The relative roles of family and peer support in metabolic control and quality of life for adolescents with type 1 diabetes

Abstract

Background: Metabolic control declines during adolescence, increasing the risk of severe medical complications. Numerous burdensome treatments including insulin management, blood glucose monitoring, diet and exercise are necessary to prevent such complications. Adolescence is characterised by the transition from reliance on the family to independence and increased peer affiliation. It is therefore important to examine the roles of family and peer support for diabetes management tasks within a developmental context. Previous research indicates that family may have a role in supporting practical diabetes management, whilst peers may provide emotional support. Currently there is no research that compares the impact of diabetes-specific family and peer support on both metabolic control and quality of life. The present study addresses these issues. Methods: Ninety adolescents aged 13-18 with type 1 diabetes participated in this crosssectional study. Data included youth report of diabetes-specific social support (DSSQ) from peers and family, quality of life (PedsQL) and metabolic control (HbA1c). The relationships between social support, quality of life and HbA1c were examined using t-tests and correlations. Fishers Z transformations and hierarchical multiple regression were used to investigate the social support measures as potential predictors of HbA1c and quality of life. Results: Family provided significantly more support for practical diabetes management tasks than did peers. Peers provided significantly more support for exercise, but less emotional support, than did family. Better metabolic control was predicted by lower levels of peer support for insulin management, higher levels of peer support for blood glucose monitoring, increased mood and higher levels of family support for exercise. Quality of life was predicted by increased mood, higher levels of family emotional support, family support for diet, lower levels of peer support for insulin management and higher levels of peer support for exercise. Conclusion: Whilst family support remains important throughout adolescence, peer support also has an important role in the metabolic control and quality of life of adolescents with diabetes. This has implications for clinical practice, the most significant of which being the education and inclusion of peers in diabetes care.