Parental marital relationship satisfaction predicts glycemic outcomes in children with type 1 diabetes
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Lindsey A. Loomba
,
Amy Hughes Lansing
Abstract
Objectives
Glycemic outcomes in children with type 1 diabetes (T1D) vary widely, despite uniform care. We hypothesized that glycemic outcomes in children with T1D are affected by the marital relationship satisfaction of the child’s parents.
Methods
We evaluated a prospective sample of 51 families with a child with newly diagnosed T1D, including 36 married parent families. We assessed indicators of marital relationship satisfaction and used multiple regression models to determine whether marital relationship satisfaction at diagnosis was associated with mean HbA1c 18–24 months after diagnosis.
Results
Marital status and parental relationship satisfaction at the time of the child’s T1D diagnosis were associated with HbA1c 18–24 months later. These differences persisted after adjusting for demographic factors associated with glycemia.
Conclusions
The quality of the primary diabetes caregiver’s relationship with a spouse predicts glycemic outcomes for children with T1D. Interventions to improve spousal relationships and caregiver support could improve glycemic control in children with T1D.
Acknowledgments
We gratefully acknowledge Dr. Lester Baker (deceased), Dr. Bernice Rosman (deceased) and Dr. Salvador Minuchin whose groundbreaking work in the 1970s and 1980s laid the foundation for the studies described in this manuscript.
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Research funding: The authors have no financial relationships relevant to this article to disclose. All phases of this study were supported by internal funding (Children’s Miracle Network grant). There was no external funding source.
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Author contributions: Dr. Loomba obtained funding, planned the studies, supervised data collection and wrote the manuscript. Justine Cortez and Kearnan Welch assisted in study planning and data collection, reviewed the manuscript and provided edits. Joe Solowiejczyk assisted in study planning and data interpretation and provided manuscript edits. Dr. Ghetti assisted in study planning and data analysis and interpretation, and edited the manuscript. Dr. Styne assisted in family enrollment, contributed to study planning and data interpretation, and reviewed the manuscript. Dr. Glaser assisted in study planning and supervision of data collection, assisted with data interpretation, performed data analyses and co-wrote the manuscript. Dr. Hughes Lansing performed data analyses, assisted with data interpretation and reviewed and co-wrote the manuscript. Dr. Loomba takes responsibility for the contents of the article. The study has not been previously published. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: No authors report a conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: All procedures performed in this study were in accordance with the ethical standards of institutional guidelines.
References
1. Butwicka, A, Zalepa, A, Fendler, W, Szadkowska, A, Mlynarski, W. Maternal depressive symptoms predict acute hospitalization among children with type 1 diabetes. Pediatr Diabetes 2013;14:288–94. https://doi.org/10.1111/pedi.12010.Search in Google Scholar PubMed
2. Hoey, H, Hvidoere Study Group on Childhood, D. Psychosocial factors are associated with metabolic control in adolescents: research from the Hvidoere Study Group on Childhood Diabetes. Pediatr Diabetes 2009;10:9–14. https://doi.org/10.1111/j.1399-5448.2009.00609.x.Search in Google Scholar PubMed
3. Loomba, LA, Lansing, AH, Cortez, JN, Welch, K, Solowiejczyk, JN, Ghetti, S, et al.. Parental marital relationship satisfaction is associated with glycemic outcomes in children with type 1 diabetes. J Diabetes Metab Disord 2022. https://doi.org/10.1007/s40200-022-01084-2.Search in Google Scholar
4. Grych, JH, Seid, M, Fincham, FD. Assessing marital conflict from the child’s perspective: the children’s perception of interparental conflict scale. Child Dev 1992;63:558–72. https://doi.org/10.2307/1131346.Search in Google Scholar
5. Taylor, ZE, Larsen-Rife, D, Conger, RD, Widaman, KF. Familism, interparental conflict, and parenting in Mexican-origin families: a cultural-contextual framework. J Marriage Fam 2012;74:312–27. https://doi.org/10.1111/j.1741-3737.2012.00958.x.Search in Google Scholar PubMed PubMed Central
6. Rodrigues, D, Lopes, D. The Investment Model Scale (IMS): further studies on construct validation and development of a shorter version (IMS-S). J Gen Psychol 2013;140:16–28. https://doi.org/10.1080/00221309.2012.710276.Search in Google Scholar PubMed
