The influence of peers on diabetes management in adolescents and emerging adults: a longitudinal study

Abstract

Background. Whereas qualitative research has acknowledged the importance of peers toward adolescents’ and emerging adults’ diabetes management, quantitative studies have failed to consistently replicate these findings. These inconsistencies might be explained due to (1) the lack of longitudinal designs linking peer variables with diabetes outcomes and (2) the lack of focus on negative peer influences. Hence, the present study related both positive and negative peer variables with diabetes outcomes over a time interval of one year. Methods. A total of 476 adolescents (14-17 years) and emerging adults (18-25 years) with type 1 diabetes completed questionnaires at baseline and one year later. Questionnaires tapped into generic emotional support provided by peers, extreme peer orientation, diabetes-related problems, and treatment adherence. As a measure of glycemic control, HbA1c-values were obtained from patients’ treating physicians. Cross-lagged analyses from a structural equation modelling approach were performed to analyze the data. Findings. Emotional support from peers negatively predicted diabetes-related problems over time. Extreme peer orientation positively predicted treatment problems over time. Treatment adherence negatively predicted extreme peer orientation and treatment problems over time. For emerging adults specifically, there was a reciprocal reinforcing relationship between HbA1c-values and extreme peer orientation. Discussion. Being one of the few studies linking peer influences with diabetes outcomes over time, we found that peers may impact, both positively and negatively, the functioning of youth with type 1 diabetes. Emerging adults’ health might be especially vulnerable to peer influences, as we found a reciprocal reinforcing relationship between HbA1c-values and extreme peer orientation.