Family Density and SES Related to Diabetes Management and Glycemic Control in Adolescents With Type 1 Diabetes

J Pediatr Psychol. 2015 Jun;40(5):500-8. doi: 10.1093/jpepsy/jsu113. Epub 2015 Jan 17.

Abstract

Objective: Youth with Type 1 diabetes (T1D) from single-parent families have poorer glycemic control; a finding confounded with socioeconomic status (SES). Family density (FD), or youth:adult ratio, may better characterize family risk status.

Methods: Structural equation modeling assessed the relation of single-parent status, SES, and FD to parenting stress, diabetes-related conflict, parental monitoring, adherence, and glycemic control using cross-sectional parent and youth data (n = 257).

Results: Single-parent status exhibited similar relations as SES and was removed. Lower FD was associated with better glycemic control (β = -.29, p = .014) via less conflict (β = .17, p = .038) and greater adherence (β = -.54, p < .001).

Conclusions: Beyond SES, FD plays a significant role in adherence and glycemic control via diabetes-related conflict. In contrast, the effects of single-parent status were indistinguishable from those of SES. FD provides distinct information related to adolescent glycemic control.

Keywords: SES; Type 1 diabetes; adolescence; family structure; glycemic control.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / analysis
  • Blood Glucose Self-Monitoring
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / psychology*
  • Family / psychology*
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Male
  • Parenting / psychology
  • Parents
  • Patient Compliance / psychology*
  • Self Care / psychology
  • Single Parent
  • Social Class*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A