Reference : Are family factors universally related to metabolic outcomes in adolescents with type...
Scientific journals : Article
Human health sciences : Multidisciplinary, general & others
Are family factors universally related to metabolic outcomes in adolescents with type 1 diabetes?
Cameron, F. J. [Department of Endocrinology and Diabetes, Royal Children's Hospital, Flemington Rd, Parkville, VIC 3052, Australia, Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, VIC, Australia]
Skinner, T. C. [Department of Psychology, University of Wollongong, NSW, Australia]
De Beaufort, Carine mailto [University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) >]
Hoey, H. [Department of Paediatrics, Trinity College, National Children's Hospital, Dublin, Ireland]
Swift, P. G. F. [Leicester Royal Infirmary Children's Hospital, Leicester, United Kingdom]
Aanstoot, H. [Diabeter, Center for Pediatric and Adolescent Diabetes, Netherlands]
Åman, J. [Department of Pediatrics, Örebro University Hospital, Örebro, Sweden]
Martul, P. [Endocrinology and Diabetes Research Group, Hospital de Cruces, Bizkaia, Spain]
Chiarelli, F. [Department of Pediatrics, University of Chieti, Italy]
Daneman, D. [Hospital for Sick Children, University of Toronto, ON, Canada]
Danne, T. [Chefarzt Pädiatrie III, Kinderkrankenhaus Auf der Bult, Hannover, Germany]
Dorchy, H. [Diabetology Clinic, Children's University Hospital Queen Fabiola, Brussels, Belgium]
Kaprio, E. A. [Peijas Hospital, Vantaa, Finland]
Kaufman, F. [Children's Hospital of Los Angeles, CA, United States]
Kocova, M. [Pediatric Clinic, Medical Faculty Department of Endocrinology and Genetics, Macedonia]
Mortensen, H. B. [Paediatric Dept. L, Glostrup University Hospital, Denmark]
Njølstad, P. R. [Department of Pediatrics, Haukeland University Hospital, University of Bergen, Norway]
Phillip, M. [National Center of Childhood Diabetes, Schneider Children's Medical Center of Israel, Israel]
Robertson, K. J. [Royal Hospital for Sick Children, Glasgow, United Kingdom]
Schoenle, E. J. [University Children's Hospital, Zurich, Switzerland]
Urakami, T. [Department of Paediatrics, Nihon University, School of Medicine, Tokyo, Japan]
Vanelli, M. [Centro di Diabetologia, University of Parma, Italy]
Ackermann, R. W. [Novo Nordisk, Bagsværd, Denmark]
Skovlund, S. E. [Novo Nordisk, Bagsværd, Denmark]
Diabetic Medicine: A Journal of the British Diabetic Association
Yes (verified by ORBilu)
[en] Adolescents ; Families ; Type 1 diabetes ; Adolescent ; Blood Glucose ; Blood Glucose Self-Monitoring ; Child ; Diabetes Mellitus, Type 1 ; Female ; Humans ; Male ; Parent-Child Relations ; Patient Acceptance of Health Care ; Quality of Life ; Questionnaires ; Treatment Outcome
[en] Aims: To assess the importance of family factors in determining metabolic outcomes in adolescents with Type 1 diabetes in 19 countries. Methods: Adolescents with Type 1 diabetes aged 11-18 years, from 21 paediatric diabetes care centres, in 19 countries, and their parents were invited to participate. Questionnaires were administered recording demographic data, details of insulin regimens, severe hypoglycaemic events and number of episodes of diabetic ketoacidosis. Adolescents completed the parental involvement scale from the Diabetes Quality of Life for Youth - Short Form (DQOLY-SF) and the Diabetes Family Responsibility Questionnaire (DFRQ). Parents completed the DFRQ and a Parental Burden of Diabetes score. Glycated haemoglobin (HbA1c) was analysed centrally on capillary blood. Results: A total of 2062 adolescents completed a questionnaire, with 2036 providing a blood sample; 1994 parents also completed a questionnaire. Family demographic factors that were associated with metabolic outcomes included: parents living together (t = 4.1; P < 0.001), paternal employment status (F = 7.2; d.f. = 3; P < 0.001), parents perceived to be over-involved in diabetes care (r = 0.11; P < 0.001) and adolescent-parent disagreement on responsibility for diabetes care practices (F = 8.46; d.f. = 2; P < 0.001). Although these factors differed between centres, they did not account for centre differences in metabolic outcomes, but were stronger predictors of metabolic control than age, gender or insulin treatment regimen. Conclusions: Family factors, particularly dynamic and communication factors such as parental over-involvement and adolescent-parent concordance on responsibility for diabetes care appear be important determinants of metabolic outcomes in adolescents with diabetes. However, family dynamic factors do not account for the substantial differences in metabolic outcomes between centres. © 2008 The Authors.

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