Self-efficacy, diabetes distress, self-management, and glycemic regulation: within-person pathways in type 1 diabetes.

This article focuses on the within-person, bidirectional, temporal relationships among self-efficacy, diabetes distress, self-management behavior, and glycemic regulation in adults with type 1 diabetes (T1D). Using data from the Function and Emotion in Everyday Life with Type 1 Diabetes (FEEL-T1D) study, which combined ecological momentary assessment (EMA) and continuous glucose monitoring (CGM) over 14 days in 173 diverse adults, the study found that higher morning diabetes self-efficacy predicted lower diabetes distress and better self-management throughout the day. These factors, in turn, were associated with improved glycemic outcomes measured by CGM, while prior-day glucose levels did not predict next-morning self-efficacy. The findings support Bandura's theory that self-efficacy influences future behavior and is shaped by prior emotional states and self-management performance, highlighting self-efficacy as a potential target for interventions to improve diabetes management and glycemic control in T1D.