Are family factors universally related to metabolic outcomes in adolescents with Type 1 diabetes?

被引：134

作者：

Cameron, F. J. ^{[1
]}

Skinner, T. C. ^{[2
]}

de Beaufort, C. E. ^{[3
]}

Hoey, H. ^{[4
]}

Swift, P. G. F. ^{[5
]}

Aanstoot, H.

Aman, J. ^{[6
]}

Martul, P. ^{[7
]}

Chiarelli, F. ^{[8
]}

Daneman, D. ^{[9
]}

Danne, T. ^{[10
]}

Dorchy, H. ^{[11
]}

Kaprio, E. A. ^{[12
]}

Kaufman, F. ^{[13
]}

Kocova, M.

Mortensen, H. B. ^{[14
]}

Njolstad, P. R. ^{[15
,16
]}

Phillip, M. ^{[17
]}

Robertson, K. J. ^{[18
]}

Schoenle, E. J. ^{[19
]}

Urakami, T. ^{[20
]}

Vanelli, M. ^{[21
]}

Ackermann, R. W. ^{[22
]}

Skovlund, S. E. ^{[22
]}

机构：

[1] Royal Childrens Hosp, Dept Endocrinol & Diabet, Parkville, Vic 3052, Australia

[2] Univ Wollongong, Dept Psychol, Wollongong, NSW, Australia

[3] CHL, Pediat Clin, DECCP, Luxembourg, Luxembourg

[4] Natl Childrens Hosp, Trinity Coll, Dept Paediat, Dublin, Ireland

[5] Childrens Hosp, Leicester Royal Infirm, Leicester, Leics, England

[6] Orebro Univ Hosp, Dept Pediat, Orebro, Sweden

[7] Hosp Cruces, Endocrinol & Diabet Grp, Bizkaia, Spain

[8] Univ G dAnnunzio, Dept Pediat, Chieti, Italy

[9] Univ Toronto, Hosp Sick Children, Toronto, ON, Canada

[10] Kinderkrankenhaus Bult, Hannover, Germany

[11] Childrens Univ Hosp Queen Fabiola, Diabetol Clin, Brussels, Belgium

[12] Peijas Hosp, Vantaa, Finland

[13] Childrens Hosp Los Angeles, Los Angeles, CA USA

[14] Glostrup Univ Hosp, Paediat Dept L, Glostrup, Denmark

[15] Univ Bergen, Dept Clin Med, N-5020 Bergen, Norway

[16] Haukeland Hosp, Dept Pediat, Bergen, Norway

[17] Schneider Childrens Med Ctr Israel, Natl Ctr Childhood Diabet, Petah Tiqwa, Israel

[18] Royal Hosp Sick Children, Glasgow G3 8SJ, Lanark, Scotland

[19] Univ Childrens Hosp, Zurich, Switzerland

[20] Nihon Univ, Sch Med, Dept Paediat, Tokyo, Japan

[21] Univ Parma, Ctr Diabet, I-43100 Parma, Italy

[22] Novo Nordisk AS, DK-2880 Bagsvaerd, Denmark

来源：

DIABETIC MEDICINE | 2008年 / 25卷 / 04期

关键词：

adolescents; Type; 1; diabetes; families;

D O I：

10.1111/j.1464-5491.2008.02399.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 (HbA(1c)) 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.

引用

页码：463 / 468

页数：6

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