The impact of cognitive distortions, stress, and adherence on metabolic control in youths with type 1 diabetes

Abstract 

Purpose

To investigate the role of cognitive distortions in the relationship between adherence behavior, diabetes-specific stress, general stress, and metabolic control.

Methods

Obtained questionnaire data, glucometer readings, and glycosylated hemoglobin (HbgA_1c) assays from 143 youths (11–18 years old) with type 1 diabetes. Examined path model of relationships between cognitive distortions, stress, adherence behavior, and metabolic control. Data were analyzed using path analysis.

Results

Higher levels of negative cognitive distortions were associated with more stress (both diabetes-specific and general). Higher levels of general stress then led to less adherent behavior and subsequently poorer metabolic control (higher HbgA_1c). More diabetes-specific stress also led to poorer metabolic control, as well as general stress.

Conclusions

The findings indicate an indirect role of negative cognitive distortions in metabolic control. The current findings suggest that instead of the proposed direct link between cognitive distortions and adherence behavior, an indirect relationship may exist through stress.

Keywords:  Adherence, Adolescents, Cognitive distortions, Diabetes-specific stress, Insulin-dependent diabetes, Type 1 diabetes