OBJECTIVE The increasing importance of peers in adolescence and emerging adulthood has been widely acknowledged. However, longitudinal research linking the peer context to diabetes management and outcomes is scarce. The present longitudinal study in a large sample of youths with type 1 diabetes related both positive and negative peer variables to diabetes outcomes over a time interval of 1 year.

RESEARCH DESIGN AND METHODS Our sample consisted of 467 adolescents (14–17 years of age) and emerging adults (18–25 years of age) with type 1 diabetes who participated in a two-wave longitudinal study. Questionnaires tapped into peer support, extreme peer orientation, parental responsiveness, diabetes-related distress, and treatment adherence. HbA_1c values were obtained from the treating physicians of patients. Cross-lagged analysis from a structural equation modeling approach was performed to assess the directionality of effects.

RESULTS Peer support negatively predicted diabetes-related distress over time. Extreme peer orientation positively predicted treatment distress over time. Parental responsiveness negatively predicted food distress over time. Treatment adherence negatively predicted extreme peer orientation, treatment distress, and HbA_1c values over time. For emerging adults specifically, there was a reciprocal relationship between HbA_1c values and extreme peer orientation, because they positively predicted each other.

CONCLUSIONS This study highlights the importance of peers in predicting the functioning of youths with type 1 diabetes. Additionally, treatment adherence at baseline was found to negatively predict extreme peer orientation, treatment distress, and worse glycemic control over time. In sum, the current study underscores the importance of the peer context for adolescents and emerging adults with type 1 diabetes.

目的同龄人在青春期和成年期的重要性日益提高，这一点已得到广泛认可。但是，缺乏将同龄人背景与糖尿病管理和结局联系起来的纵向研究很少。目前的纵向研究是在1年的时间间隔内对一大批1型糖尿病青年进行正向和负向同伴变量与糖尿病结局的相关性研究。

研究设计和方法我们的样本包括467名青少年（14-17岁）和新兴成年人（18-25岁），他们参加了两波纵向研究，患有1型糖尿病。问卷调查涉及同龄人的支持，极端的同龄人的定向，父母的反应能力，与糖尿病有关的困扰和治疗依从性。HbA _1c值是从患者的治疗医生那里获得的。进行了结构方程建模方法的交叉滞后分析，以评估效应的方向性。

结果同伴支持随着时间的推移负面预测与糖尿病有关的困扰。极端的同龄人取向肯定会随着时间的推移预测治疗的困扰。父母的反应能力会随着时间的推移负面地预测食物困扰。治疗依从性负面地预测了极端的同龄人定向，治疗困扰和HbA _1c值随时间的变化。特别是对于新兴成年人，HbA _1c值与极端同伴取向之间存在相互关系，因为他们彼此之间具有积极的相互预测作用。

结论本研究强调了同伴在预测1型糖尿病青年中的功能的重要性。另外，发现基线时的治疗依从性不利地预测极端的同龄人定向，治疗困扰以及随着时间的流逝血糖控制更差。总而言之，当前的研究强调了同伴情境对于青少年和1型糖尿病新兴成年人的重要性。