Global stress and daily general and type 1 diabetes stressors and links to daily affect and diabetes outcomes during emerging adulthood.

We examined how global stress and general stressors of daily life relate to emotional well-being and type 1 diabetes (T1D) outcomes and amplify the effects of diabetes stressors in emerging adults. Two-hundred and seven 18-19-year-olds with T1D (duration 8.47 years) completed the Perceived Stress Scale (global stress) and a daily diary assessing daily diabetes and general stressors, positive and negative affect, self-care behaviors, and blood glucose (BG). Multi-level analyses indicated that global stress and within-person daily general and diabetes stressors were associated with more negative and less positive affect. In addition, general stress (between-person) was associated with more negative affect. Global stress amplified the association between daily diabetes stressors and negative affect, with greater affect reactivity to stress for those experiencing higher global stress. Global stress and both within- and between-person diabetes stressors were associated with lower self-care and higher BG. Emerging adults' general stressors in their daily lives relate to poorer well-being beyond the experience of diabetes stressors.

Executive Functioning, Daily Self-Regulation, and Diabetes Management while Transitioning into Emerging Adulthood.

BACKGROUND: Executive functioning (EF) predicts better Type 1 diabetes (T1D) management in the high-risk years after high school, but the daily self-regulation processes involved are unclear. PURPOSE: To examine whether EF is associated with daily self-regulation that minimizes one's exposure or buffers adverse reactions to daily diabetes problems, and to determine whether these patterns become stronger during the transition out of high school. METHODS: A measurement burst design with convenience sampling was used. Seniors in high school with T1D (N = 207; 66% female) completed self-report (i.e., Behavioral Rating Inventory of Executive Functioning) and performance measures of EF (i.e., Delis-Kaplan Executive Function System). A 14-day daily diary assessing self-regulation failures, diabetes problems, affect, and indicators of diabetes management was completed at baseline and 1 year later. RESULTS: Correlations and multilevel modeling were conducted. Lower self-reported EF problems were associated with lower average levels of daily self-regulation failures, and these variables were associated with fewer daily diabetes problems. In contrast, better EF performance was unrelated to average daily self-regulation failures, and was unexpectedly associated with more frequent diabetes problems in year 2. Equally across years, on days participants reported lower than their average levels of daily self-regulation failures, they had fewer diabetes problems, regardless of EF. On days with lower than average diabetes problems, participants reported better diabetes management indicators. EF generally did not buffer daily associations in either year. CONCLUSIONS: Regardless of EF, promoting daily self-regulation may prevent diabetes problems and promote T1D management in daily life at this high-risk transitional time.

Type 1 diabetes (T1D) requires daily self-regulation (e.g., remembering to check blood glucose; regulating emotions, thoughts, and behaviors when diabetes problems arise). These processes draw on executive function (EF) abilities, which may be challenged after high school, when youth experience many life transitions while managing diabetes more independently from parents. The study examined how EF is associated with daily diabetes management as youth transition out of high school. Seniors in high school with T1D completed measures of EF and two 14-day daily diaries, one in the senior year and one the following year. Each evening, participants completed an online survey reporting on self-regulation failures (e.g., forgetting to test blood glucose), diabetes problems, and diabetes management over the past 24 hr. Those with better self-reported EF had lower self-regulation failures and fewer diabetes problems on average. On days with lower self-regulation failures, participants had fewer diabetes problems. On days with fewer diabetes problems, participants reported lower negative emotions, higher confidence in diabetes management, and better self-care behaviors and blood glucose levels. These daily associations occurred regardless of EF. Providing youth with training in self-regulation to prevent daily diabetes problems may promote T1D management during this high-risk transition.

Parents' Empathic Accuracy: Associations With Type 1 Diabetes Management and Familism.

