Evaluating the Association of Adolescent and Caregiver Grit with Hemoglobin A1c in Adolescents with Type 1 Diabetes

OBJECTIVE:"Grit" is a personality construct defined as the tendency to work toward long-term goals and may influence chronic disease management behaviors in type 1 diabetes. We sought to determine whether adolescent and caregiver grit are associated with hemoglobin A1c in adolescents with type 1 diabetes. We also evaluated the relationship between adolescent and caregiver self-control, another construct already explored in type 1 diabetes, with hemoglobin A1c to determine whether similar patterns of association are observed. METHODS:We performed a single-center, cross-sectional study of 114 adolescents with type 1 diabetes and their primary diabetes caregiver. Patients were English-speaking, 13-15 years old, and had diabetes for ≥2 years. Using unadjusted and adjusted regression models, we examined the relationship between adolescent and caregiver grit and hemoglobin A1c. Unadjusted and adjusted effect estimates are also reported for adolescent and caregiver self-control with hemoglobin A1c. RESULTS:After confounding adjustment, higher adolescent grit was associated with a lower hemoglobin A1c (B = -0.5% [-0.8 to -0.2] or -5 mmol/mol [-9 to -2]). Caregiver grit was not associated with adolescent hemoglobin A1c. We observed similar associations between self-control and hemoglobin A1c. CONCLUSIONS:To our knowledge, this is the first study to examine the relationship between grit and hemoglobin A1c among adolescents with type 1 diabetes. Adolescents with more grit had lower hemoglobin A1c values than those with less grit. These findings suggest that longitudinal studies to evaluate this association further are warranted. Trials testing the efficacy of behavioral interventions to augment grit and improve glycemic stability can then follow.