Abstract: Objective: To investigate the current status of emotional regulation among adolescents with Type 1 Diabetes Mellitus (T1DM), examine its relationship with glycemic management, and analyze the mediating effects of diabetes distress, thereby exploring novel strategies to improve blood glucose management in adolescents. Methods: A total of 206 adolescents aged 13-17 years old with T1DM were selected as study participants through convenience sampling from the outpatient follow-up or inpatient department of a pediatric hospital in Beijing for November, 2023 to August, 2024. Data on their most recent glycated hemoglobin (HbA1c) levels were collected. The study utilized the Brief Version of the Difficulties in Emotion Regulation Scale, the Problem Areas in Diabetes Scale-5, and a general information questionnaire for data collection. Structural equation modeling was employed to analyze the relationships among the relevant variables. Results: The mean HbA1c level of the T1DM adolescents in the study was (7.69±1.14)%. The mean scores for emotional regulation difficulties and diabetes distress were (38.16±12.71) and (5.60±2.92), respectively. Meanwhile, participants' emotional regulation ability was found to be at a moderate level with only 4.4% of them reporting no diabetes distress. The structural equation model showed good fit, indicating that emotional regulation difficulties had both direct and indirect positive effects on diabetes distress and HbA1c levels (β=0.363, 0.032, P<0.01). Additionally, emotional regulation difficulties had an indirect negative effect on patients' dietary and exercise behaviors (β=-0.124, -0.083, P<0.01). Conclusion: Emotional regulation can influence glycemic management in adolescents with T1DM through the mediating effect of diabetes distress. Family-based emotional regulation interventions may be a promising approach to improve glycemic management in those young patients.

Key words: Type 1 Diabetes Mellitus; adolescents; blood glucose management; emotional regulation; diabetes distress