Objective To examine how children's appraisals of maternal involvement in coping with diabetes are associated with adherence, metabolic control, and quality of life across adolescence. Methods Children (N = 127, ages 10-15 years) with type 1 diabetes completed measures of adherence, quality of life, and appraisals of mothers' involvement in dealing with diabetes problems (i.e., mother appraised as uninvolved, controlling, or collaborative). Metabolic control was indexed through medical records.

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... Results Regardless of age or sex of child, appraised maternal uninvolvement was associated with poorer adherence and quality of life, while appraised collaboration was associated with better adherence and metabolic control. There was evidence that the association between appraised collaboration and metabolic control was partially mediated by adherence. Appraised control was associated with poorer adherence among older, but not younger, children and with poorer quality of life among older females but not among older males or younger children of either sex. Conclusions Maintaining maternal involvement in diabetes care is important across ages 10 to 15, but the optimal form of this involvement may need to be adjusted to be consistent with the child's level of development. The present findings suggest that better adherence is seen across age when mothers are viewed as collaborating with, as opposed to controlling, their child when dealing with diabetes problems. Diabetes is a source of stress for patients of all ages, but particularly so during adolescence, as the affected child faces normal developmental challenges while having to manage a serious illness. For children with diabetes, the transition into adolescence is frequently marked by declines in adherence, in metabolic control, and in psychosocial well-