The relationship between perceived executive function and self-reported self-management behaviour in adults with type 1 diabetes

This mixed-method study examined whether and how perceived executive function (EF) is linked to self-reported self-management in 173 people diagnosed with Type 1 diabetes (T1D) during adulthood, combining a cross-sectional survey with thematic analysis of 11 interviews. Stronger global EF significantly predicted better selfmanagement (B = -0.04, t(165) = 4.15; p < .001) after controlling for demographic factors. Stronger perceptions of EF correlated with better self-reported adherence to dietary behaviour, glucose monitoring and physical activity, but not medication-taking or cooperation with healthcare teams. Qualitative interviews identified key challenges in self-management requiring stronger EF including planning behaviours, maintaining attention and vigilance over time, and responding flexibly to changing demands. Strategies which reduce demands on EF, such as establishing routines and delegating control of tasks, helped to improve self-management. Adults with perceived EF impairments may struggle to effectively manage T1D, suggesting supportive interventions should aim to reduce the cognitive demands of self-management.