CHILDREN WITH diabetes who come from broken homes are likely to fare worse in controlling the condition, new research has found. It also found that parents who are over-protective of diabetic children are not doing them any favours in terms of managing the disease.
About one in 400 children in the Republic or about 3,000 children currently have diabetes. The study, details of which emerged yesterday, is the first to show a clear link between diabetes control and quality of life, according to one of the authors, Prof Hilary Hoey.
The international research found that children of parents who live apart had poorer diabetes control than those who live with both parents. And adolescent diabetes was less likely to be well managed if the young person reported their parents were overly protective or if they acted as if diabetes was their (the parents’) disease.
Prof Hoey, professor of paediatrics at Trinity College Dublin (TCD) and consultant paediatric endocrinologist at the National Children’s Hospital, Tallaght and other researchers from Europe, Australia, North America and Japan looked at 2,062 adolescents, aged 11-18, with type 1 diabetes to see if there was a relationship between recommended blood sugar levels and factors such as parental wellbeing, a child’s quality of life and family dynamics.
Type 1 diabetes occurs when the pancreas gland does not produce enough insulin, the hormone that controls the level of sugar in the blood. People with type 1 diabetes need regular injections of insulin. While levels of type 2 diabetes – caused by obesity – are rising, most children with diabetes have type 1.
The quality of life diabetes study has been led by Irish researchers, including Prof Hoey, Prof Hannah Magee of the department of psychology at the Royal College of Surgeons in Ireland and Prof Michael Fitzgerald of the department of child psychiatry at TCD. About 300 Irish children took part in the research.
A substance called Haemoglobin A1c (HbA1c), low blood levels which indicate good diabetes control, were measured in adolescents and compared with the results of questionnaires given to them and their parents.
Some 80 per cent of parents reported good wellbeing; their children had significantly lower HbA1c levels and were less worried about their diabetes. The adolescents of parents with poor quality of life scores had higher levels of HbA1c, while maternal wellbeing was found to be a significant arbiter of how well an adolescent’s diabetes was doing.
“Psychosocial issues are often not obvious to clinicians and it is important that health professionals do not make assumptions but assess psychosocial factors scientifically so that we can support and respond to individual needs,” Prof Hoey said.
The research team has developed a new quality of life assessment questionnaire for young people with diabetes. Presented at the recent International Society for Paediatric Diabetes meeting in Durban, South Africa, the questionnaire looks at the impact of diabetes on adolescents’ social and leisure activities.
Asked what needed to be done to improve the care of adolescents with diabetes in the Republic, Prof Hoey said there was a particular need to develop multidisciplinary teams outside the main centres of population.
“We need teams throughout the country made up of paediatric endocrinologists, specialist nurses, psychologists, dietitians and social workers who can provide cohesive care to children and their families.”