OBJECTIVE: To (1) test associations between parents' empathic accuracy for their adolescents' positive and negative emotions and adolescents' physical and mental health (HbA1c, diabetes self-care, and depressive symptoms) in a predominantly Latinx sample of adolescents with type 1 diabetes and their parents, and (2) explore how familism values were associated with parent empathic accuracy and adolescent physical and mental health in this population. METHODS: Parents and adolescents engaged in a discussion about a topic of frequent conflict related to the adolescents' diabetes management. Parents and adolescents subsequently completed a video recall task in which they rated their own and their partner's emotions once per minute; parents' empathic accuracy was calculated from an average discrepancy between parent and adolescent ratings of the adolescent's emotions. Adolescents reported on their depressive symptoms and both parents and adolescents reported on adolescents' diabetes self-care and their own familism values; HbA1c was obtained from medical records. RESULTS: Results from structural equation modeling revealed that parents' empathic accuracy for adolescents' negative (but not positive) emotions was uniquely associated with adolescents' HbA1c, self-care, and depressive symptoms. There was limited evidence that familism was related to parent empathic accuracy or adolescent physical and mental health. CONCLUSIONS: Promoting parents' empathic accuracy for adolescents' negative emotions in the context of type 1 diabetes management may have important implications for adolescents' mental and physical health.

Parental Relationships, Patient-Centered Communication With Healthcare Providers, and Diabetes Management Across Emerging Adulthood.

OBJECTIVE: To examine whether yearly fluctuations in acceptance from and disclosure to parents were associated with fluctuations in perceptions of patient-centered communication (PCC) with the healthcare provider and whether fluctuations in PCC were associated with self-efficacy, type 1 diabetes self-care, and HbA1c across four annual assessments during early emerging adulthood (EA). METHODS: A total of 228 high school seniors (M age = 17.76 years at time 1) reported on mothers' and fathers' acceptance and diabetes-related disclosure to parents, diabetes self-care, and PCC once per year for 4 years. HbA1c was collected from assay kits. RESULTS: Multilevel models revealed within-person associations such that in years when individuals reported greater maternal acceptance than their average, they reported higher PCC. In addition, between-person differences indicated that individuals who reported more maternal acceptance on average relative to others also perceived greater PCC. Similar associations were found for EAs' reports of fathers. No significant effects were found for disclosure to either mother or father. Yearly fluctuations in PCC were associated with self-efficacy such that in years when perceived PCC was higher, self-efficacy was higher. Between person-effects were found for self-efficacy, self-care, and HbA1c such that individuals who reported more PCC on average relative to others reported higher self-efficacy, better self-care, and lower HbA1c. CONCLUSIONS: Aspects of EA's relationships with parents fluctuate with perceptions of PCC with healthcare providers. Perceived PCC with the healthcare provider may be important in higher self-efficacy, diabetes self-care, and lower HbA1c across the early EA years.

Division of Type 1 Diabetes Responsibility in Latinx and Non-Latinx White Mother-Adolescent Dyads.

Incidence rates of type 1 diabetes are increasing faster in Latinx youth than other ethnic groups, yet this population remains understudied. The current study (1) tested differences in division of diabetes-related responsibility (adolescent alone, mother alone, and shared) across Latinx and non-Latinx White families (N = 118 mother-adolescent dyads, 56 = Latinx dyads, Mage=13.24 years), and (2) examined associations between diabetes responsibility and adolescent health (HbA1c, diabetes self-management behaviors, and depressive symptoms). Latina mothers reported more shared and less adolescent responsibility than non-Latinx White mothers, but there were no ethnic differences in adolescent reports of responsibility. Independent of demographic and illness-related characteristics, mother- and adolescent-reports of shared responsibility were associated with higher self-management behaviors, while individual responsibility (adolescent or mother alone) was generally associated with lower self-management behaviors. Shared responsibility associations with higher mother-reported self-management behaviors occurred among Latinx families, but not non-Latinx White families. Shared and individual responsibility were not associated with HbA1c or depressive symptoms. The findings suggest the importance of shared responsibility for diabetes management in adolescence, particularly in Latinx families.

Diabetes support from romantic partners during early emerging adulthood.

We examined support for type 1 diabetes in casual versus committed romantic relationships and links to blood glucose, self-care, and affect in 101 young adults (Mage 18.8). Individuals provided survey and daily measures of support and blood glucose and affect during a 14-day diary period. Survey data indicated individuals viewed partners as helpful, with partners in committed relationships rated more helpful than those in casual relationships. Daily assessments indicated partners were seen as only moderately helpful. Individuals in committed relationships discussed diabetes with partners on more diary days than those in casual relationships. When individuals in any relationship type experienced more helpful partner support than their average, they reported higher positive and lower negative affect. However, those in casual relationships also experienced more negative affect and higher mean blood glucose the next day. Results suggest tradeoffs between immediate benefits and subsequent costs of partner support to adults in casual relationships.

