Association of family structure with type 1 diabetes management and outcomes in adolescents: A population‐based cross‐sectional survey

Bächle, Christina; Stahl‐Pehe, Anna; Castillo, Katty; Selinski, Silvia; Holl, Reinhard W.; Rosenbauer, Joachim

doi:10.1111/pedi.13166

Cited by 4 publications

(5 citation statements)

References 37 publications

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“…However, the living arrangement made a difference in how much physical burden parents, specifically mothers, experienced. This finding provides support for recent studies revealing a significant association between family structure and glycemic control [ 13 , 30 ]. This is particularly important because of the increasing trend of one-parent households in recent years, and in most cases, the mother lives with the child.…”

Section: Discussionsupporting

confidence: 90%

Understanding Daily, Emotional, and Physical Burdens and Needs of Parents Caring for Children with Type 1 Diabetes

Saßmann

Kim-Dorner

Berndt

et al. 2022

Journal of Diabetes Research

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Aims. To investigate (1) daily, emotional, and physical caregiving burdens in parents of children with type 1 diabetes, (2) the sociodemographic and clinical predictors of three burdens, and (3) support measures that parents wish to receive. Methods. The study was a multicenter cross-sectional survey conducted in nine German pediatric diabetes centers. A questionnaire assessing three types of burdens and wishes for support was distributed to parents with a child with type 1 diabetes visiting one of the pediatric centers for a routine check-up. Results. Data from 1,107 parents (83% mothers) were analyzed. Parents reported significantly higher emotional burdens compared to daily and physical burdens ( p < 0.0001 ). Mothers felt more burdened than fathers did. Parents of younger children reported higher daily and physical burdens compared to the parents of older children, and similarly, parents of technology users reported higher daily and physical burdens compared to the parents of nontechnology users. However, emotional burdens did not differ in both comparisons. Other demographic factors (i.e., parent’s age, migration status, and single-parent family status) predicted high levels of daily or physical burdens, but only HbA1c level and the parent’s gender (mother) predicted a high emotional burden. Independent of the level of burden, 78% of parents wanted additional diabetes training. Conclusion. Despite parents reporting high emotional burdens in connection with diabetes care, HbA1c and the gender of the reporting parent were the only risk factors. As the child gets older, parents’ daily and physical distress decrease but not the emotional burden. Diabetes training including regularly offered booster sessions as well as low-threshold interventions for mental health issues and practical self-care skills is recommended to provide continuous support for parents.

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Section: Discussionsupporting

confidence: 90%

Understanding Daily, Emotional, and Physical Burdens and Needs of Parents Caring for Children with Type 1 Diabetes

Saßmann

Kim-Dorner

Berndt

et al. 2022

Journal of Diabetes Research

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“…These negative interactions with metabolic control are confirmed by our results—children from one-parent families, blended families and children living without biological parents have worse metabolic outcomes compared to children and adolescents from two-parent households. Similar results were reported by Baechle et al [ 4 ]. About 15% of the variance in HbA 1c parameters can be explained by family structure and working time models.…”

Section: Discussionsupporting

confidence: 92%

“…Hence, the proportion of new family constellations like one biological parent with their partner, one-parent families with single mothers, and rainbow-families has increased [ 3 ]. Baechle et al [ 4 ] described ‘non-classical’ family structures being associated with substantially poorer outcomes for T1DM-related treatment parameters. Furthermore, adolescents living with one parent and having a low socioeconomic status (SES) are more susceptible to a reduced 'health-related quality of life' [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Family structures and parents’ occupational models: its impact on children’s diabetes

Schlarb,

Büttner,

Tittel

et al. 2023

Acta Diabetol

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Aims This study examines how family-related factors influence the management of children and adolescents with type 1 diabetes (T1DM). We investigate the relationship between family patterns, parental work schedules and metabolic control. Materials and methods We analysed data from a nationwide diabetes survey (DPV) focusing on HbA1c, severe hypoglycaemia, diabetic ketoacidosis, hospital admissions and inpatient treatment duration. We used linear regression and negative binomial regression models. Our study includes 15,340 children under the age of 18 with data on family structure and parental division of labour. Results Children from two-parent households have better HbA1c outcomes than children from single-parent, blended or no-parent households (p < .0001). Higher HbA1C levels are associated with children living with an unemployed father, as opposed to those with full-time working parents or with a full-time working father and a part-time working mother (p < .001). Conclusions These findings emphasise the importance of carefully considering family structure and working time models in the management of paediatric T1DM. Our results highlight risk factors within the family environment and emphasise the need for family-focused counselling of high-risk patients or severe cases in clinical practice.

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“… 56 Moreover, they gain support from both parents in terms of motivation for self-care, thus showing improved adherence to SMBG. 57 …”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Adherence to Self-Monitoring of Blood Glucose Among Young People with Type 1 Diabetes in China: A Cross-Sectional Study

Lv¹,

Luo²,

Long³

et al. 2021

PPA

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Background Self-monitoring of blood glucose (SMBG) plays a crucial role in the maintenance of glycemic control in young people with type 1 diabetes mellitus (T1DM), but most of them do not perform SMBG as recommended. Few studies comprehensively explored factors that correlate with adherence to SMBG among this population on the basis of a framework. Hence, the aims of this study were to describe adherence to SMBG among young people with T1DM in China and explore its associating factors according to the Self and Family Management (SFM) framework. Methods A cross-sectional study was conducted on young people with T1DM in Hunan Province of China from July to August 2020. Based on the SFM framework, self-reported questionnaires were organized for the collection of data on adherence to SMBG, socio-demographic and clinical factors, resources, health care system, and personal factors. Factors associated with adherence to SMBG were determined through multivariate logistic regression analysis. Results A total of 165 young people were invited, of which 122 (73.9%) completed the questionnaires. The mean age was 12.41 years (SD = 3.18), and the proportion of young people who adhered to SMBG was 53.3%. Multivariate logistic regression analysis revealed that children aged 8–12 years (OR = 0.188, P = 0.002), from two-parent families (OR = 0.232, P = 0.019), and with better personal factors (eg, with more information of SMBG, OR = 1.072, P = 0.020; lower diabetes-related worry, OR = 0.917, P = 0.031; higher level of pain during SMBG, OR = 1.852, P = 0.001), had better adherence to SMBG. Conclusion Nearly half of the young people with T1DM were not adherent to SMBG in China. Clinicians need to pay more attention to adolescents from single-parent families with regard to their adherence to SMBG. Providing management strategies of SMBG, including delivering SMBG-related information, decreasing diabetes-related worry, and relieving pain related to SMBG, may improve adherence.

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Association of family structure with type 1 diabetes management and outcomes in adolescents: A population‐based cross‐sectional survey

Cited by 4 publications

References 37 publications

Understanding Daily, Emotional, and Physical Burdens and Needs of Parents Caring for Children with Type 1 Diabetes

Understanding Daily, Emotional, and Physical Burdens and Needs of Parents Caring for Children with Type 1 Diabetes

Family structures and parents’ occupational models: its impact on children’s diabetes

Factors Associated with Adherence to Self-Monitoring of Blood Glucose Among Young People with Type 1 Diabetes in China: A Cross-Sectional Study

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