Illness intrusiveness in parents and glycemic control in youth with type 1 diabetes: Intergenerational processes

Objectives. Type 1 Diabetes (T1D) is a chronic condition imposing strict treatment regimens, impacting both patients and their parents. Despite an extensive diabetes literature on specific intergenerational links, comprehensive models relating broader parental functioning to patient functioning are scarce. The present study investigated an intergenerational path model, in which parental functioning (illness intrusiveness and depressive symptoms) was expected to relate to patient functioning (depressive symptoms, treatment adherence, and glycemic control) through parenting practices (overprotection and psychological control). Methods. Selected through the Belgian Diabetes Registry, 316 patient-mother dyads and 277 patient-father dyads completed questionnaires. All patients were diagnosed with T1D, were aged 14-25, and were living with their parents. Patients indicated their depressive symptoms and treatment adherence; treating physicians provided patients’ HbA1c values. Parents reported on their experience of illness intrusiveness, their depressive symptoms, and the patient’s treatment adherence. Parenting, as operationalized by the dimensions of overprotection and psychological control, was assessed in both parents and patients. Results. Structural equation modelling favored our hypothesized path model to an alternative, child-driven model. An adequate fit was found for both patient-mother and patient-father dyads. Parental functioning seemed to predict patient functioning with parenting dimensions as intervening mechanisms. Parental illness intrusiveness was associated with parental depressive symptoms, both predicting overprotection and psychological control. Psychological control in particular predicted patient depressive symptoms, treatment adherence, and glycemic control. Conclusions. These findings underscore the relevance of including parental functioning when assessing patient outcomes.status: publishe