Parent and Adolescent Distribution of Responsibility for Diabetes Self-care: Links to Health Outcomes

TLDR

The study examined how the distribution of diabetes self‑care responsibility between adolescents and parents relates to psychological and physical health. They interviewed children annually for three years and had parents complete questionnaires to quantify the distribution of diabetes self‑care responsibility, then assessed psychological distress, competence, and diabetes outcomes at each wave. Shared responsibility was consistently linked to better psychological health, improved self‑care behavior, and better metabolic control, whereas sole child or parent responsibility showed no such benefits, with stronger effects observed in older adolescents.

Abstract

To examine the relation of adolescent and parent responsibility distribution for diabetes self-care to psychological and physical health.We interviewed children (mean age 12 years) annually for 3 years and asked parents to complete a questionnaire. Both reported how diabetes self-care was distributed in the family. Amount of responsibility held by the child only, the parent only, and shared between child and parent was calculated. Psychological distress, competence, and diabetes outcomes were assessed at each wave.In both cross-sectional and longitudinal (lagged) analyses, multilevel modeling showed that shared responsibility was consistently associated with better psychological health, good self-care behavior, and good metabolic control, whereas child and parent responsibility were not. In some cases, links of shared responsibility to health outcomes were stronger among older adolescents.These findings highlight the importance of shared responsibility for diabetes self-care through early to middle adolescence.