This is how the parents’ relationship affects diabetes

About 30,000 people in Austria suffer from type 1 diabetes, including about 1,600 schoolchildren. A European study involving Viennese pediatricians now shows “how family-related factors influence the treatment of type 1 diabetes in children and adolescents,” wrote Burkhard Brosig of the Center for Pediatrics and Adolescent Medicine at Justus Liebig University in Giessen in Germany and his co-authors, including Gabriele Berger (MedUni Vienna/AKH and Klinik Floridsdorf).

Type 1 diabetics rely on optimal blood sugar control
Although the responsibility of parents is often emphasized in politics, children and young people who develop insulin-dependent diabetes (type 1 diabetes) at a young age probably have little chance to influence their immediate environment.

Once the disease begins, you are immediately and throughout your life dependent on optimal control of your blood sugar levels and all risk factors for complications such as kidney damage, heart attack, stroke and retinal damage (blindness). Your “diabetes disease” extends over many decades – lifelong.

Disease diagnosed at an average age of 8.1 years
The analysis included data from 15,340 type 1 diabetics who were first diagnosed with the disease between 2000 and 2018. They came from 286 treatment centers in Germany, 14 institutions in Austria and one center in Luxembourg. 52 percent of those affected were boys or boys. The diabetes was diagnosed at an average age of 8.1 years.

The observation period was 12.8 years. 70 percent of children and young people grew up with two parents in the household, 17.8 percent in a household with one parent, 8.5 percent lived in patchwork families and 3.4 percent in a household without biological parents.

Advantage if both parents live together
The evaluation clearly showed a benefit for children in households with both biological parents in a relationship. This was reflected in the so-called HbA1c values. In diabetes, this blood laboratory value is used as a measure of medium-term blood sugar levels (percentage of red blood cells loaded with sugar).

In adults, an HbA1c value of more than 6.5 percent is a sign of diabetes. According to the latest Austrian recommendations, diabetic children and adolescents up to 18 years of age with diabetes should have an HbA1c value of less than seven percent if no complications occur (“low blood sugar”, hypoglycemia).

In any case, the new research showed that family structure has a major impact on young diabetes patients: If both parents lived in the same household, their HbA1c value was 7.7 percent. If there was only one parent in the household, the average HbA1c value was already 8.06 percent. In patchwork families it was 8.07 percent and in patchwork families it was 8.21 percent when the children or young people grew up without their biological parents.

The father’s work situation is also relevant
Within families of young type 1 diabetics where both parents were at home, the largest difference was in the employment status of the father. If the mother and father both had full-time jobs, the HbA1c value of the affected child was on average 7.63 percent. However, if the father had lost his job and was unemployed, the average HbA1c value of the child with diabetes was 7.96 percent.

Fewer complications in ‘intact’ families
The acute complications of the most common metabolic disease in children and adolescents were also less common in ‘intact’ families. This affected episodes of severe hypoglycemia, as well as phases of extremely high blood sugar levels and the frequency of necessary hospital admissions.

“These results emphasize the importance of careful consideration of family structure and work situations (note) when treating type 1 diabetes in childhood and adolescence,” the experts wrote. Possible risk factors must be taken into account when providing advice and support to those affected.