Impact of family environment and support on adherence, metabolic control, and quality of life in adolescents with diabetes

Int J Behav Med. 2008;15(3):187-93. doi: 10.1080/10705500802222436.


Background: Diabetes is a common disease in pediatric populations. Family functioning has been related to child adaptation to diabetes.

Purpose: To determine the impact of family factors on diabetes, particularly the influence of family support and family environment on adherence to treatment, quality of life, and metabolic control in Portuguese adolescents with type 1 diabetes, taking in consideration age, sex, duration of disease, and social class.

Method: This study used a cross-sectional design. A sample of 157 Portuguese diabetic patients filled disease-specific measures on adherence and quality of life and family functioning measures. Hypotheses were that family support and an organized family environment (high cohesion and low conflict) would be positively associated with better adherence, metabolic control, and quality of life.

Results: This study's results confirmed that adherence was predicted by family support for females and lower-class patients while metabolic control was predicted by family conflict for upper-class patients. Quality of life was predicted by lack of family conflict and family social support for both males and females as well as lower-class patients.

Conclusion: The results highlight the importance of studying family variables in adolescents' diabetes care within the wider cultural factors affecting the patient.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Child
  • Child Behavior / psychology*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / psychology*
  • Family Relations*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Insulin / therapeutic use
  • Male
  • Patient Compliance
  • Portugal
  • Quality of Life*
  • Social Support


  • Glycated Hemoglobin A
  • Insulin
  • hemoglobin A1c protein, human