Are Family Dynamics and Psychosocial Support a Determinant of Glycaemic Control in Children with Diabetes Mellitus in Port Harcourt, Nigeria?

Abstract

Background: Diabetes control in children is usually predicted by availability of insulin, family dynamics, environmental stability and economic factors. Home or family dynamics can lead to psychosocial stress and affect the level of care provided for the child living with diabetes. This research studied family dynamics and as a determinant of glycaemic control in children living with diabetes mellitus. Methods: This was a descriptive cross-sectional study among sixty-three children and caregiver pairs at the Paediatrics department of the University of Port Harcourt Teaching Hospital between January to July 2022 for diabetes mellitus. The family dynamics and psychosocial supports were determined by a modified questionnaire. Glycaemic control was determined using the HbA1c done within the past 3 months. The mean HbA1c of the psychosocial variables was compared using student t-test/ANOVA. The associations between good control and the psychosocial factors were analysed using Pearson’s correlation test and logistic regression analyses, and p < 0.05 was set for statistical significance. Results: Patients were aged 3 – 19 years, with mean age of 12.98 ± 3.97 years and a mean HbA1c of 11.13 ± 2.46%. The majority, 43 (67.4%) of children were living in two parents’ family settings Twenty-three (36.5%) were living in poor conditions with limited financial resources and 30 parents (47.6%) could not provide their parental functions adequately. The mean HbA1c for children living in 2 parent setting was 10.51  2.38%, as against 12.3  2.25% for those in single-parent/ nuclear settings, t = 2.71, p = 0.009. Good glycaemic control had weak positive correlations with caretaker type, satisfactory home environment and parental functioning. Conclusion: Good glycaemic control is common with two-parent families and families with financial adequacy and a satisfactory home environment. Helping families cope with social and psychological stresses may help improve glycaemic control in children with diabetes.