Parental influence on glycemic

control at baseline and one

year post diagnosis in
children and adolescents with
Type 1 Diabetes Mellitus
Peter Sand, lic psychologist
Anna Nilsson Kleiberg, lic psychologist
Gun Forsander MD PhD
Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at The
University of Gothenburg, The Queen Silvia Childrens Hospital, Sahlgrenska University
Hospital, Gothenburg, Sweden and Vrdalinstitutet, The Swedish Institute for Health Sciences

Presenter Disclosure Information

Peter Sand

Disclosed no conflict of interest.

Background
Stress reactions, overwhelming worry and
symptoms of depression are seen among
parents as a result of their child's chronic illness
Associations have been shown between high
levels of stress among parents and poor
glycemic control in their children
Helgeson et al 2012
Forsander et al 1992
Tsiouli et al 2013

Background
Correlations between the parental
educational level and the outcome of
the childs glycemic control has been
found
Demirel et al 2013

Background
Older children have poorer glycemic
control compared to younger children
Girls tend to have unfavourable glycemic
control compared to boys

Swediabkids 2013

The Overall Aim of the Study

To examine the change in the childs
glycemic control from the onset of T1DM
to 1-year post diagnosis in relation to
maternal and paternal influences
respectively

Study design
An explorative analysis was performed within
a prospective, RCT-Study

The study took place at The Queen Silvia

Childrens Hospital, Sahlgrenska University
Hospital, Gothenburg, Sweden
The inclusion period started in October 2008,
ended in December 2013
104 families were included according to the
inclusion criteria, 101 families fullfilled the
study

Descriptives
The mean age of the participating
children was 8.9 years (range 3-15
years)
54 % of the children were boys
The mean HbA1c value at diagnosis
was 93 mmol/mol (10.7 % NGSP)

Descriptives
DKA, was present at diagnosis in 11
patients (11%)
61 % of the mothers and 39 % of the
fathers had a university education

Method
Data collection was performed at
diabetes diagnosis and 1-year postdiagnosis
A mixed model, with longitudinell
analysis of the variables was used
HbA1c was regarded as the
dependent variable

Results
Linear model for repeated measures (baseline and 12 months), fathers and
mothers
Dependent Variable: HbA1c
Model 1, Fathers

SE

Sig.

Age

1.21

0.296

.000 Age

Education 1

9.39

6.08

.127 Education 1
.002 Education 2

Education 2

6.03

1.9

Education 3

PedsQL FIM

AIC*

-.156

1326

.066

Model 2, Mothers

Education 3
.020 PedsQL FIM

AIC*

.932

SE

.302

25.96
6.16

0
-.188

1421

Sig.

,003

5.81

,000

2.15

.005

0
,002

Results
The explanatory variables of glycemic
control 1-year post-diagnosis were:
Parent and family functioning (PedsQL
FIM)

Parent educational level

Age of the child

The father model had at least as high

explanatory value as the mother model

Conclusion
This study highlights the importance
of involving both of the parents in the
childs diabetes treatment, at onset
and henceforth in the ongoing care

Acknowledgements
The participating families
Vardalinstitutet, The Swedish Institute for Health
Sciences

The Swedish Child Diabetes Foundation

ISPAD Science School, Berlin