FAMILY ENVIRONMENT AND GLYCEMIC CONTROL - A 4-YEAR PROSPECTIVE-STUDY OF CHILDREN AND ADOLESCENTS WITH INSULIN-DEPENDENT DIABETES-MELLITUS

An onset cohort of children and adolescents with insulin-dependent dia betes mellitus (IDDM) and their parents were studied. Aspects of famil y environment were evaluated at study inception, and their influence o n the initial level of, and change in, glycemic control over 4 years w as examined. Family measures of expressiveness, cohesiveness, and conf lict were linked to differences in the longitudinal pattern of glycemi c control. In particular, the encouragement to act openly and express feelings directly (expressiveness) seemed to ameliorate deterioration of glycemic control over time in both boys and girls. Boys were especi ally sensitive to variations in family cohesiveness and conflict; thos e from more cohesive and less conflicted families showed less deterior ation in glycemic control. This study demonstrated the important influ ence of family psychosocial factors present at diabetes onset on glyce mic control in children and adolescents over the first 4 years of IDDM .