RESUMEN
Objectives: We hypothesized that glycemic outcomes in children with type 1 diabetes are linked to marital satisfaction of primary caregivers above and beyond parent neuroticism and child effortful control. Methods: We evaluated a cross-sectional sample of 73 married parent families with a child (ages 7-18 years) with type 1 diabetes of at least 2 years duration. We assessed marital relationship satisfaction, parent neuroticism, and child effortful control through the use of validated questionnaires. We used univariate comparisons and multivariable models to determine whether marital relationship satisfaction was associated with hemoglobin A1c [HbA1c] and whether this association persisted after adjusting for demographic factors and parent neuroticism/child effortful control. Results: In univariate analyses, HbA1c was associated with marital relationship satisfaction of the primary caregiver. In multivariable models adjusting for demographic factors, marital satisfaction remained associated with HbA1c, whereas none of the other factors tested (including family income and race/ethnicity) retained significance. In univariate analyses, child effortful control was also associated with HbA1c. When child effortful control was added to the multivariable model, marital satisfaction remained associated with HbA1c with similar coefficient and confidence intervals describing the relationship between marital satisfaction and hemoglobin A1c. Conclusions: Higher levels of marital satisfaction of the primary diabetes caregiver are associated with glycemic outcomes for children with type 1 diabetes. Interventions to improve spousal relationships may have downstream benefits that could include promoting more optimal child HbA1c levels.
RESUMEN
OBJECTIVES: Glycemic outcomes in children with type 1 diabetes (T1D) vary widely, despite uniform care. We hypothesized that glycemic outcomes in children with T1D are affected by the marital relationship satisfaction of the child's parents. METHODS: We evaluated a prospective sample of 51 families with a child with newly diagnosed T1D, including 36 married parent families. We assessed indicators of marital relationship satisfaction and used multiple regression models to determine whether marital relationship satisfaction at diagnosis was associated with mean HbA1c 18-24 months after diagnosis. RESULTS: Marital status and parental relationship satisfaction at the time of the child's T1D diagnosis were associated with HbA1c 18-24 months later. These differences persisted after adjusting for demographic factors associated with glycemia. CONCLUSIONS: The quality of the primary diabetes caregiver's relationship with a spouse predicts glycemic outcomes for children with T1D. Interventions to improve spousal relationships and caregiver support could improve glycemic control in children with T1D.