Original Article

The Glucose Control Resistance Scale (GCRS)


  • Maria-Eleni Nikita
  • Helen M. Hendy
  • Keith E Williams
  • Paul L Mueller

Received Date: 12.07.2018 Accepted Date: 03.10.2018 J Clin Res Pediatr Endocrinol 0;0(0):0-0 [e-Pub] PMID: 30282617


While past research found family conflict, disordered eating, body image concerns, and anxious self-doubts may affect glucose control (A1C), available measures of adherence mainly focus on management tasks. The goal of the current study was to combine emotional distress and beliefs with decisions on management in a new measure of adolescent resistance to treatment adherence: the 12-item Glucose Control Resistance Scale (GCRS).


Participants included 135 adolescents and their parents from a pediatric diabetes clinic. Surveys measured family conflict, body image concerns, anxious self-doubts, and glucose control resistance.


Factor analysis showed 12 items with loadings of .40 or higher to form the Glucose Control Resistance Scale (GCRS). The scale had adequate reliability and there was a significant correlation between child and parent GCRS scores. One factor, family conflict, was significantly related to A1C levels, but the set of four factors explained a total of 12% of the variance in A1C levels. Of the adolescent demographic variables considered (gender, number of parents at home, age, BMIz), only gender was significantly associated with adolescent perceptions of family conflict.


The GCRS may allow diabetic care teams to better understand the origin of family conflict perceptions and the motivational beliefs that modify behavior and contribute to independent self-management and glucose control. Each question was designed to be meaningful in interventions by addressing common items of resistance to adherence and impulsive management decisions. The GCRS may be used by providers as an initial short screening survey on an annual or semi-annual basis.

Keywords: Adolescent beliefs, Type I diabetes, family conflict, resistance, non-compliance