participants for this project were identified from the diabetes research into adolescent transitions ( drat ) study .
the drat project was a 3-year longitudinal project examining the self - management of young people with type 1 diabetes , living in rural and urban areas of new south wales and the australian capital territory .
a total of 158 children and adolescents , 819 years of age , together with their families , were recruited into the drat study , independent of their source of care . as described elsewhere ( 1,2 )
, the drat study involved three annual visits for which a researcher traveled to interview the young person and their family in their home . at each of these annual visits
data relating to frequency of blood glucose monitoring were obtained from the memory of blood glucose meters for the preceding 2 weeks .
a capillary blood sample was also collected , and hba1c values were determined by a single laboratory using high - performance liquid chromatography ( bio - rad , hercules , ca ; upper limit of normal 6.0% ) .
participants who had completed their first annual visit were posted a letter inviting them to be involved in this extension of the drat study , along with an information sheet , consent form , and personality data collection tool . to improve return rates ,
the package was followed up by a telephone call from the researcher who had met with the family at the first annual visit , and a reply paid envelope was included in the package to assist participants in returning completed forms .
other participants were approached directly by researchers during their first annual visit , and personality data were completed at this time .
a total of 142 of 158 drat participants agreed to take part in the personality study .
personality data were gathered using the five - factor personality inventory for children ( ffpi - c ) .
the ffpi - c is a validated , untimed pen - and - paper questionnaire designed to measure personality dimensions of conscientiousness , agreeableness , emotional regulation , extraversion , and openness to experience in children and adolescents from 9 years and 0 months of age to 18 years and 11 months of age ( 13 ) .
the ffpi - c consists of 75 items ( 15 items per factor ) , with each item having two opposing anchor statements aimed at assessing trait variability on the personality dimensions .
there are five circles between the anchor statements that allow the participant to choose the statement that best reflects their response ( 13 ) .
raw scores for the five - factor domains were summed and converted to t - scores using the manual provided ( 13 ) .
cronbach alphas ranged from 0.75 ( openness ) to 0.88 ( conscientiousness ) . to assess for statistical significance of the relationships between personality traits and outcome measures over time , multivariate regressions using the five - factor domains as independent variables and hba1c or frequency of blood glucose monitoring as dependent variables were conducted for each year of data collection .
pearson product correlations were computed between independent and dependent variables , and coefficients are reported in supplementary table 1 .
scores for emotional regulation suggested a curvilinear relationship with glycemic control ( hba1c ) ; therefore , a centered quadratic term for this trait was included in the regression analyses , allowing for linear and quadratic regression models to be compared .
if the addition of a quadratic term improved the overall fit of a bivariate regression model , the relationship between the independent and dependent variables was considered to be of curvilinear nature ( 1416 ) .
control variables of age , sex , duration of diabetes , family responsibility , and interaction terms were entered into hierarchical regressions along with all five of the personality traits .
after this , significant variables were re - entered into forced - entry regression models .
the forced - entry models for the second and third years also included the initial outcome measure from the first year to control for its effects ( i.e. , hba1c from year 1 was included in year 2 and year 3 hba1c regressions , and smbg from year 1 was included in year 2 and year 3 smbg regressions ) .
the contribution of personality was calculated as the difference in adjusted r between a model including all predictors of hba1c or smbg and a second model with personality variables excluded . to assess longitudinal change ,
mixed - design anovas were used using high and low baseline groups ( upper and lower tertiles ) for traits found to be significant predictors of outcomes .
baseline personality traits were used based on the temporal stability of these factors ( correlation coefficients r = 0.550.84 ) .
three groups ( upper , middle , and lower quintiles ) were created for analyses of emotional regulation and hba1c based on the nonlinear relationship that was found . the research protocol used in this project
was approved by the university of western sydney and the university of sydney human ethics committees , as well as the relevant state area health units .
personality data were gathered using the five - factor personality inventory for children ( ffpi - c ) .
