The relationship between psychological factors and blood glucose regulation in insulin-dependent diabetic adolescents

Fifty-two insulin-dependent diabetic, white, rural, middle-class adolescent subjects who had diabetes 5 or more years participated in a project comparing psychological and personality variables to the degree of altered blood glucose regulation as measured by hemoglobin A1c (HbA1c) levels. An HbA1c level of 9.5% was arbitrarily chosen as a cutoff score to divide subjects into two groups: those having "adequate" (N = 25) and those having "inadequate" (N = 27) blood glucose regulation. There were no significant differences between high and low HbA1c groups for all psychological variables tested, i.e., anxiety, locus of control, self-concept, and various personality traits measured by the High School Personality Questionnaire (HSPQ). Female subjects scored significantly higher on the anxiety scale and had significantly higher HbA1c values and weight percentiles compared with male subjects. Six self-report diabetes questionnaires dealing with various aspects of diabetes care and adjustment were completed by mothers and five similar questionnaires were completed by the adolescents. There were no significant differences in the mean scores of the 11 diabetes questionnaires between the high and low HbA1c groups. Girls scored significantly higher than boys in "self-care" and on individual items pertaining to dysphoric feelings about diabetes. Our findings may have resulted from the homogeneity of the sample, but underlying metabolic and genetic factors need to be considered in differentiating subjects according to the level of blood glucose regulation.