Behavioral characteristics of children with type-1 diabetes and the effect of family attitudes on dietary adherence problems

Abstract

Objective: Assessing the behavioral characteristics and family attitudes of children and adolescents in diabetes is linked to determining the reasons for difficulties in dietary adherence. Our aim was to assess the relationship between behavioral characteristics, family attitudes in children diagnosed with type 1 diabetes mellitus (T1DM), and the dietary adherence and glycemic control. Method: Fifty-four patients T1DM patients and 47 controls aged 7-18 years were included in the study together with their parents. Among the patients diagnosed with T1DM followed in the Pediatric Endocrinology Outpatient Clinic, those with high HbA1c levels (with poor dietary compliance) and those with a HbA1c level below 7.5 (with good dietary compliance) were included in the study as the patient and control group, respectively. A psychiatric assessment interview was conducted with both groups. Sociodemographic data and information on diabetes-related variables, Strengths and Difficulties Questionnaire and Parental Attitude Scale scores were recorded. Results: We have found higher standard diet application rates in patients compared to regular carbohydrate count. The patient group had higher odds of neglecting blood glucose measurement, insulin doses, and a history of stress before decompensation. The rate of psychiatric diagnosis was 26.2%, similar to the general literature, and combined diagnoses were less frequent. Hospital admissions and hypoglycemic episodes were observed at a higher rate in the group that had problems in dietary adherence. Compared to those with good dietary compliance, patients in the dietary non-adherence group had a higher level of parental control and poorer parental perception of their children’s peer relationships. Conclusion: To reduce the risk of acute complications of the disease and to prevent long-term chronic sequelae, it is important to identify positive and some negative behavioral characteristics of child and parental attitudes. Parental role is among the key factors in supporting the autonomy of the child in ensuring dietary compliance.