the ffpi - c is a validated , untimed pen - and - paper questionnaire designed to measure personality dimensions of conscientiousness , agreeableness , emotional regulation , extraversion , and openness to experience in children and adolescents from 9 years and 0 months of age to 18 years and 11 months of age ( 13 ) .
the ffpi - c consists of 75 items ( 15 items per factor ) , with each item having two opposing anchor statements aimed at assessing trait variability on the personality dimensions .
there are five circles between the anchor statements that allow the participant to choose the statement that best reflects their response ( 13 ) .
raw scores for the five - factor domains were summed and converted to t - scores using the manual provided ( 13 ) .
to assess for statistical significance of the relationships between personality traits and outcome measures over time , multivariate regressions using the five - factor domains as independent variables and hba1c or frequency of blood glucose monitoring as dependent variables were conducted for each year of data collection .
pearson product correlations were computed between independent and dependent variables , and coefficients are reported in supplementary table 1 .
scores for emotional regulation suggested a curvilinear relationship with glycemic control ( hba1c ) ; therefore , a centered quadratic term for this trait was included in the regression analyses , allowing for linear and quadratic regression models to be compared .
if the addition of a quadratic term improved the overall fit of a bivariate regression model , the relationship between the independent and dependent variables was considered to be of curvilinear nature ( 1416 ) .
control variables of age , sex , duration of diabetes , family responsibility , and interaction terms were entered into hierarchical regressions along with all five of the personality traits .
after this , significant variables were re - entered into forced - entry regression models .
the forced - entry models for the second and third years also included the initial outcome measure from the first year to control for its effects ( i.e. , hba1c from year 1 was included in year 2 and year 3 hba1c regressions , and smbg from year 1 was included in year 2 and year 3 smbg regressions ) .
the contribution of personality was calculated as the difference in adjusted r between a model including all predictors of hba1c or smbg and a second model with personality variables excluded . to assess longitudinal change ,
mixed - design anovas were used using high and low baseline groups ( upper and lower tertiles ) for traits found to be significant predictors of outcomes .
baseline personality traits were used based on the temporal stability of these factors ( correlation coefficients r = 0.550.84 ) .
three groups ( upper , middle , and lower quintiles ) were created for analyses of emotional regulation and hba1c based on the nonlinear relationship that was found .
the research protocol used in this project was approved by the university of western sydney and the university of sydney human ethics committees , as well as the relevant state area health units .
overall , glycemic control remained stable over the 3-year study period , with a nonsignificant rise in hba1c from 8.6% ( sd 1.4 ) in year 1 to 8.8% ( sd 1.4 ) in year 2 and 8.7% ( sd 1.3 ) in year 3 .
baseline characteristics of young people participating in the personality study and drat project correlations indicated that four of the five - factor domains  conscientiousness , agreeableness , emotional regulation , and openness to experience 
were associated with hba1c levels at different points across the 3-year study period ( supplementary table 1 ) .
hierarchical regressions indicated that conscientiousness , agreeableness , and the centered quadratic term for emotional regulation were significant independent predictors of hba1c levels .
no significant interactions were identified between personality traits and demographic variables . despite a significant correlation between openness to experience and hba1c ,
a model including conscientiousness , agreeableness , and the quadratic term for emotional regulation significantly predicted 8% of the variance in hba1c scores at baseline [ r = 0.08 ; f(3,115 ) = 3.21 ; p = 0.03 ] .
the quadratic term for emotional regulation was the only significant independent predictor within this model ( table 2 ) .
standardized  coefficients and r in regression models predicting glycemic control ( hba1c ) and frequency of smbg over the 3-year study period a regression model that included the participants hba1c at baseline together with conscientiousness , agreeableness , and the quadratic term for emotional regulation significantly predicted their second - year hba1c [ r = 0.55 ; f(4,120 ) = 37.28 ; p < 0.001 ] . for this year
, conscientiousness and agreeableness were significant independent predictors of glycemic control , whereas the quadratic term for emotional regulation was nonsignificant .
