背景：我国1型糖尿病青少年人群增长迅速，其自我管理水平普遍偏低， 面临血糖管理困难及情绪问题高发风险，情绪调节在成年糖尿病患者中被证实可通过缓解负性情绪间接改善血糖管理，而父母作为主要照护者，其情绪调节能力不足可能通过代际传递加剧青少年情绪恶化。探究1型糖尿青少年和父母情绪调节现况、父母与青少年的情绪调节代际传递以及情绪调节对青少年血糖管理的影响，以期为制订1型糖尿青少年人群进行针对性的情绪管理干预措施提供依据。

目的：描述1型糖尿青少年及其父母的情绪调节现状；探究青少年与父母情绪调节对青少年负性情绪（糖尿病痛苦、焦虑、抑郁）及血糖管理的关联路径，验证糖尿病痛苦在情绪调节与血糖管理间的中介作用，为制定以家庭为中心的1型糖尿青少年心理干预策略提供理论依据。

方法：本研究为横断面描述性研究。于2023年11月至2024年8月，便利选取北京儿童医院门诊随诊或者住院符合纳入排除标准的206例13~17岁1型糖尿病青少年和父母为调查对象。收集最近一次糖化血红蛋白指标，使用一般资料调查问卷、简版情绪调节困难量表、5条目糖尿病痛苦量表、广泛性焦虑自评量表、9条目病人健康问卷、中国父母对青少年负面情绪的回应方式问卷收集资料。

结果：本研究共收集青少年206例和其家长206例有效数据，1型糖尿病青少年病程平均为（47.36±21.49）月，糖化血红蛋白水平平均为（7.69±1.14)%，血糖监测、饮食和运动管理达标率分别为85.9%、25.73%和63.11% ；情绪调节困难为（38.16±12.71）分，情绪调节能力处于中等水平，糖尿病痛苦、焦虑和抑郁得分分别为（5.60±2.92）分、（3.99±4.32）分和（6.09±5.50）分，发生率分别为95.63%、36.41%和52.43% 。1型糖尿病青少年家庭中承担主要照顾职责的父母（40.99±3.89）岁，母亲占比高达88.35%，情绪调节困难得分（37.61±12.01）分，负性养育行为得分为（83.89±18.39）分。T1DM青少年个人视角下，糖尿病痛苦中介了情绪调节困难对血糖管理的影响，情绪调节困难对糖尿病痛苦和HbA1c水平分别起直接（β=0.363，P＜0.001）和间接正向作用（β=0.032，P＜0.01），对饮食、运动起到间接负向作用（β=-0.124、-0.083，P＜0.01）。家庭视角下，父母的非支持性教养行为在情绪调节代际传递中起较为微弱的中介作用，父母情绪调节困难对T1DM青少年情绪调节困难起直接正向作用（β=0.509，P＜0.001）。父母非支持性教养行为（β=0.012, P=0.003）表现出比父母情绪调节困难（β=0.009, P=0.005）对青少年HbA1c更大的效应量。

结论：本研究中1型糖尿病青少年血糖管理现状好于既往研究但仍待改善，青少年情绪调节困难和负性情绪高于同龄人群，父母情绪调节困难会代际传递给青少年，父母非支持性教养行为起较为微弱的中介作用。与成年人群类似，糖尿病痛苦在青少年情绪调节困难对血糖管理的影响中起到中介作用。未来的临床工作中，针对1型糖尿病青少年的心理护理过程中，重点识别青少年糖尿病痛苦，改善以家庭为基础的情绪调节可以作为干预的护理目标。

Background: The population of adolescents with type 1 diabetes mellitus (T1DM) in China is rapidly increasing, yet this group faces challenges in self-management, poor glycemic control, and elevated risks of emotional distress. Emotion regulation has been shown to indirectly improve glycemic management in adults with diabetes by alleviating negative emotions. However, parents, as primary caregivers, may exacerbate adolescents’ emotional deterioration through intergenerational transmission if they exhibit poor emotion regulation skills. This study investigates the current status of emotion regulation in T1DM adolescents and their parents, explores the intergenerational transmission of emotion regulation patterns, and examines how emotion regulation influences adolescents’ glycemic management, aiming to inform targeted emotion-focused interventions for this population.

Objective: To describe the emotion regulation profiles of T1DM adolescents and their parents; To explore the pathways linking adolescent and parental emotion regulation to adolescents’ negative emotions (diabetes distress, anxiety, and depression) and glycemic management, and to validate the mediating role of negative emotions between emotion regulation and glycemic outcomes, thereby providing theoretical support for family-centered psychological interventions.

Methods: A cross-sectional descriptive study was conducted from November 2023 to August 2024. A total of 206 adolescents aged 13–17 years with T1DM and their parents were recruited from Beijing Children’s Hospital. Data were collected using the most recent glycated hemoglobin (HbA1c) levels and validated scales: a general information questionnaire, the Brief Version of the Difficulties in Emotion Regulation Scale (DERS-16), Problem Areas in Diabetes Scale-5 (PAID-5), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and the Chinese version of the Parental Responses to Children’s Negative Emotions questionnaire (PRCNE).

Results: A total of 206 valid adolescent-parent dyads were included in this study. Adolescents with T1DM had a mean disease duration of 47.36 ± 21.49 months, with an average HbA1c level of 7.69 ± 1.14%. Compliance rates for glycemic monitoring, dietary management, and physical activity were 85.9%, 25.73%, and 63.11%, respectively. Adolescents exhibited moderate emotion regulation difficulties (38.16 ± 12.71), with elevated scores for diabetes distress (5.60 ± 2.92), anxiety (3.99 ± 4.32), and depression (6.09 ± 5.50), and prevalence rates of 95.63%, 36.41%, and 52.43%, respectively. Primary caregivers (mean age: 40.99 ± 3.89 years) were predominantly mothers (88.35%), reporting moderate emotion regulation difficulties (37.61 ± 12.01) and suboptimal negative parenting behaviors (83.89 ± 18.39). From the adolescent perspective, diabetes distress mediated the relationship between emotion regulation difficulties and glycemic management. Emotion regulation difficulties exerted a direct positive effect on diabetes distress (β = 0.363, P < 0.001) and an indirect positive effect on HbA1c levels (β = 0.032, P < 0.01), while negatively influencing dietary and exercise compliance (β = -0.124 and -0.083, P < 0.01).From the family perspective, non-supportive parenting behaviors demonstrated a minor mediating role in the intergenerational transmission of emotion regulation difficulties. Parental emotion regulation difficulties directly exacerbated adolescents’ emotion regulation challenges (β = 0.509, P < 0.001). Notably, non-supportive parenting behaviors exhibited a larger effect size on adolescents’ HbA1c (β = 0.012, P = 0.003) compared to parental emotion regulation difficulties (β = 0.009, P = 0.005). However, adolescents’ own emotion regulation difficulties remained weaker than parental factors in predicting glycemic outcomes.

Conclusion: While glycemic management in T1DM adolescents has improved compared to previous studies, significant challenges remain. Adolescents exhibit heightened emotion regulation difficulties and negative emotions compared to peers. Parental emotion regulation deficits are intergenerationally transmitted to adolescents, with non-supportive parenting behaviors playing a minor mediating role. Diabetes distress mediated the impact of emotion regulation difficulties on glycemic outcomes. Future clinical interventions should prioritize screening for diabetes distress and implement family-based emotion regulation training as a core component of T1DM care for adolescents.