The highly structured climate in families of adolescents with diabetes: Functional or dysfunctional for metabolic control?

Abstract

Objective: Compare changes in perceived family climate over time in families with healthy adolescents and families with adolescents with diabetes and analyze the links to metabolic control. Method: In a total of four annually conducted surveys, 89 German adolescents with diabetes and 106 healthy adolescents as well as their parents completed the Family Environment Scale (FES). Metabolic control was determined by physicians' reports of adolescents' hemoglobin (HbA1) levels. Results: Compared to families with healthy adolescents, families caring for an adolescent with diabetes portrayed their family interactions as considerably more structured and less cohesive and stimulating. Family climate was not associated with metabolic control and varied little with time, illness duration, and adolescents' gender. Conclusions: The findings suggest that continued parental monitoring is necessary for good metabolic control. However, a balance must be found between medical adaptation to illness and the adolescent's developmental needs.