the contribution of these personality traits to the overall model was calculated at 9% ( table 2 ) .
similar results were obtained for the third year of data collection . as shown in table 2 , the full model , including baseline hba1c , significantly predicted third - year hba1c [ r = 0.39 ; f(4 , 126 ) = 20.49 ; p < 0.01 ] . once again , conscientiousness and agreeableness were the only significant personality trait predictors of glycemic control within this model . in year 3
while glycemic control did not change over the study period for the group as a whole [ f(2 , 278 ) = 1.34 ; p = 0.26 ] , there were differences in hba1c between individuals with high and low levels of conscientiousness [ f(1 , 100 ) = 5.09 ; p = 0.03 ] and individuals with high and low levels of agreeableness [ f(1 , 96 ) = 9.79 ; p < 0.01 ] .
1a , while hba1c was similar at entry to the study ( year 1 ) , there was an interaction between conscientiousness groups and time [ f(2 , 200 ) = 4.48 ; p = 0.01 ] .
glycemic control deteriorated over the 3-year study period in individuals in the lowest tertile of conscientiousness [ f(2 , 98 ) = 6.10 ; p < 0.01 ] .
in contrast , no significant changes in hba1c values were found for the high - conscientiousness group [ f(2 , 102 ) = 0.37 ; p = 0.69 ] .
a similar interaction was found between agreeableness group and hba1c over time [ f(2 , 192 ) = 4.91 ; p < 0.01 ] .
individuals in the lowest tertile of agreeableness had worsening glycemic control [ f(2 , 88 ) = 5.00 ; p < 0.01 ] , whereas no significant main effect of time on hba1c values was found for the high - agreeableness group [ f(2 , 104 ) = 0.64 ; p = 0.53 ] .
since there was a statistically significant curvilinear relationship between emotional regulation and hba1c , the upper , middle , and lower quintile groups for baseline emotional regulation were compared to examine the role of this trait in long - term glycemic control .
there was a significant interaction between emotional regulation and hba1c scores over time [ f(4 , 190 ) = 3.01 ; p = 0.02 ] .
between - group differences also approached significance [ f(2 , 95 ) = 2.88 ; p = 0.06 ] . within - group analyses indicated no significant changes in glycemic control within the low emotional regulation group [ f(2 , 56 ) = 1.80 ;
p = 0.18 ] or the high emotional regulation group [ f(2 , 74 ) = 2.18 ; p = 0.12 ] .
however , there was significant decline in glycemic control within the moderate emotional regulation group [ f(2 , 60 ) = 5.44 ; p < 0.01 ] .
1c , individuals with low emotional regulation had consistently worse glycemic control across the study period compared with those with moderate emotional regulation , while hba1c trended down steeply in the final year for those high in emotional regulation .
correlations indicated that conscientiousness , emotional regulation , and agreeableness were associated with blood glucose monitoring at different points across the 3-year study period ( supplementary table 1 ) .
hierarchical regressions indicated that age and conscientiousness were the only significant independent predictors of blood glucose monitoring .
a model including conscientiousness and age significantly predicted 7% of the variance in blood glucose monitoring at baseline [ r= 0.07 ; f(2 , 118 ) = 4.10 ; p = 0.02 ] . a model including baseline number of blood glucose estimations , age , and conscientiousness significantly predicted blood glucose monitoring behavior in the second year ; however , the trait of conscientiousness only contributed to 3% of the variance ( table 2 ) . in the third year , a similar model predicted 30% variance in smbg behavior [ r= 0.30 ; f(3 , 127 ) = 18.33 ; p < 0.00 ] , with conscientiousness providing 5% of this contribution .