Understanding the Roles of Romantic Partners and Parents in the Management of Type 1 Diabetes in Emerging Adults.

During the emerging adulthood of people with type 1 diabetes, long-term romantic partners may be involved in diabetes management in ways that supplant parental involvement. We examined the perspectives of involvement in diabetes management of the parents and romantic partners of 29 emerging adults with type 1 diabetes, using qualitative interviews and an online survey. When the individuals with diabetes were in long-term romantic relationships, their partners were heavily involved in managing diabetes and providing support; however, when the individuals with diabetes were in short-term relationships or not in a relationship, their parents were described as having the biggest positive impact on their diabetes management. Emerging adults described the involvement of their parents and romantic partners in both positive and negative ways. Romantic relationship status is an important but understudied variable in understanding social involvement and its effects on type 1 diabetes management during emerging adulthood.

Qualitative analysis of helpful and unhelpful aspects of social relationships among young adults with type 1 diabetes.

AIMS: Young adulthood is a high-risk time for type 1 diabetes management when individuals are managing diabetes within changing social contexts and new social relationships. This qualitative study examined helpful and unhelpful aspects of social relationships in the daily lives of young adults with type 1 diabetes. METHODS: Semi-structured qualitative interviews with 29 young adults with type 1 diabetes (ages 22-24, mean = 23 years; 55% female) explored: (a) who in the past week was present when diabetes management occurred; (b) what others did that was helpful or unhelpful for diabetes management; (c) what made helpful and unhelpful aspects of social relationships more or less likely; and (d) what young adults disclosed to others about diabetes. RESULTS: Romantic partners and parents were commonly present and helpful in giving reminders and offering instrumental support, but the presence of trusted individuals was also helpful to management. Co-workers and friends were present during episodes of diabetes management but were often unhelpful, especially when lacking knowledge about participants' diabetes or its management. Participants also discussed conflicting and spontaneous changes in schedules were unhelpful to management. Disclosing diabetes to others and planning for social context barriers were described as strategies to facilitate helpful and reduce unhelpful aspects of social relationships. CONCLUSIONS: Young adults face social barriers to management if they are unable to utilize their relationships effectively. Interventions to promote disclosure to trusted others and planning to avoid social context-related barriers to diabetes management may facilitate more effective self-management at this high-risk time of development.

Insulin Restriction, Emotion Dysregulation, and Depressive Symptoms in Late Adolescents with Diabetes.

OBJECTIVE: Insulin restriction occurs when an individual takes less insulin than recommended and is a serious concern for those with diabetes. General insulin restriction (IR) and insulin restriction for weight control (IRWC) have not been clearly distinguished in the literature, creating inconsistencies and limited understanding of factors that underlie this behavior. We examined whether these are distinct, and how emotion dysregulation and depressive symptoms relate to both forms of insulin restriction during late adolescence. METHODS: As part of a larger study, late adolescents (ages 17-18) with type 1 diabetes (N = 236) completed measures of depressive symptoms (Center for Epidemiologic Studies-Depression Scale [CES-D]), facets of Difficulties In Emotion Regulation Scale (DERS), diabetes self-management behaviors, insulin restriction, and hemoglobin A1c (HbA1c). RESULTS: IR and IRWC were not significantly associated with each other. IR was associated with self-management behaviors but not HbA1c, whereas the opposite was true for IRWC. All DERS subscales (M = 10.60-16.73) and CES-D (M = 16.56) were correlated with greater IRWC; CES-D and all but one DERS subscale were correlated with IR. Covariation with CES-D explained associations between DERS and IRWC. CES-D moderated associations with IR, indicating most subscales of the DERS were associated with IR only when CES-D was higher. CONCLUSION: Emotion dysregulation and depressive symptoms are important correlates of the dangerous behavior of insulin restriction, but function differently when insulin is restricted specifically for weight control versus nonspecified reasons. Future research to understand these underlying processes will be necessary to develop emotion-based theory and evidence-based interventions for this dangerous behavior.

Executive Cognitive Functions and Behavioral Control Differentially Predict HbA1c in Type 1 Diabetes across Emerging Adulthood.

