UVM Theses and Dissertations
Cohen, Laura Bethany
Adolescents with type 1 diabetes must learn to balance the complexities of managing a chronic disease with managing non-disease-related experiences in their daily life that also contribute to stress. For example, in addition to diabetes management, these adolescents must also balance ongoing demands from everyday life stressors including school, social interactions, and home and family life. However, it remains unclear if daily diabetes management might contribute to experiences of everyday life stress. The present study assessed the association between daily everyday life stress and blood glucose regulation in adolescents with type 1 diabetes using both linear and nonlinear models. Thirty-nine adolescents diagnosed with type 1 diabetes between the ages of 13-17 completed seven daily diary surveys. Data were analyzed using multilevel modeling, including both linear covariation and autoregressive dynamic systems approaches. Results found that everyday life stress represents a regulatory system (attractor state) at the daily level, but daily blood glucose regulation did not covary with everyday life stress in the linear model nor change the state of the regulatory system in the autoregressive systems model. Future studies should continue to explore the relationship between everyday life stress and blood glucose regulation using a dynamic systems framework with different methodological approaches to better capture within-day nuances in stress and glucose regulation in adolescents with type 1 diabetes.