Parents’ representations and glycemic control among adolescents with type 1 diabetes

  • Alon GoldbergEmail author
Original Article



Parents of adolescents with type 1 diabetes mellitus (T1DM) experience major challenges as they cope with the adolescent-child disease. The current research investigated maternal and paternal representations of parents of adolescents diagnosed with T1DM, specifically, the association between parental representations and adolescents’ glycemic control (A1C level).


Seventy-five mothers and fathers of adolescents (13–18 years of age) diagnosed with T1DM (disease onset ≥ 12 months) were recruited from a large medical center in Israel. Data were gathered from a demographic questionnaire, a blood test for A1C level, and the Parenting Representations Interview.


No significant correlations were found between A1C level and maternal representations or balanced narrative. However, for fathers, a negative correlation was found between A1C level and paternal representations of the self, representations of the child, and positive relationships; and between A1C level and balanced narrative.


The association found between paternal positive representations and glycemic control and the lack of any significance association within mothers point to the differences between motherhood and fatherhood in the context of an adolescent with T1DM. Therefore, fathers should be addressed as significant caregivers in treatment at the clinical practice.


Parenting representation Type 1 diabetes Adolescents A1C 



Special thanks to the adolescents and their parents who participated in the study, and to the Juvenile Diabetes Research Foundation of Israel; without them, the study would not have been possible.

Compliance with ethical standards

There was no funding for the current research, and no conflict of interest. This research involves human participants. Hence, a Helsinki committee at a large medical center approved the study (titled: “The health and adjustment of adolescents with type 1 diabetes,” protocol number 2357), and all participants signed informed consent forms to confirm their participation. Families were informed that their anonymity would be preserved throughout the study, that the data collected would be used for research purposes only, and that their names would remain confidential. They were also assured that they had the right to discontinue their participation in the study at any time.


