Family Ties Help Young Adults With Type 1 Diabetes Flourish
Type 1 diabetes is a challenging, time-intensive disease that often strikes children, and new research suggests that strong family support helps improve the well-being of young adults with the condition.
The study found that young adults (under 30) with type 1 diabetes were more likely to be "flourishing" if they had good family connections. Flourishing was defined in the study as having a general sense of well-being, including having a purpose in life, feeling self-acceptance, and having positive relationships with others.
"Communication and connection with parents is super-important throughout human development, but type 1 diabetes can become a rupturing event for some families. The stress of the disease can be more than some families can handle," said study author Dr. Robert Whitaker. He's the director of research and research education at the Columbia-Bassett Program in Cooperstown, N.Y.
"People caring for the disease can get distracted by it. But children with diabetes have a bunch of the same childhood experiences and struggles as other children. Parents need to stay in touch with the whole child," he said.
And that's not always easy with type 1 diabetes. The condition requires frequent management, which can allow other childhood issues to fall by the wayside.
Dr. Molly Regelmann, an endocrinologist at the Children's Hospital at Montefiore in New York City, explained, "Good diabetes management requires constant monitoring of blood sugars and insulin administration. Every time [someone] wants to eat, they have to think about their blood sugar, the food they are about to eat, their physical activity level, and the dose of insulin."
Regelmann added that people need to be sure they have diabetes supplies with them any time they leave the house, and if they're traveling, they have to predict what they might need for an extended time. People with diabetes or their parents also have to deal with insurance companies and the need for extra paperwork to get diabetes supplies, she explained.
While there may be many complications linked to day-to-day management, there's also more opportunities for parents and kids to connect out of necessity.
"It's easier to manage diabetes with someone than alone, and connection is a key part of that. Parents can provide a safe place to process it all. And connection in the context of adversity leads to flourishing," Whitaker said.
The study included almost 750 young adults with type 1 diabetes. They were between the ages of 18 and 29, and were recruited from one diabetes specialty clinic in New York City. All of the study participants completed an online survey in 2017.
The survey included questions about the relationships between parents and children, and whether or not parents understood kids' worries and if the young people felt they could confide in their parents and if they felt loved.
Young people who reported more positive answers to these questions were significantly more likely to be flourishing in their late teens and 20s.
While blood sugar management is an important goal, Whitaker said someone who is flourishing doesn't necessarily have better blood sugar control. He noted that the reverse is also true -- like someone who has straight A's, but struggles in other areas of life, it's possible to have great blood sugar control without having balance in other parts of your life.
If connection to parents helps predict who might flourish more in young adulthood, does that mean teens with type 1 diabetes who don't have a strong parental connection or who are abused won't flourish later?
Whitaker said the connection didn't have to be with both parents. They saw positive effects from a connection with one parent. For those without a connection to either parent, Whitaker suggested, "Look for the assets in your life. Who is safe, stable and nurturing? Other adults can be a source of positive connection [such as teachers, coaches, doctors]."
Regelmann also recommended turning to doctors and diabetes educators for support, particularly in the transition between the teen years and becoming a young adult.
"It is essential to have dedicated physicians and nurse practitioners with experience caring for and appreciating the specific needs of young adults [with type 1 diabetes]," she said, adding that mental health and social service support is also important for these young people.
The findings were published recently in JAMA Network Open.
Learn more about type 1 diabetes from the U.S. Centers for Disease Control and Prevention.
SOURCES: Robert Whitaker, M.D., M.P.H., director, research and research education, Columbia-Bassett Program, Cooperstown, N.Y., and professor, clinical pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York City; Molly Regelmann, M.D., endocrinologist, Children's Hospital at Montefiore, New York City; March 5, 2020, JAMA Network Open