older participants monitored less frequently than their younger counterparts , whereas participants who scored high in the domain of conscientiousness consistently performed a higher frequency of blood glucose monitoring ( mean number of smbg in a fortnight : 81.0 [ sd 43.7 ] vs. 66.8 [ sd 24.7 ] in year 1 ; 79.0 [ sd 33.7 ] vs. 62.4 [ sd 22.3 ] in year 2 and 76.2 [ sd 27.7 ] vs. 58.8 [ sd 26.9 ] in year 3 ; f(1 , 98 ) = 9.53 ; p < 0.01 ) .
overall , glycemic control remained stable over the 3-year study period , with a nonsignificant rise in hba1c from 8.6% ( sd 1.4 ) in year 1 to 8.8% ( sd 1.4 ) in year 2 and 8.7% ( sd 1.3 ) in year 3 .
correlations indicated that four of the five - factor domains  conscientiousness , agreeableness , emotional regulation , and openness to experience  were associated with hba1c levels at different points across the 3-year study period ( supplementary table 1 ) .
hierarchical regressions indicated that conscientiousness , agreeableness , and the centered quadratic term for emotional regulation were significant independent predictors of hba1c levels .
no significant interactions were identified between personality traits and demographic variables . despite a significant correlation between openness to experience and hba1c ,
a model including conscientiousness , agreeableness , and the quadratic term for emotional regulation significantly predicted 8% of the variance in hba1c scores at baseline [ r = 0.08 ; f(3,115 ) = 3.21 ; p = 0.03 ] .
the quadratic term for emotional regulation was the only significant independent predictor within this model ( table 2 ) .
standardized  coefficients and r in regression models predicting glycemic control ( hba1c ) and frequency of smbg over the 3-year study period a regression model that included the participants hba1c at baseline together with conscientiousness , agreeableness , and the quadratic term for emotional regulation significantly predicted their second - year hba1c [ r = 0.55 ; f(4,120 ) = 37.28 ; p < 0.001 ] . for this year
, conscientiousness and agreeableness were significant independent predictors of glycemic control , whereas the quadratic term for emotional regulation was nonsignificant .
the contribution of these personality traits to the overall model was calculated at 9% ( table 2 ) .
similar results were obtained for the third year of data collection . as shown in table 2 , the full model , including baseline hba1c , significantly predicted third - year hba1c [ r = 0.39 ; f(4 , 126 ) = 20.49 ; p < 0.01 ] .
once again , conscientiousness and agreeableness were the only significant personality trait predictors of glycemic control within this model . in year 3 , personality contributed 12% of the variance in hba1c results .
correlations indicated that four of the five - factor domains  conscientiousness , agreeableness , emotional regulation , and openness to experience  were associated with hba1c levels at different points across the 3-year study period ( supplementary table 1 ) .
hierarchical regressions indicated that conscientiousness , agreeableness , and the centered quadratic term for emotional regulation were significant independent predictors of hba1c levels .
no significant interactions were identified between personality traits and demographic variables . despite a significant correlation between openness to experience and hba1c ,
a model including conscientiousness , agreeableness , and the quadratic term for emotional regulation significantly predicted 8% of the variance in hba1c scores at baseline [ r = 0.08 ; f(3,115 ) = 3.21 ; p = 0.03 ] .
the quadratic term for emotional regulation was the only significant independent predictor within this model ( table 2 ) .
standardized  coefficients and r in regression models predicting glycemic control ( hba1c ) and frequency of smbg over the 3-year study period a regression model that included the participants hba1c at baseline together with conscientiousness , agreeableness , and the quadratic term for emotional regulation significantly predicted their second - year hba1c [ r = 0.55 ; f(4,120 ) = 37.28 ; p < 0.001 ] . for this year
, conscientiousness and agreeableness were significant independent predictors of glycemic control , whereas the quadratic term for emotional regulation was nonsignificant .
the contribution of these personality traits to the overall model was calculated at 9% ( table 2 ) .
similar results were obtained for the third year of data collection . as shown in table 2 , the full model , including baseline hba1c , significantly predicted third - year hba1c [ r = 0.39 ; f(4 , 126 ) = 20.49 ; p < 0.01 ] .
once again , conscientiousness and agreeableness were the only significant personality trait predictors of glycemic control within this model . in year 3 , personality contributed 12% of the variance in hba1c results .
while glycemic control did not change over the study period for the group as a whole [ f(2 , 278 ) = 1.34 ; p = 0.26 ] , there were differences in hba1c between individuals with high and low levels of conscientiousness [ f(1 , 100 ) = 5.09 ; p = 0.03 ] and individuals with high and low levels of agreeableness [ f(1 , 96 ) = 9.79 ; p < 0.01 ] . as shown in fig .
