Poor metabolic control is a major health concern for children and adolescents with type 1 diabetes, particularly for African American youth. The aims of this study were to test the mediating relationship between two variables consistently related to metabolic control, depressive symptoms and adherence, as well as to attempt to explain racial disparities in metabolic control. The study sample consisted of 53 European American youth and 33 African American youth ages 5 to 20 (M = 13.59, SD = 3.49) with type 1 diabetes. Information on depressive symptoms, adherence, and HbA1c was collected during routine outpatient clinic visits. Significant associations were found between depressive symptoms and metabolic control, depressive symptoms and adherence, and adherence and metabolic control. When included together in a regression model, adherence mediated the relationship between depressive symptoms and metabolic control. This mediation pathway did not significantly differ between African American youth and European American youth; however, African American youth had significantly higher HbA1c levels. These findings indicate the importance of considering depressive symptoms during treatment for type 1 diabetes. This study also supports previous research findings of racial disparities in metabolic control among youth with type 1 diabetes. Future studies should further examine mechanisms by which these racial disparities emerge.
