The Role of Peers for Diabetes Management in Adolescents and Emerging Adults with Type 1 Diabetes: A Longitudinal Study

Objective. The increasing importance of peers in adolescence and emerging adulthood has been widely acknowledged. However, longitudinal research linking the peer context to diabetes management and outcomes is scarce. The present longitudinal study in a large sample of youth with type 1 diabetes related both positive and negative peer variables to diabetes outcomes over a time interval of one year. Research Design and Methods. Our sample consisted of 467 adolescents (14-17 years) and emerging adults (18-25 years) with type 1 diabetes who participated in a two-wave longitudinal study. Questionnaires tapped into peer support, extreme peer orientation, parental responsiveness, diabetes-related distress, and treatment adherence. HbA1c-values were obtained from patients’ treating physicians. Cross-lagged analysis from a structural equation modelling approach was performed to assess directionality of effects. Results. Peer support negatively predicted diabetes-related distress over time. Extreme peer orientation positively predicted treatment distress over time. Parental responsiveness negatively predicted food distress over time. Treatment adherence negatively predicted extreme peer orientation, treatment distress, and HbA1c-values over time. For emerging adults specifically, there was a reciprocal relationship between HbA1c-values and extreme peer orientation, as they positively predicted each other. Conclusions. This study highlights the importance of peers in predicting the functioning of youth with type 1 diabetes. Additionally, treatment adherence at baseline was found to negatively predict extreme peer orientation, treatment distress, and worse glycemic control over time. In sum, the present study underscores the importance of the peer context for adolescents and emerging adults with type 1 diabetes.status: publishe