1a , while hba1c was similar at entry to the study ( year 1 ) , there was an interaction between conscientiousness groups and time [ f(2 , 200 ) = 4.48 ; p = 0.01 ] .
glycemic control deteriorated over the 3-year study period in individuals in the lowest tertile of conscientiousness [ f(2 , 98 ) = 6.10 ; p < 0.01 ] .
in contrast , no significant changes in hba1c values were found for the high - conscientiousness group [ f(2 , 102 ) = 0.37 ; p = 0.69 ] .
a similar interaction was found between agreeableness group and hba1c over time [ f(2 , 192 ) = 4.91 ; p < 0.01 ] . individuals in the lowest tertile of agreeableness had worsening glycemic control [ f(2 , 88 ) = 5.00 ; p < 0.01 ] , whereas no significant main effect of time on hba1c values was found for the high - agreeableness group [ f(2 , 104 ) = 0.64 ; p = 0.53 ] .
since there was a statistically significant curvilinear relationship between emotional regulation and hba1c , the upper , middle , and lower quintile groups for baseline emotional regulation were compared to examine the role of this trait in long - term glycemic control .
there was a significant interaction between emotional regulation and hba1c scores over time [ f(4 , 190 ) = 3.01 ; p = 0.02 ] .
between - group differences also approached significance [ f(2 , 95 ) = 2.88 ; p = 0.06 ] . within - group analyses indicated no significant changes in glycemic control within the low emotional regulation group [ f(2 , 56 ) = 1.80 ; p = 0.18 ] or the high emotional regulation group [ f(2 , 74 ) = 2.18 ; p = 0.12 ] . however , there was significant decline in glycemic control within the moderate emotional regulation group [ f(2 , 60 ) = 5.44 ; p < 0.01 ] . as seen in fig .
1c , individuals with low emotional regulation had consistently worse glycemic control across the study period compared with those with moderate emotional regulation , while hba1c trended down steeply in the final year for those high in emotional regulation .
correlations indicated that conscientiousness , emotional regulation , and agreeableness were associated with blood glucose monitoring at different points across the 3-year study period ( supplementary table 1 ) .
hierarchical regressions indicated that age and conscientiousness were the only significant independent predictors of blood glucose monitoring .
no significant interactions between demographics and personality traits were found . a model including conscientiousness and age significantly predicted 7% of the variance in blood glucose monitoring at baseline [ r= 0.07 ; f(2 , 118 ) = 4.10 ; p = 0.02 ] .
a model including baseline number of blood glucose estimations , age , and conscientiousness significantly predicted blood glucose monitoring behavior in the second year ; however , the trait of conscientiousness only contributed to 3% of the variance ( table 2 ) . in the third year , a similar model predicted 30% variance in smbg behavior [ r= 0.30 ; f(3 , 127 ) = 18.33 ; p < 0.00 ] , with conscientiousness providing 5% of this contribution .
older participants monitored less frequently than their younger counterparts , whereas participants who scored high in the domain of conscientiousness consistently performed a higher frequency of blood glucose monitoring ( mean number of smbg in a fortnight : 81.0 [ sd 43.7 ] vs. 66.8 [ sd 24.7 ] in year 1 ; 79.0 [ sd 33.7 ] vs. 62.4 [ sd 22.3 ] in year 2 and 76.2 [ sd 27.7 ] vs. 58.8 [ sd 26.9 ] in year 3 ; f(1 , 98 ) = 9.53 ; p < 0.01 ) .
