Self-care autonomy and outcomes of intensive therapy or usual care in youth with type 1 diabetes

Tim Wysocki, Michael A. Harris, Lisa M. Buckloh, Karen Wilkinson, Michelle Sadler, Nelly Mauras, Neil H. White

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Objective: This article evaluated whether deviation from developmentally appropriate self-care autonomy moderated the effects of intensive therapy (IT) or usual care (UC) on glycosylated hemoglobin (HbA1C) in 142 youths with diabetes. Methods: Youths received an autonomy/maturity ratio (AMR) score at baseline that was a ratio of standardized scores on measures of self-care autonomy to standardized scores on measures of psychological maturity and were categorized by tertile split into low, moderate, and high AMR. Results: Higher baseline AMR was associated with higher baseline HbA1C for IT and UC. Baseline AMR scores predicted glycemic outcomes from UC; the high AMR tertile showed deteriorating glycemic control over time, whereas the low AMR tertile maintained better glycemic control. All three AMR groups derived equal glycemic benefit from IT. Conclusion: Children with inordinate diabetes self-care autonomy may fare poorly in UC but these same children may realize less glycemic deterioration during IT.

Original languageEnglish (US)
Pages (from-to)1036-1045
Number of pages10
JournalJournal of pediatric psychology
Issue number10
StatePublished - Nov 2006
Externally publishedYes


  • Adolescents
  • Children
  • Intensive therapy
  • Type 1 diabetes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology


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