Fathers of children with diabetes mellitus and their role in coping strategies in the family

Family structure and social disadvantage are thought to have adverse effect s on the outcome of diabetes mellitus (DM), While there are data on family functioning and maternal coping in relation to some measures of metabolic c ontrol, little is known about the role of fathers in respect to coping and outcome of DM. We are presently conducting prospective studies to assess th e role of fathers in families with children with DM, In addition, family fu nctioning and psychosocial factors are being investigated in relation to pu tative effects on metabolic control. Structured questionnaire studies are b eing performed in 182 children and adolescents with type 1 DM, Similar ques tions are also put to the families. Mean age of the patients is 12,9 years, range 1.8-18 years, with an equal distribution between the sexes. Metaboli c control as assessed by the mean of the last four HbA(1c) values (HPLC met hod; intraassay coefficient of variation [CV] 2,1-3,3%, interassay CV 2.6-4 .3%) is 7.4%; range 5.0-14,8%, The patients attend outpatient clinics at an average interval of six weeks. Structured educational in-patient programs are attended by less than one-third of the patients, There is a large preva lence of unemployment in the families. In the majority of cases mothers acc ompany their children to the clinic while fathers are absent. It is the mot hers who adjust daily insulin doses, take care of food preparation and ensu re the children's self-assessment. In conclusion, our preliminary data sugg est that the role of fathers in diabetes management is rather passive and e motionally labile, Special educational programs targeted towards the father s of children with DM and towards improving parental interactive strategies are urgently needed to better use parental resources of coping and support .