correlations indicated that conscientiousness , emotional regulation , and agreeableness were associated with blood glucose monitoring at different points across the 3-year study period ( supplementary table 1 ) .
hierarchical regressions indicated that age and conscientiousness were the only significant independent predictors of blood glucose monitoring .
a model including conscientiousness and age significantly predicted 7% of the variance in blood glucose monitoring at baseline [ r= 0.07 ; f(2 , 118 ) = 4.10 ; p = 0.02 ] .
a model including baseline number of blood glucose estimations , age , and conscientiousness significantly predicted blood glucose monitoring behavior in the second year ; however , the trait of conscientiousness only contributed to 3% of the variance ( table 2 ) . in the third year , a similar model predicted 30% variance in smbg behavior [ r= 0.30 ; f(3 , 127 ) = 18.33 ; p < 0.00 ] , with conscientiousness providing 5% of this contribution .
older participants monitored less frequently than their younger counterparts , whereas participants who scored high in the domain of conscientiousness consistently performed a higher frequency of blood glucose monitoring ( mean number of smbg in a fortnight : 81.0 [ sd 43.7 ] vs. 66.8 [ sd 24.7 ] in year 1 ; 79.0 [ sd 33.7 ] vs. 62.4 [ sd 22.3 ] in year 2 and 76.2 [ sd 27.7 ] vs. 58.8 [ sd 26.9 ] in year 3 ; f(1 , 98 ) = 9.53 ; p < 0.01 ) .
the current study suggests that personality traits may be a predictor of how well a young person with type 1 diabetes does over time in terms of glycemic control and self - monitoring behavior .
( 12 ) showed that high agreeableness and high conscientiousness were associated with better glycemic control in the first 2 years of living with diabetes .
, the current study shows that these traits continue to play a role regardless of duration of diabetes .
although the hba1c of the participants who were high on these two traits in our study was above target , it remained stable over the 3 years .
of more concern , however , were those participants who were low on conscientiousness and/or agreeableness . in these individuals ,
therefore , low scores on these personality traits may be risk factors for poor or worsening glycemic control and confirm that baseline personality scores may have a continuous effect on diabetes management outcomes .
it is intuitive that conscientiousness would also play a role in self - care behavior . indeed , skinner et al .
( 17 ) showed that conscientiousness , as well as emotional regulation , influenced type 1 diabetes self - management behavior through a mediating effect on a person s treatment beliefs .
more broadly , conscientiousness has been found to be associated with better adoption of health - protective behaviors relating to issues such as tobacco use and physical activity ( 18 ) . in this current study
, those participants with high scores on conscientiousness performed a higher frequency of blood glucose estimations .
importantly , this group continued to show high levels of self - care in relation to monitoring throughout the study period .
conversely , participants with low scores on this trait , as well as older participants , monitored less frequently .
although agreeableness was associated with glycemic control , it did not predict self - monitoring behaviors . of interest , the work by vollrath et al .
( 12 ) showed that children low on neuroticism ( now known as emotional regulation ) also had better glycemic control .
emotional regulation refers to a person s capacity to control their emotional responses to their environment and others , and those scoring low on this factor are prone to be emotionally over reactive and more vulnerable to negative emotional states ( 19 ) .
( 12 ) , our study showed a curvilinear relationship between emotional regulation and glycemic control .
individuals with either low or high scores on this trait had consistently higher hba1c values across the first 2 years of the study compared with those with moderate scores .
there is some prior evidence of a curvilinear relationship between emotional regulation and progression of diabetes complications .
a study by brickman et al . ( 20 ) demonstrated that , in adults with diabetes , extreme scores on emotional regulation ( either low or high ) were related to more rapid deterioration in renal function .
