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Depressive symptoms and glycaemic control in adults with type 1 diabetes: an exploratory study on the role of family functioning

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Abstract

Aims

Psychological distress and family functioning have a considerable impact on diabetes self-management and glycaemic control in individuals with type 1 diabetes (T1D). However, the influence of both individual and family factors on glycaemic control has not been adequately investigated yet. This study aimed at examining the relationship between perceived family functioning and depressive symptoms with the frequency of capillary self-monitoring of blood glucose (SMBG) and glycaemic control (HbA1c) in a large sample of adults with T1D.

Methods

In a cross-sectional study design, we consecutively enrolled 90 adults with T1D diagnosis from at least 1 year and currently living in their family of origin or conjugal family from at least 1 year before the enrolment. Questionnaires were administered to assess family functioning and depressive symptoms. The SMBG frequency over the past 3 months and the most recent HbA1c measurement were also collected in each individual. Correlation and mediation analyses were carried out.

Results

Glycaemic control showed a positive relationship with depressive symptoms and family balanced cohesion, while SMBG frequency was correlated with family balanced flexibility and rigidity, but not with depressive symptoms. Mediation analyses showed that family rigidity mediates the effect of depressive symptoms on glycaemic control.

Conclusions

This exploratory study highlighted the significance of a cohesive family context to facilitate the achievement of individual glycaemic goals in individuals with T1D. These observations, if confirmed in larger data sets, would timely call for a comprehensive family care assessment as part of the evaluations routinely carried out in the ambulatory care of these individuals.

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Acknowledgements

This study was supported by Fondazione Diabete Ricerca (Fo.Di.Ri, Rome, Italy). The funder had no role in the study design, data collection, data analysis, manuscript preparation and/or publication decision. The support of the administrative and clinical personnel of the Verona Diabetes Center (University and General Hospital of Verona, Verona, Italy) is gratefully acknowledged.

Author information

Authors and Affiliations

  1. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy

    Liliana Indelicato, Marco Dauriz, Arianna Negri, Carlo Negri, Maddalena Trombetta & Enzo Bonora

  2. Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova, Padua, Italy

    Vincenzo Calvo

Authors
  1. Liliana Indelicato
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  2. Vincenzo Calvo
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  3. Marco Dauriz
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  4. Arianna Negri
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  5. Carlo Negri
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  6. Maddalena Trombetta
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  7. Enzo Bonora
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Contributions

LI designed the study and researched data; VC analysed data; LI, VC and MD wrote the manuscript; AN contributed to data collection; CN and MT provided care for study patients; EB edited the manuscript and provided substantial contribution to the overall discussion. LI and VC are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity and the accuracy of the data analysis.

Corresponding author

Correspondence to Liliana Indelicato.

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Conflict of interest

The author declares that there is no conflict of interest.

Ethical approval

The experimental protocol has been reviewed by the Human Investigation Committee of the Verona General Hospital and it has been therefore performed in accordance with the ethical standards laid down in the latest version of the 1964 Declaration of Helsinki.

Infomed consent

All persons gave written informed consent prior to their inclusion in the study.

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Managed by Antonio Secchi.

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Indelicato, L., Calvo, V., Dauriz, M. et al. Depressive symptoms and glycaemic control in adults with type 1 diabetes: an exploratory study on the role of family functioning. Acta Diabetol 57, 23–30 (2020). https://doi.org/10.1007/s00592-019-01356-z

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  • DOI: https://doi.org/10.1007/s00592-019-01356-z

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