Executive function and somatic problems in adolescents with above target glycemic control.

Area of Science:

• Pediatric Endocrinology
• Neuropsychology
• Adolescent Health

Background:

• Adolescents with type 1 diabetes (T1D) are at increased risk for somatic problems.
• Executive function (EF) deficits may contribute to these somatic issues.
• Understanding the relationship between EF, adherence, and somatic problems is crucial for T1D management.

Purpose of the Study:

• To investigate the association between executive function (EF) problems and somatic problems in adolescents with T1D and above-target glycemic control.
• To determine if metacognitive and behavior regulation EF skills independently predict somatic problems.
• To differentiate the impact of EF on somatic problems beyond disease severity and adherence.

Main Methods:

• Cross-sectional, baseline data from 93 adolescents with T1D.
• Assessment of glycated hemoglobin (HbA1c) for metabolic control.
• Parent-reported questionnaires for adherence, somatic problems, and global, metacognitive, and behavior regulation EF.

Main Results:

• Bivariate analyses showed significant associations between somatic problems and global EF, metacognitive EF, behavior regulation EF, adherence, and metabolic control.
• In multivariate analyses, only global EF problems (b=0.15, P<0.01) and metacognitive EF problems (b=0.16, P<0.01) remained independently associated with somatic problems.
• Behavior regulation EF problems were not independently associated with somatic problems after controlling for adherence.

Conclusions:

• Metacognitive EF problems are significant independent predictors of somatic problems in adolescents with T1D and suboptimal glycemic control.
• These findings suggest that targeting metacognitive deficits may help alleviate somatic complaints in this population.
• Comprehensive assessment and intervention for EF, especially metacognitive skills, are vital for managing somatic health in adolescents with T1D.