OBJECTIVES: To examine the contributions of two aspects of executive functioning (executive cognitive functions and behavioral control) to changes in diabetes management across emerging adulthood. METHODS: Two hundred and forty-seven high school seniors with type 1 diabetes were assessed at baseline and followed up for 3 years. The baseline assessment battery included performance-based measures of executive cognitive functions, behavioral control, IQ estimate (IQ-est), and psychomotor speed; self-report of adherence to diabetes regimen; and glycated hemoglobin (HbA1c) assay kits as a reflection of glycemic control. RESULTS: Linear and quadratic growth curve models were used to simultaneously examine baseline performance on four cognitive variables (executive cognitive functions, behavioral control, IQ, and psychomotor speed) as predictors of indices of diabetes management (HbA1c and adherence) across four time points. Additionally, general linear regressions examined relative contributions of each cognitive variable at individual time points. The results showed that higher behavioral control at baseline was related to lower (better) HbA1c levels across all four time points. In contrast, executive cognitive functions at baseline were related to HbA1c trajectories, accounting for increasingly more HbA1c variance over time with increasing transition to independence. IQ-est was not related to HbA1c levels or changes over time, but accounted instead for HbA1c variance at baseline (while teens were still living at home), above and beyond all other variables. Cognition was unrelated to adherence. CONCLUSIONS: Different aspects of cognition play a different role in diabetes management at different time points during emerging adulthood years.

The separation in coordination between social- and self-regulation for emerging adults with type 1 diabetes.

To examine how self-regulation and social-regulation surrounding type 1 diabetes (T1D) management are coordinated during early emerging adulthood and whether classes of coordination relate to HbA1c and executive functioning (EF). Emerging adult participants (N = 212) with T1D (M age = 18.8 years, SD = .40) completed a 14-day diary to capture components of self-regulation and social-regulation. A mixture multi-level latent coordination model first determined the separate but coordinated factor structure of self- and social-regulation, then determined the number of distinct classes of coordination and how those classes linked to HbA1c and EF. The best-fitting model included three coordinative factors (self, mother, and father) of regulation and two distinct classes. The class with lower HbA1c and higher EF had more stable self- and social-regulation, more connections between self- and social-regulation and reflected more adaptive patterns, consistent with medical management goals. Social connection with parents may aid in regulation during this at-risk transitional time of emerging adulthood.

Parental Self-Control as a Moderator of the Association Between Family Conflict and Type 1 Diabetes Management.

OBJECTIVE: To examine whether parental self-control (i.e., parents' ability to regulate their emotions, cognitions, and behaviors) moderates the detrimental association between type 1 diabetes (T1D)-specific family conflict and adherence and HbA1c, such that conflict is most detrimental when parental self-control is low. METHODS: One hundred and forty-nine adolescents diagnosed with T1D (Mage = 14.09; 53% female) reported on their T1D-specific conflict with their mothers and fathers and their adherence to the T1D regimen at two time points (6 months apart). Mothers and fathers reported on their self-control. Glycated hemoglobin (HbA1c) was obtained from the medical record at both time points. RESULTS: Higher adolescent-reported conflict with father was associated concurrently with higher HbA1c and lower adherence only for fathers with low self-control (ps < .05). Higher adolescent-reported conflict with mother was also associated concurrently with lower adherence only for mothers with lower self-control (p < .05); no significant moderation was found for mothers' self-control in predicting HbA1c. Longitudinal analyses indicated family conflict with mother predicted changes in adherence and HbA1c, but there were no significant moderating effects of either mother or father self-control. CONCLUSIONS: Lower parental self-control may prevent parents from handling diabetes-related family conflict in a productive manner. We discuss the implications of parental self-control as an intervention target for health care professionals working with adolescents with T1D and their families.

Parental Involvement and Executive Function in Emerging Adults with Type 1 Diabetes.

OBJECTIVE: To examine (a) changes in parental involvement across early emerging adulthood, (b) whether yearly fluctuations in parental involvement were associated with adherence and glycated hemoglobin (HbA1c) over time, and (c) whether higher involvement was more beneficial for those with poorer executive function (EF). METHODS: A total of 228 high school seniors (M age = 17.76) with type 1 diabetes reported on mothers' and fathers' acceptance, knowledge of diabetes activities, disclosure to mothers and fathers regarding diabetes, and adherence at four yearly time points. At baseline, participants completed performance-based measures of EF. HbA1c was collected from assay kits. RESULTS: Growth curve models revealed significant declines in disclosure to fathers and mothers' and fathers' knowledge of diabetes activities; no changes were found in mothers' or fathers' acceptance nor disclosure to mothers. Multilevel models indicated significant between-person effects for nearly all aspects of parental involvement with more acceptance, knowledge, and disclosure associated with better HbA1c and adherence. Within-person effects for disclosure to fathers, and mothers' and fathers' knowledge indicated that in years when emerging adults perceived higher amounts of these types of involvement (compared with their own average), HbA1c was lower. Within-person effects were found for acceptance to mothers, disclosure to mothers and fathers, and mothers' diabetes knowledge for adherence. Disclosure to fathers and mothers' knowledge of diabetes activities were especially beneficial for HbA1c for those with poorer EF performance. CONCLUSIONS: Parental involvement in diabetes management remains important during the high-risk time of emerging adulthood, especially for those with poorer EF.

