Family interaction and metabolic balance in juvenile diabetes mellitus. A prospective study.

Family interaction was assessed in 30 children with insulin-dependent diabetes mellitus (IDDM) of at least 2 years' duration using video-tapes of standardised family tasks. The relationship between measures of family interaction and metabolic balance (HbA1) was investigated 1 and 5 years after the task performance. No significant relationship between family interaction and HbA1 was found after 1 year, but HbA1 values 5 years after the family assessments were significantly higher in the children who belonged to families in which family interaction was considered disturbed (P less than 0.05). If family interaction was used as a predictor of metabolic control, 67% of the cases were correctly classified. In the group with disturbed family interaction HbA1 increased during the observation period in 44% of cases while in the group with functional interaction this occurred in only 11% of the cases. When the children were divided according to age, significantly higher HbA1 values were found only in the younger group (less than 18 years at the 5-year evaluation) of the children of families with disturbed family interaction (P = 0.025). Here a correlation between disturbed family interaction and HbA1 was found (rs = 0.46, p = 0.03). In conclusion, certain family interaction patterns seem to influence metabolic balance in IDDM in children during adolescence, but not during pre-adolescence and early adulthood.