Patton Susana R, Piazza-Waggoner Carrie, Modi Avani C, Dolan Lawrence M, Powers Scott W
Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, USA.
J Paediatr Child Health. 2009 Dec;45(12):736-41. doi: 10.1111/j.1440-1754.2009.01604.x. Epub 2009 Oct 26.
This study examined associations between mealtime family functioning, dietary adherence and glycaemic control in young children with type 1 diabetes mellitus (T1DM). We hypothesised that poorer family functioning would correlate with poorer dietary adherence and glycaemic control.
Thirty-five families of children (M = 5.6 +/- 1.5 years) with T1DM had meals videotaped in their home, which were coded for family functioning according to the McMaster Interaction Coding System. Children's dietary adherence was assessed according to deviations from the prescribed number of carbohydrate units per meal and recommended carbohydrate intake levels per day. Glycaemic control was measured via 14 days of self-monitoring of blood glucose levels.
Findings demonstrated significant negative associations between children's dietary adherence and two dimensions of family functioning: Task Accomplishment (r=-0.43, P= 0.03) and Behavioral Control (r=-0.54, P= 0.00). Affect Management correlated negatively with the percent of blood glucose levels below the normal range (r=-0.33, P= 0.05). Eleven families (31%) of young children with type 1 diabetes demonstrated mealtime family functioning in the unhealthy range.
This was the first study to examine the relationship between mealtime family functioning and children's dietary adherence and glycaemic control in families of young children with T1DM. Previous research has found mealtime family functioning to be impaired in families of young children with T1DM when compared with families of children without diabetes. Research is needed to determine if family functioning and dietary adherence can be improved via specific family-based behavioural training around mealtimes.
本研究探讨1型糖尿病（T1DM）幼儿进餐时家庭功能、饮食依从性和血糖控制之间的关联。我们假设较差的家庭功能会与较差的饮食依从性和血糖控制相关。
对35名患有T1DM的儿童（平均年龄5.6±1.5岁）的家庭进行家庭进餐录像，根据麦克马斯特互动编码系统对家庭功能进行编码。根据每餐规定的碳水化合物单位数量和每日推荐的碳水化合物摄入量的偏差评估儿童的饮食依从性。通过14天的血糖自我监测来测量血糖控制情况。
研究结果表明，儿童的饮食依从性与家庭功能的两个维度之间存在显著的负相关：任务完成（r = -0.43，P = 0.03）和行为控制（r = -0.54，P = 0.00）。情感管理与血糖水平低于正常范围的百分比呈负相关（r = -0.33，P = 0.05）。11个（31%）患有1型糖尿病的幼儿家庭在进餐时的家庭功能处于不健康范围。
这是第一项研究T1DM幼儿家庭进餐时家庭功能与儿童饮食依从性和血糖控制之间关系的研究。先前的研究发现，与无糖尿病儿童的家庭相比，T1DM幼儿家庭在进餐时的家庭功能受损。需要开展研究以确定是否可以通过围绕进餐时间进行特定的家庭行为训练来改善家庭功能和饮食依从性。
