Executive Functioning, Treatment Adherence, and Glycemic Control in Children with Type 1 Diabetes

  1. Dennis Drotar, PhD (Dennis.Drotar{at}
  1. 1Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
  2. 2Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
  3. 3Department of Pediatrics, A.I. duPont Hospital for Children/Nemours Children's Clinic, Wilmington, Delaware
  4. 4Department of Pediatrics, University of Miami School of Medicine, Miami Florida


Objective. The primary aim of the study was to investigate the relationship among executive functioning, diabetes treatment adherence, and glycemic control.

Research Design and Methods. Two hundred and thirty-five children with type 1 diabetes and their primary caregivers were administered the Diabetes Self-Management Profile (DSMP) to assess treatment adherence. Executive functioning was measured using the Behavior Rating Inventory of Executive Functioning (BRIEF) and glycemic control was based on hemoglobin A1c.

Results. Structural equation modeling indicated that a model in which treatment adherence mediated the relationship between executive functioning and glycemic control best fit the data. All paths were significant at p<.01.

Conclusions. These results indicate that executive functioning skills (e.g. planning, problem-solving, organization, and working memory) were related to adherence, which was related to diabetes control. Executive functioning may be helpful to assess in ongoing clinical management of type 1 diabetes.


    • Received November 17, 2009.
    • Accepted February 25, 2010.

This Article

  1. Diabetes Care
  1. All Versions of this Article:
    1. dc09-2116v1
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