  1. Anderson BJ, Vangsness L, Connell A, Butler D, Goebel-Fabbri A, Laffel LMB (2002) Family conflict, adherence, and glycaemic control in youth with short duration type 1 diabetes. Diabet Med 19:635–642. CrossRefPubMedGoogle Scholar
  2. Bowlby J (1982) Attachment and loss: vol. 1. — Attachment, 2nd edn. Basic Books, New YorkGoogle Scholar
  3. Bretherton I, Munholland KA (1999) Internal working models in attachment relationships: a construct revisited. In: Cassidy J, Shaver PR (eds) Handbook of attachment: theory, research, and clinical application. Guilford, New York, pp 89–111Google Scholar
  4. Dolev S (2006) Maternal insight and coming to terms with diagnosis among mothers of children with autism: relationship with maternal feelings. Unpublished doctoral dissertation, University of Haifa, Israel [Hebrew]Google Scholar
  5. Edgar KA, Skinner TC (2003) Illness representations and coping as predictors of emotional well-being in adolescents with type 1 diabetes. J Pediatr Psychol 28:485–493. CrossRefPubMedGoogle Scholar
  6. George C, Solomon J (2008) The caregiving system: a behavioral systems approach to parenting. In: Cassidy J, Shaver PR (eds) Handbook of attachment: theory, research, and clinical applications, 2nd edn. Guilford, New York, pp 833–856Google Scholar
  7. Goethals ER, Oris L, Soenens B, Berg CA, Prikken S, Van Broeck N, Weets I, Casteels K, Luyckx K (2017) Parenting and treatment adherence in type 1 diabetes throughout adolescence and emerging adulthood. J Pediatr Psychol 42:922–932. CrossRefPubMedGoogle Scholar
  8. Goldberg A, Wiseman H (2016) Parental resolution and the adolescent’s health and adjustment: the case of adolescents with type 1 diabetes. Soc Work Health Care 55:87–100. CrossRefPubMedGoogle Scholar
  9. Guill Liles R, Juhnke GA (2008) Adolescent diabetic control: using the process–person–context–time model. J Couns Dev 86:75–86. CrossRefGoogle Scholar
  10. Hilliard ME, Rohan JM, Carle AC, Pendley JS, Delamater A, Drotar D (2011) Fathers’ involvement in preadolescents’ diabetes adherence and glycemic control. J Pediatr Psychol 36:911–922. CrossRefPubMedPubMedCentralGoogle Scholar
  11. Hilliard ME, Holmes CS, Chen R, Maher K, Robinson E, Streisand R (2013) Disentangling the roles of parental monitoring and family conflict in adolescents’ management of type 1 diabetes. Health Psychol 32:388–396. CrossRefPubMedGoogle Scholar
  12. Hilliard ME, Rohan JM, Rausch JR, Delamater A, Pendley JS, Drotar D (2014) Patterns and predictors of paternal involvement in early adolescents’ type 1 diabetes management over 3 years. J Pediatr Psychol 39:74–83. CrossRefPubMedGoogle Scholar
  13. Ivey JB, Wright A, Dashiff CJ (2009) Finding the balance: adolescents with type 1 diabetes and their parents. J Pediatr Health Care 23:10–18. CrossRefPubMedGoogle Scholar
  14. Juvenile Diabetes Research Foundation (2016) Type 1 diabetes facts. Accessed 16 Mar 2017
  15. Lam CB, McHale SM, Crouter AC (2012) Parent–child shared time from middle childhood to late adolescence: developmental course and adjustment correlates. Child Dev 83:2089–2103. CrossRefPubMedPubMedCentralGoogle Scholar
  16. Landolt MA, Vollrath M, Laimbacher J, Gnehm HE, Sennhauser FH (2005) Prospective study of posttraumatic stress disorder in parents of children with newly diagnosed type 1 diabetes. J Am Acad Child Adolesc Psychiatry 44:682–689. CrossRefPubMedGoogle Scholar
  17. Maas-van Schaaijk NM, Roeleveld-Versteegh ABC, van Baar AL (2013) The interrelationships among paternal and maternal parenting stress, metabolic control, and depressive symptoms in adolescents with type 1 diabetes mellitus. J Pediatr Psychol 38:30–40. CrossRefPubMedGoogle Scholar
  18. Martin MT, Miller-Johnson S, Kitzmann KM, Emery RE (1998) Parent–child relationships and insulin dependent diabetes mellitus: observational ratings of clinically relevant dimensions. J Fam Psychol 12:102–111. CrossRefGoogle Scholar
  19. Martz E, Livneh H (2007) Do posttraumatic reactions predict future time perspective among people with insulin-dependent diabetes mellitus? Rehabil Couns Bull 50:87–98. CrossRefGoogle Scholar
  20. Melamed BG (2008) Parenting the ill child. In: Bornstein MH (ed) Practical issues in parenting. Lawrence Erlbaum, Mahwah, pp 329–348Google Scholar
  21. Scharf M, Mayseless O (1997\2000) Parenting representations interview — adolescence (PRI-A). Unpublished manuscript, University of HaifaGoogle Scholar
  22. Scharf M, Shulman S (2006) Intergenerational transmission of experiences in adolescence: the challenges of parenting adolescents. In: Mayseless O (ed) Parenting representations: theory, research, and clinical implications. Cambridge University Press, New York, pp 319–351. CrossRefGoogle Scholar
  23. Scharf M, Mayseless O, Kivenson-Baron I (2015) The viability of the parenting representations interview for assessing and measuring change in parents of adolescents. Attach Hum Dev 17:199–219. CrossRefPubMedGoogle Scholar
  24. Shorer M, David R, Schoenberg-Taz M, Levavi-Lavi I, Phillip M, Meyerovitch J (2011) Role of parenting style in achieving metabolic control in adolescents with type 1 diabetes. Diabetes Care 34:1735–1737. CrossRefPubMedPubMedCentralGoogle Scholar
  25. Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, Deeb L, Grey M, Anderson B, Holzmeister LA, Clark N, American Diabetes Association (2005) Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 28:186–212. CrossRefPubMedGoogle Scholar
  26. Steinberg L, Silk JS (2002) Parenting adolescents. In: Bornstein MH (ed) Children and parenting. Lawrence Erlbaum, Mahwah, pp 103–133Google Scholar
  27. Wray-Lake L, Crouter AC, McHale SM (2010) Developmental patterns in decision-making autonomy across middle childhood and adolescence: European American parents’ perspectives. Child Dev 81:636–651. CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of EducationTel-Hai CollegeUpper GalileeIsrael

Personalised recommendations