Structural model of patient-centered communication and diabetes management in early emerging adults at the transfer to adult care.

Early emerging adulthood (ages 18-25) is a time of risk for type 1 diabetes (T1D) when relationships with parents and providers are changing. We examined whether individuals' high-quality relationships with mothers are associated with greater perceptions of patient-centered communication (PCC) with their doctor and whether PCC is associated with better adherence and glycemic control through diabetes-related self-efficacy. Additionally, we tested whether associations of PCC with self-efficacy and diabetes outcomes are stronger among those who had transferred to adult care. One-year post-high school, 217 individuals with T1D (60% women, 53% in adult care) reported perceptions of maternal relationship quality, PCC, self-efficacy, and adherence. Glycemic control was measured via HbA1c assay kits. Structural equation modeling indicated good model fit and revealed indirect paths linking higher maternal relationship quality to better adherence through higher PCC, and higher PCC to better HbA1c through adherence. Transfer status moderated the link between PCC and self-efficacy, suggesting PCC may be especially important when emerging adults transfer to adult care.

Self- and Social-Regulation in Type 1 Diabetes Management During Late Adolescence and Emerging Adulthood.

PURPOSE OF REVIEW: This paper aims to examine how self-regulation (i.e., cognition, emotion) and social-regulation (i.e., parents, friends, romantic partners) are interrelated risk and protective factors for type 1 diabetes management during late adolescence and emerging adulthood. RECENT FINDINGS: Problems in cognitive (e.g., executive function) and emotional (e.g., depressive symptoms) self-regulation are associated with poorer management, both at the between- and within-person levels. Better management occurs when parents are supportive and when individuals actively regulate the involvement of others (e.g., seek help, minimize interference). Friends both help and hinder self-regulation, while research on romantic partners is limited. Facets of self- and social-regulation are important risk and protective factors for diabetes management during emerging adulthood. At this time when relationships are changing, the social context of diabetes may need to be regulated to support diabetes management. Interventions targeting those with self-regulation problems and facilitating self- and social-regulation in daily life may be useful.

Coordination of Self- and Parental-Regulation Surrounding Type I Diabetes Management in Late Adolescence.

Background: Type 1 diabetes management involves self- and social-regulation, with past research examining components through individual differences unable to capture daily processes. Purpose: Dynamical systems modeling was used to examine the coordinative structure of self- and social-regulation (operationalized as parental-regulation) related to daily diabetes management during late adolescence. Methods: Two hundred and thirty-six late adolescents with type 1 diabetes (M age = 17.77 years, SD = .39) completed a 14-day diary reporting aspects of self- (e.g., adherence behaviors, cognitive self-regulation failures, and positive and negative affect) and parental-regulation (disclosure to parents, knowledge parents have, and help parents provide). Results: Self-regulation functioned as one coordinative structure that was separate from parental-regulation, where mothers and fathers were coordinated separately from each other. Mothers' perceived helpfulness served as a driver of returning adolescents back to homeostasis. Conclusions: The results illustrate a dynamic process whereby numerous facets of self- and social-regulation are coordinated in order to return diabetes management to a stable state.

Adolescent Information Management and Parental Knowledge in Non-Latino White and Latino Youth Managing Type 1 Diabetes.

