Physical and Psychological Health in Adolescents and Young Adults With Type 1 Diabetes: The Mediating Roles of Diabetes Self-Management and Social Relationships

PURPOSE: The purpose of this study was to examine whether diabetes self-management and social relationships mediate the association between self-perceived physical health and psychological health among Israeli adolescents and young adults with type 1 diabetes (T1D). METHODS: A cross-sectional online survey was conducted among 79 individuals ages 16 to 25 years with T1D, recruited through diabetes-related social media platforms. Participants completed self-report measures of diabetes self-management and quality of life. Physical health, psychological health, and social relationships were assessed using the World Health Organization Quality of Life Questionnaire-Brief Version, and diabetes self-management was assessed using the Diabetes Self-Management Questionnaire. Parallel mediation analyses were conducted using PROCESS Model 4 with 5000 bootstrap resamples. RESULTS: Better physical health was significantly associated with better psychological health. When diabetes self-management and social relationships were included in the model, the direct association remained significant. Significant indirect effects were found through social relationships and diabetes self-management. The total indirect effect was significant, but the contrast between the 2 indirect effects was not. CONCLUSIONS: Diabetes self-management and social relationships statistically accounted for part of the association between physical and psychological health among adolescents and young adults with T1D. Because the study was cross-sectional, the results should be interpreted as indirect associations rather than causal pathways. Overall, these findings highlight the importance of addressing both behavioral and interpersonal resources in diabetes care and education during the transition to adulthood.