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Declining metabolic control and decreasing parental support among families with adolescents with diabetes: the risk of restrictiveness.

ABSTRACT: Background For children with diabetes, metabolic control typically declines across the adolescent years.The longitudinal interplay between supportive relationships with parents and metabolic control were investigated in families that differ in parents' restrictiveness.The time-dependent links between perceived parental social support and metabolic control were investigated in a sample of 109 German adolescents with diabetes. 3 waves of data were collected at annual intervals; metabolic control (indexed by HbA1c) was assayed by physicians annually.Family restrictiveness moderated longitudinal associations between metabolic control and perceived social support. For adolescents reporting high family restrictiveness, poorer initial metabolic control predicted greater subsequent declines in perceived parent social support, and lower initial perceived parental social support predicted greater subsequent deterioration in metabolic control.The findings add to the growing body of work suggesting that restrictiveness is a risk factor that exacerbates problems associated with low perceived parental support.

SUBMITTER: Seiffge-Krenke I

PROVIDER: S-EPMC3666117 | biostudies-literature | 2013 Jun

REPOSITORIES: biostudies-literature

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Declining metabolic control and decreasing parental support among families with adolescents with diabetes: the risk of restrictiveness.

Seiffge-Krenke Inge I Laursen Brett B Dickson Daniel J DJ Hartl Amy C AC

Journal of pediatric psychology 20130405 5

<h4>Unlabelled</h4>Background For children with diabetes, metabolic control typically declines across the adolescent years.<h4>Objective</h4>The longitudinal interplay between supportive relationships with parents and metabolic control were investigated in families that differ in parents' restrictiveness.<h4>Method</h4>The time-dependent links between perceived parental social support and metabolic control were investigated in a sample of 109 German adolescents with diabetes. 3 waves of data wer ...[more]

PMID: 23564837

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Project description:BACKGROUND:Type 1 diabetes mellitus (T1DM) is one of the most common pediatric diseases and its incidence is rising in many countries. Recently, it has been shown that metabolites other than glucose play an important role in insulin deficiency and the development of diabetes. The aim of our study was to look for discriminating variation in the concentrations of small-molecule metabolites in the plasma of T1DM children as compared to non-diabetic matched controls using proton nuclear magnetic resonance (1H-NMR)-based metabolomics. METHODS:A cross-sectional study was set-up to examine the metabolic profile in fasting plasma samples from seven children with poorly controlled T1DM and seven non-diabetic controls aged 8-18 years, and matched for gender, age and BMI-SDS. The obtained plasma 1H-NMR spectra were rationally divided into 110 integration regions, representing the metabolic phenotype. These integration regions reflect the relative metabolite concentrations and were used as statistical variables to construct (train) a classification model in discriminating between T1DM patients and controls. RESULTS:The total amount of variation explained by the model between the groups is 81.0% [R2Y(cum)] and within the groups is 75.8% [R2X(cum)]. The predictive ability of the model [Q2(cum)] obtained by cross-validation is 50.7%, indicating that the discrimination between the groups on the basis of the metabolic phenotype is valid. Besides the expected higher concentration of glucose, the relative concentrations of lipids (triglycerides, phospholipids and cholinated phospholipids) are clearly lower in the plasma of T1DM patients as compared to controls. Also the concentrations of the amino acids serine, tryptophan and cysteine are slightly decreased. CONCLUSIONS:The present study demonstrates that metabolic profiling of plasma by 1H-NMR spectroscopy allows to discriminate between T1DM patients and controls. The metabolites that significantly differ between both groups might point to disturbances in biochemical pathways including (1) choline deficiency, (2) increased gluconeogenesis, and (3) glomerular hyperfiltration. Although the sample size of this study is still somewhat limited and a validation should be performed, the proof of principle looks promising and justifies a deeper investigation of the diagnostic possibilities of 1H-NMR metabolomics in follow-up studies. Trial registration NCT03014908. Registered 06/01/2017. Retrospectively registered.

Dataset Information

Declining metabolic control and decreasing parental support among families with adolescents with diabetes: the risk of restrictiveness.

Publications

Declining metabolic control and decreasing parental support among families with adolescents with diabetes: the risk of restrictiveness.

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