7. Rusbult, C, Martz, J, Agnew, C. The Investment Model Scale: measuring commitment level, satisfaction level, quality of alternatives, and investment size. Pers Relat 1998;5:357–91. https://doi.org/10.1111/j.1475-6811.1998.tb00177.x.Search in Google Scholar
8. Agarwal, S, Jawad, AF, Miller, VA. A multivariate model exploring the predictive value of demographic, adolescent, and family factors on glycemic control in adolescents with type 1 diabetes. Pediatr Diabetes 2016;17:500–8. https://doi.org/10.1111/pedi.12331.Search in Google Scholar PubMed PubMed Central
9. Semenkovich, K, Berlin, KS, Ankney, RL, Klages, KL, Keenan, ME, Rybak, TM, et al.. Predictors of diabetic ketoacidosis hospitalizations and hemoglobin A1c among youth with Type 1 diabetes. Health Psychol 2019;38:577–85. https://doi.org/10.1037/hea0000719.Search in Google Scholar PubMed
10. Redondo, MJ, Libman, I, Cheng, P, Kollman, C, Tosur, M, Gal, RL, et al.. Racial/ethnic minority youth with recent-onset type 1 diabetes have poor prognostic factors. Diabetes Care 2018;41:1017–24. https://doi.org/10.2337/dc17-2335.Search in Google Scholar PubMed
11. Winnick, JB, Berg, CA, Wiebe, DJ, Schaefer, BA, Lei, PW, Butner, JE. Metabolic control and academic achievement over time among adolescents with type 1 diabetes. Sch Psychol Q 2017;32:105–17. https://doi.org/10.1037/spq0000190.Search in Google Scholar PubMed PubMed Central
12. Pedro, MF, Ribeiro, T, Shelton, KH. Marital satisfaction and partners’ parenting practices: the mediating role of coparenting behavior. J Fam Psychol 2012;26:509–22. https://doi.org/10.1037/a0029121.Search in Google Scholar PubMed
13. Berg, CA, Butner, J, Wiebe, DJ, Lansing, AH, Osborn, P, King, PS, et al.. Developmental model of parent-child coordination for self-regulation across childhood and into emerging adulthood: type 1 diabetes management as an example. Dev Rev 2017;46:1–26. https://doi.org/10.1016/j.dr.2017.09.001.Search in Google Scholar PubMed PubMed Central
14. Haugstvedt, A, Wentzel-Larsen, T, Rokne, B, Graue, M. Perceived family burden and emotional distress: similarities and differences between mothers and fathers of children with type 1 diabetes in a population-based study. Pediatr Diabetes 2011;12:107–14. https://doi.org/10.1111/j.1399-5448.2010.00661.x.Search in Google Scholar PubMed
15. Hansen, JA, Weissbrod, C, Schwartz, DD, Taylor, WP. Paternal involvement in pediatric Type 1 diabetes: fathers’ and mothers’ psychological functioning and disease management. Fam Syst Health 2012;30:47–59. https://doi.org/10.1037/a0027519.Search in Google Scholar PubMed
16. McCarthy, AM, Lindgren, S, Mengeling, MA, Tsalikian, E, Engvall, J. Factors associated with academic achievement in children with type 1 diabetes. Diabetes Care 2003;26:112–7. https://doi.org/10.2337/diacare.26.1.112.Search in Google Scholar PubMed
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Articles in the same Issue
- Frontmatter
- Original Articles
- Newborn screening for propionic, methylmalonic acidemia and vitamin B12 deficiency. Analysis of 588,793 newborns
- Use of letrozole to augment height outcome in pubertal boys: a retrospective chart review
- Study of the frequency and clinical features of maturity-onset diabetes in the young in the pediatric and adolescent diabetes population in Iran
- Iatrogenic hyperthyroidism in primary congenital hypothyroidism: prevalence and predictive factors
- Utility of head CT scan in treatment decisions for suspected cerebral edema in children with DKA
- Newborn screening and genetic variation of medium chain acyl-CoA dehydrogenase deficiency in the Chinese population
- Performance of glucagon stimulation test in diagnosing central adrenal insufficiency in children when utilising the Roche Elecsys® cortisol II assay: a pilot study
- Effects and dose-response relationship of exercise training on cardiometabolic risk factors in children with obesity
- Biochemical indicators of euthyroid sick syndrome in critically ill children
- Short Communication
- Parental marital relationship satisfaction predicts glycemic outcomes in children with type 1 diabetes
- Case Reports
- Late onset Bartter syndrome: Bartter syndrome type 2 presenting with isolated nephrocalcinosis and high parathyroid hormone levels mimicking primary hyperparathyroidism
- Three pediatric cases of symptomatic hyponatremia in Prader–Willi syndrome
- Identification of a novel mutation in FGFR1 gene in mother and daughter with Kallmann syndrome
- Exaggerated mini-puberty in a preterm girl: a case report and review of literature
- Diabetic ketoacidosis masquerading behind alkalemia an undiagnosed or missed variant of diabetic ketoacidosis
