Abstract

Abstract Objective Using a profile-based approach to the assessment of diabetes management, the purpose of this study was to identify and evaluate an empirically-derived classification system of distinct self-management styles.

Abstract Research Design and Methods Youth with type 1 diabetes (n = 156) aged 10 to16 years and their parents were administered a modified version of the Diabetes Self-Management Profile (DSMP). Cluster analyses were performed independently on parent- and youth-report forms to categorize patients based on their patterns of scores in five diabetes self-management areas.

Abstract Results Cluster analyses revealed three self-management styles that emerged from both youth and parent report: a “methodical style” (METH, 33%) with an emphasis on careful meal planning and correct insulin administration; an “adaptive style” (ADAP, 46%), characterized by high rates of blood glucose testing, exercise, and self-care adjustments; and an “inadequate style” (INAD, 21%) with moderate rates of self-care adjustments and otherwise low DSMP scores. Convergence between parent- and youth-report classifications was moderate (Cohen's κ = .47, p < .0001). HbA_1c was 1.6% higher in the INAD than in both other groups (p < .0001), and the classification significantly accounted for differences in HbA_1c above what was explained by an overall DSMP score.

Abstract Conclusions The findings provide support for recognizing subgroups of patients with unique multidimensional patterns of self-care behaviors. The assessment of self-management styles may prove useful for customized treatments that are targeted directly to the patients' needs.