Objectives: The objective of this study is to examine associations between adolescents' regulation of information about their type 1 diabetes (adolescent disclosure, secrecy), parental knowledge about their adolescent's diabetes management, diabetes outcomes (adherence, HbA1c), and depressive symptoms in Non-Latino White and Latino families. Methods: In all, 118 adolescents (56 = Latino, 62 = Non-Latino White) completed surveys of disclosure to and secrecy from parents, parental knowledge of adolescent diabetes management, adherence, and depressive symptoms, and mothers completed measures of maternal knowledge and adolescent adherence. Glycemic control was extracted from medical records. Adolescents also completed structured interviews about parental knowledge about their diabetes-related problems. Results: Interviews revealed that adolescent disclosure is the primary method by which parents gain knowledge about adolescent diabetes management problems. Adolescent disclosure to and secrecy from parents were uniquely associated with diabetes management and depressive symptoms independent of parental knowledge across ethnic groups; maternal reports of knowledge about her adolescent's diabetes care activities were associated with diabetes management independent of adolescent disclosure and secrecy. Conclusions: Adolescent information management strategies are a primary means by which parents gain knowledge about diabetes, which may facilitate more effective management.

Attention Problems as a Predictor of Type 1 Diabetes Adherence and Metabolic Control Across Adolescence.

Objective: Management of type 1 diabetes is a difficult self-regulatory process requiring continued attention to complex regimen tasks. The purpose of this study was to examine whether youths' attention problems were associated with poorer adherence and HbA1c across time, and whether higher parental involvement reduced these associations. Methods: Adolescents with type 1 diabetes (N = 199, M age = 12.43 years, SD = 1.50) and their mothers rated youths' attention problems and adherence at three time points. Adolescents rated parents' diabetes-specific monitoring and behavioral involvement. HbA1c was collected from medical records. Results: Adolescents' (but not mothers') greater reports of attention problems compared with their average related to lower adherence across time. Adolescents' (but not mothers') reports of greater attention problems compared with their average related to lower adherence across time. Conclusions: Youth attention problems may help us understand poor adherence, and interventions to promote parental involvement may buffer this risk.

Iowa Gambling Task Performance Prospectively Predicts Changes in Glycemic Control among Adolescents with Type 1 Diabetes.

OBJECTIVES: Good glycemic control is an important goal of diabetes management. Late adolescents with type 1 diabetes (T1D) are at risk for poor glycemic control as they move into young adulthood. For a subset of these patients, this dysregulation is extreme, placing them at risk for life-threatening health complications and permanent cognitive declines. The present study examined whether deficiency in emotional decision making (as measured by the Iowa Gambling Task; IGT) among teens with T1D may represent a neurocognitive risk factor for subsequent glycemic dysregulation. METHODS: As part of a larger longitudinal study, a total of 241 high-school seniors (147 females, 94 males) diagnosed with T1D underwent baseline assessment that included the IGT. Glycated hemoglobin (HbA1c), which reflects glycemic control over the course of the past 2 to 3 months, was also assessed at baseline. Of the 241,189 (127 females, 62 males, mean age=17.76, mean HbA1c=8.11) completed HbA1c measurement 1 year later. RESULTS: Baseline IGT performance in the impaired range (per norms) was associated with greater dysregulation in glycemic control 1 year later, as evidenced by an average increase in HbA1c of 2%. Those with normal IGT scores (per norms) exhibited a more moderate increase in glycemic control, with an HbA1c increase of 0.7%. Several IGT scoring approaches were compared, showing that the total scores collapsed across all trials was most sensitive to change in glycemic control. CONCLUSIONS: IGT assessment offers promise as a tool for identifying late adolescents at increased risk for glycemic dysregulation. (JINS, 2017, 23, 204-213).

The Stress and Coping Context of Type 1 Diabetes Management Among Latino and Non-Latino White Early Adolescents and Their Mothers.

Objective: Examine ethnic differences in diabetes-related stress and coping among adolescents with type 1 diabetes and their mothers. Early adolescents with type 1 diabetes ( N = 118, ages 10-15 years; 54% female; 47% Latino and 53% non-Latino White) and mothers described the adolescent's diabetes-related stressors and coping strategies, and rated stressor severity and controllability and coping competence. Surveys measured adherence; glycemic control (HbA1c) was indexed from medical records. Few ethnic differences in stress and coping emerged among adolescents. However, Latina mothers reported fewer diabetes-related stressors, had lower congruence with their adolescent on reports of diabetes-related stress, and appraised their adolescent as less competent in coping than non-Latino Whites. Lower dyadic stressor congruence and lower appraisals of coping competence were associated with poorer HbA1c. Mother-adolescent congruence in perceptions of diabetes stress, and appraisals of early adolescents' coping, may be important for understanding diabetes management in ethnically diverse samples.