PSYCHOSOCIAL PREDICTORS OF ACUTE COMPLICATIONS OF DIABETES IN YOUTH

In this paper we determine whether individual and family psychosocial functioning predicts the risk for recurrent acute diabetic complicatio ns. An onset-cohort of 61 children and adolescents with Type 1 diabete s received conventional diabetes care. Episodes of ketoacidosis and of severe hypoglycemia were recorded for 8 years, and glycaemic control was measured by glycohaemoglobin. Measures of psychosocial functioning of the patient and parents were obtained during the first year. Over 8 years, 28% of subjects had at least one episode of ketoacidosis, and 21% had at least one episode of hypoglycaemia. The odds of observing recurrent hypoglycaemia versus recurrent ketoacidosis was 14 times gre ater in boys than in girls (Fisher's exact test p<0.05). Girls with re current ketoacidosis had more behaviour problems and lower social comp etence, they reported higher levels of family conflict, and their pare nts reported lower levels of family cohesion, expressiveness and organ ization in year one. These relationships were independent of any assoc iation with poor glycaemic control. Recurrent hypoglycaemia in boys wa s generally unrelated to individual and family functioning or glycohae moglobin. Despite our small sample size, our findings are suggestive o f relationships that may lead to early identification of patients who are prone to recurrent ketoacidosis, and to the development of early i ntervention strategies.