Knowledge and self-efficacy as key determinants of transition readiness in adolescents with type 1 diabetes: insights from adolescents, parents, and clinicians

Aim: Assess transition readiness of adolescents with Type 1 Diabetes (T1D) from adolescent, parental, and clinician perspectives.

Methods: Cross-sectional study (n = 36, 20 Male/16 Female, 16–18 years, June 2023–June 2024, metropolitan paediatric centre). Adolescents had diabetes knowledge, self-efficacy, and diabetes distress measured. Parents had an assessment of knowledge, diabetes-related distress, and estimated the adolescent’s self-efficacy. Clinicians estimated adolescent self-efficacy.

Results: Median HbA1c was 7.4% (IQR 6.6–8.4). One adolescent met the guidelines for multidisciplinary team (MDT) appointments. Paired sample t-tests showed that adolescents’ knowledge was comparable to parent levels (t(24) = −1.69, p = 0.10). Adolescents’ knowledge was strongly associated with higher self-efficacy (r = 0.80 p < 0.001). Higher adolescent self-efficacy was associated with lower adolescent distress (r = −0.368, p = 0.03). Adolescent distress was lower than parent distress (t(24) = −3.13, p = 0.005). Although adolescent self-efficacy was strongly correlated with parent and clinician evaluation (r = 0.76, p < 0.001; r = 0.80, p < 0.001), adolescents reported higher self-efficacy than estimates by parents (t(24) = 4.76, p < 0.001) or clinicians (t(24) = 8.39, p < 0.001). Parent knowledge was moderately correlated with adolescent self-efficacy (r = 0.62, p = 0.001).

Conclusions: Diabetes knowledge may confer greater self-efficacy and reduce diabetes distress in adolescents. Distress levels are higher in parents than in adolescents. Engagement with MDT is poor. Transition efforts should focus on parents and adolescents while increasing engagement with MDT.