mol); 48% female) and their parents completed the Readiness for Independent Self‐Care Questionnaire (RISQ‐T and RISQ‐P, respectively) and a measure of self‐management. Chart review provided HbA1c values. Statistical analyses encompassed bivariate correlations, paired t‐tests and multivariable longitudinal mixed models. Results Teens perceived greater self‐care readiness than their parents at baseline and over 18 months of follow‐up. Both teen and parent perceptions of teen readiness for independent self‐care increased over time, and significantly predicted higher teen self‐ and parent proxy‐reported teen diabetes self‐management, respectively, but not improved HbA1c. Conclusions The current findings may point to a disconnect between how increased readiness for independent self‐care may translate into better perceived diabetes self‐management, but not into better HbA1c. In an effort to optimize HbA1c in teens with type 1 diabetes, future research is needed to design interventions that align perceived readiness for independent self‐care with self‐care behaviours that improve HbA1c.