Family Relations

When a child is diagnosed with diabetes, the entire family is impacted. Recent advances in treatment technologies for managing Type 1 diabetes have placed increasing demands on children and their families.

Family Stress and Conflict

The good news is that intensive diabetes treatment is the best way of ensuring current and long-term health and quality of life for the child. However, there are two potential consequences for families—an increase in family stress and conflict, and the need for more sustained parental involvement and support in diabetes management. Research shows that higher levels of diabetes-related conflict in the family are associated both with lower levels of adherence to the treatment regimen and with poorer glycaemic control. Research also shows that adolescents become more effective at managing their diabetes and optimizing glycaemic control when backed by parental involvement and support.

Provide Parental Support for Diabetes Management

In order to provide parental support for diabetes management, parents and youth should discuss in which aspects of diabetes management the youth wants parental involvement (i.e. the youth is the captain of the family team). The parents must offer warmth, encouragement and positive reinforcement for the youth’s efforts to carry out the complex daily tasks of diabetes management.

Families benefit from being part of a supportive community with other families of youth with diabetes, and this is especially true for single parents. It must be acknowledged that siblings of youth with diabetes have special needs and concerns, too.

Prevent and Reduce Diabetes-Related Family Conflict

Preventing and reducing family conflict related to diabetes depends on outlining clear behavioural goals for diabetes management with the healthcare team (i.e. when to check blood sugars; when and how to adjust insulin, how to treat low blood sugars, etc.)

Family members should avoid talking about “good” and “bad” blood sugar numbers; rather numbers are “high, low, or in the target range”. There should be parental focus on reinforcing the youth’s diabetes management behaviours and avoiding judgmental comments about blood sugar numbers.

Finally, it is important to acknowledge that the current tools for managing diabetes are not perfect. Avoid perfectionism when discussing diabetes, and set realistic goals for behaviour.

Barbara J Anderson, Ph.D.