( 20 ) may be explained by the law of yerkes and dodson ( 21 ) , which states that task performance increases with emotional arousal up to an  optimum point ,  beyond which reductions in performance occur .
therefore , people high in emotional regulation may be unconcerned about the long - term effects of poor glycemic control .
those low in emotional regulation are likely to be distressed , and this may influence their ability to look after themselves .
the findings of this study are significant , as they underline the importance of personality in determining self - management in young people with type 1 diabetes over time .
personality traits show some continuity from childhood onwards ; however , traits are not generally considered to be fixed until 30 years of age ( 22 ) .
further research is needed to identify the extent to which a young person s personality can be modified . in the meantime
, there may be benefits in clinicians taking personality into account and helping young people manage rather than change their personality .
for example , knowing whether a young patient is not particularly conscientious would be helpful in understanding the possible reasons for their poor attention to regular blood glucose monitoring . focusing on simple strategies to raise behavior - awareness and to improve self - organization , time - management , and planning skills
these strategies may include the use of telephone reminders or providing young people with blood glucose meters with alerts .
in contrast , for those who are low on emotional regulation , strategies that focus on reducing stress and anxiety may be of higher priority than using reminders or fostering time - management skills .
similarly , knowledge that a young person is particularly conscientious or emotionally well - regulated would free up precious clinic time to concentrate on other aspects of their care or equally provide a sound basis for engaging this particular attribute to ensure continued good self - management practices .
future studies are needed to examine the potential of personality - based interventions in diabetes care .
research trial interventions that develop , implement , and evaluate health care professionals skills in monitoring and fostering attributes of personality and their impact on improving self - management of this group of people are also needed .
while this study was the largest of its kind , the results were based on a comparatively small sample of participants .
relative to the sample size , a high number of correlations were performed , increasing the possibility of type i or type ii error .
the general lack of significant relationships between personality traits and first - year outcomes is intriguing .
however , the five - factor model variables showed high temporal stability within participants , and further detailed research is needed to understand these findings .
despite these limitations , the results of this study indicate that personality may be one of the many factors that contribute to less than optimal self - care behaviors and suboptimal glycemic control in young people with type 1 diabetes . harnessing those personality traits associated with improved outcomes , as well as developing effective methods of working with those traits associated with worse outcomes , may serve to optimize diabetes care .
 objectiveto determine whether personality traits ( conscientiousness , agreeableness , emotional regulation , extraversion , and openness to experience ) are associated with glycemic control and blood glucose monitoring behavior , and change or stability of these outcomes over time , in young people with type 1 diabetes.research design and methodsa 3-year longitudinal study was conducted using data from 142 individuals with type 1 diabetes , 819 years of age . 
 personality was assessed at baseline using the five - factor personality inventory for children . 
 data relating to glycemic control ( hba1c ) and frequency of blood glucose monitoring ( based on meter memory ) were collected annually . 
 relationships between personality traits and hba1c and monitoring frequency were examined using regression models and mixed - design anova.resultsthree of the five - factor domains were independently associated with glycemic control . 
 individuals high in conscientiousness and agreeableness had a lower and more stable hba1c across the 3-year study period . 
 in contrast , the hba1c of individuals scoring low on these traits was either consistently worse or deteriorated over time . 
 low or high emotional regulation scores were also associated with worse glycemic control . by the third year 
 , these domains , together with initial hba1c , accounted for 39% of hba1c variance . 
 conscientiousness was the only personality factor associated with blood glucose monitoring behavior.conclusionsresults of this study underline the importance of personality in contributing to diabetes outcomes . 
 attention to a young person s personality , and appropriate tailoring of diabetes management to ensure an individualized approach , may help to optimize diabetes outcomes . 
RESEARCH DESIGN AND METHODS
Personality data collection tool
Statistical analyses
Ethics
RESULTS
Patient characteristics
Association between personality and glycemic control
Correlations.
Hierarchical regressions.
Forced-entry regressions.
Factors associated with change in glycemic control
Association between personality and SMBG
Correlations.
Hierarchical regressions.
Forced-entry regressions.
CONCLUSIONS