Diabetes control and the influence of family functioning

Abstract

Background: The link between glycaemic control of type 1 diabetes and family functioning is complex, with the existing literature largely focussing upon the association between clear patterns of disturbances in family functioning and suboptimal diabetic control. The more subtle changes to family function that might influence the degree of successful management of a child's diabetes have been less well studied. Methods: This study sought to explore whether suboptimal glycaemic control was associated with variations in family functioning that might not in themselves prompt concern in routine clinic review. The project focussed on families attending for routine follow-up in specialist paediatric diabetes clinics in the North East of England. Mother and child participants provided demographic information and completed the Family Adaptation and Cohesion Evaluation Scale (FACES IV), and the quality of their glycaemic control was assessed using the mean HbA1c value for each child over the last year. Families with clear emotional or family difficulties, or where the level of control was causing clear concern were excluded (as were families where there was major physical or a member with significant learning disabilities). The sample was divided into two groups; families whose children were in optimal glycaemic control of their diabetes, and families where the glycaemic control was suboptimal. Results: Whatever the degree of control, nearly all the mothers and index children reported functioning within the balanced range. The mothers of children with optimal glycaemic control reported their family to be more cohesive and expressed greater satisfaction with family life than mothers whose child's glycaemic control was suboptimal. The children with suboptimal diabetic control also tended to view their family life as more chaotic. Discussion: Despite the challenges most families cope reasonably well with the issues that managing type 1 diabetes in a child bring. However suboptimal control tends to be associated with some unhelpful family issues, and the implications for intervention are discussed. Conclusions: Suboptimal control, when it is present, prompts exploration of a wide range of factors. Assessment of family functioning should be part of this process, even if there is no evidence of major family difficulties because subtle distortions in functioning can significantly influence glycaemic control, especially in early adolescence.

The relationship between the quality of life and depression levels of young people with type I diabetes

“…Similarly, previous studies showed that the HbA1c values of young individuals with diabetes were high. This may have been caused by poor diabetes management . The present study found that there was a weak relationship between metabolic control and duration of life with diabetes.…”

The influence of family characteristics on glycaemic control among adult patients with type 2 diabetes mellitus attending the general outpatient clinic, National Hospital, Abuja, Nigeria

“…This agrees with findings from other studies which have shown that glycaemic control is related to family functioning. 49,50 This finding could be explained by the central role a family plays in patient management, especially in chronic illness like diabetes in our environment. This role in some situations can engender a positive outcome and in some may have a negative effect.…”

Diagnostic des causes de complication du diabète et des méthodes de prévention à Bobo-Dioulasso, au Burkina Faso

“…Selon notre étude, 66% des femmes en âge avancé sont obèses ou ayant un surplus de poids 26,90 ± 5,80 kg/m 2 , par conséquent, renferment généralement assez de masse grasse. Dans notre étude, beaucoup de femmes ont été victimes de cette maladie et parfaitement ignoraient la survenance ou l'apparition du diabète contrairement aux mères impliquées dans l'étude d'Angleterre (Whitehead et Dimmock, 2013).…”

“…L'ignorance de l'antécédent familial et de surcroît, l'incapacité d'effectuer des analyses biologiques assez régulièrement, dû au coût élevé des examens biologiques et à la faiblesse du revenu des ménages, expliquent nos résultats. Une étude réalisée en Angleterre (Whitehead et Dimmock, 2013) indique qu'il faut un dépistage précoce, ce qui n'est pas le cas au Burkina Faso. Pour éviter des complications futures de la maladie qui est silencieuse, un dépistage précoce est à effectuer lors des inscriptions dans les structures de formations d'éducations et lors des recrutements pour un poste de travail, ce qui permet de les prendre en charge dès lors qu'ils sont positifs au diabète sucré.…”