Glycemic control and self‐rated health among ethnically diverse adolescents with type 1 diabetes.

Objective: Patient‐reported outcomes have received increased attention as treatment outcomes and indicators of wellbeing. A1c has been criticized as lacking patient‐centered relevance because individuals are often unaware of their A1c, and studies also often fail to show a benefit of intensive control on quality of life. The goal of the present study was to examine self‐rated health (SRH) in relation to diabetes self‐care behaviors, socioeconomic factors, treatment regimen characteristics, and glycemic control among predominately Hispanic and African American adolescents with type 1 diabetes (T1D). Methods: Adolescents with T1D (N = 84) were recruited for a cross‐sectional study evaluating psychosocial factors and identity development. SRH, self‐care behaviors, treatment regimen, and demographic variables were collected through self‐report while glycemic control (A1c) was determined through chart review. Results: Participants were predominantly racial and ethnic minorities (48% Hispanic, 27% African American; 52% female, M age 15.9, M diabetes duration 6.8, M A1c 10% [86 mmol/mol]). Significant bivariate relationships emerged between SRH and sex, A1c, self‐care behavior, and insulin delivery method. Covariate‐adjusted regression models showed only A1c was significantly and independently related to SRH. Mediation analyses illustrated a significant indirect effect for A1c between self‐care and SRH. Conclusion: These findings suggest glycemic control is associated with self‐ratings of health among ethnically diverse adolescents with T1D. SRH appears to be an appropriate patient‐reported outcome that is sensitive to glycemic control in this population. [ABSTRACT FROM AUTHOR]