THE ASSOCIATION OF POOR ADHERENCE AND ACUTE METABOLIC DISORDERS WITH LOW-LEVELS OF COHESION AND ADAPTABILITY IN FAMILIES WITH DIABETIC CHILDREN

A cross-sectional multicentre study was conducted in 165 French diabet ic children aged 7-13 y and their parents. A standardized scale (FACES III) was used to determine if family cohesion and adaptability (i) di ffered in diabetic children's families, as compared to other families; (ii) were related to an adherence measure; or (iii) were related to m etabolic control. More diabetic families than comparison families fell into the categories of disengaged with low levels of cohesion, and ri gid with low levels of adaptability. Scores of cohesion and adaptabili ty were significantly and positively correlated with both children's a nd parents' adherence scores, but not with HbAlc levels. Children whos e families were characterized as rigidly disengaged had a significantl y greater number of hypoglycaemias and six times as many episodes of k etoacidosis than the other diabetic children. Not only in adolescents, but also in families of diabetic children, family-centred interventio ns are needed to improve compliance and to prevent acute metabolic com plications.