Current Diabetes Reports

, 14:520 | Cite as

Young Children with Type 1 Diabetes: Challenges, Research, and Future Directions

  • Randi StreisandEmail author
  • Maureen Monaghan
Psychosocial Aspects (KK Hood, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Psychosocial Aspects


The incidence of type 1 diabetes (T1D) in young children (age <6 years) is rising. Diabetes management guidelines offered by the American Diabetes Association and health care teams understandably place a high burden of responsibility on caregivers to check young children’s blood glucose levels, administer insulin, and monitor diet and physical activity with the ultimate goal of maintaining tight glycemic control. Unfortunately, this tight control is needed during a vulnerable developmental period when behavior is unpredictable, T1D can be physiologically difficult to control, parenting stress can be elevated, and caregivers are strained by normal child caretaking routines. Despite the potentially different management needs, specific education and clinical services for managing diabetes in young children are rarely offered, and behavioral research with this young child age group has been limited in scope and quantity. Research findings pertinent to young children with T1D are reviewed, and potential clinical implications, as well as areas for future research, are discussed.


Young children Type 1 diabetes Parenting 



The authors were supported in part during the writing of this manuscript by NIH R01 DK080102 awarded to RS (Dr. Streisand is PI on an R01) and NIH K23DK099250 awarded to MM.

Compliance with Ethics Guidelines

Conflict of Interest

Randi Streisand and Maureen Monaghan declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Pettitt D, Talton J, Dabelea D, Divers J, Imperatore G, Lawrence J, et al. Prevalence of diabetes in U.S. youth in 2009: the SEARCH for Diabetes in Youth Study. Diabetes Care. 2014;37:402–8. doi: 10.2337/dc13-1838.
  2. 2.
    Patterson CC, Dahlquist GG, Gyurus E, Green A, Soltesz G. Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases 2005-20: a multicentre prospective registration study. Lancet. 2009;373:2027–33. doi: 10.1016/S0140-6736(09)60568-7.PubMedCrossRefGoogle Scholar
  3. 3.
    Vehik K, Hamman R, Lezotte D, Norris J, Klingensmith G, Bloch C, et al. Increasing incidence of type 1 diabetes in 0- to 17-year-old Colorado youth. Diabetes Care. 2007;30:503–9. doi: 10.2337/dc06-1837.PubMedCrossRefGoogle Scholar
  4. 4.
    Dabelea D, Bell R, D'Agostino RB, Imperatore G, Johansen JM, Linder B, et al. Incidence of diabetes in youth in the United States. JAMA. 2007;297:2716–24. doi: 10.1001/jama.297.24.2716.
  5. 5.
    Bade-White PA, Obrzut JE. The neurocognitive effects of type 1 diabetes mellitus in children and young adults with and without hypoglycemia. J Dev Phys Disabil. 2009;21:425–40. doi: 10.1007/s10882-009-9151-y.CrossRefGoogle Scholar
  6. 6.
    Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86. doi: 10.1056/NEJM199309303291401.CrossRefGoogle Scholar
  7. 7.
    Silverstein J, Klingensmith G, Copeland K, Plotnick LP, Kaufman F, Laffel L, et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care. 2005;28:186–212.PubMedCrossRefGoogle Scholar
  8. 8.
    American Diabetes Association. Standards of medical care in diabetes - 2013. Diabetes Care. 2013;36:S11–66. doi: 10.2337/dc13-S011.PubMedCentralCrossRefGoogle Scholar
  9. 9.
    Sullivan-Bolyai S, Deatrick J, Gruppuso P, Tamborlane W, Grey M. Mothers’ experiences raising young children with type 1 diabetes. J Spec Pediatr Nurs. 2002;7:93–103. doi: 10.1177/014572170403000316.PubMedCrossRefGoogle Scholar
  10. 10.
    Rewers M, Pihoker C, Donaghue K, Hanas R, Swift P, Klingensmith GJ. Assessment and monitoring of glycemic control in children and adolescents with diabetes. Pediatr Diabetes. 2009;10:71–81. doi: 10.1111/j.1399-5448.2009.00582.x.PubMedCrossRefGoogle Scholar
  11. 11.••
    Wood J, Miller K, Maahs D, Beck R, DiMeglio L, Libman I, et al. Most youth with type 1 diabetes in the T1D exchange clinic registry do not meet American Diabetes Association or International Society for Pediatric and Adolescent Diabetes Clinical Guidelines. Diabetes Care. 2013;36:2035–7. doi: 10.2337/dc12-1959. A majority of children with T1D are in inadequate control including young children, who are under the care of their parents for daily management. These cohort data indicate the critical need for effective interventions in T1D management across childhood.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Abdul-Rasoul M, Habib H, Al-Khouly M. ‘The honeymoon phase’ in children with type 1 diabetes mellitus: frequency, duration, and influential factors. Pediatr Diabetes. 2006;7:101–7. doi: 10.1111/j.1399-543X.2006.00155.x.PubMedCrossRefGoogle Scholar
  13. 13.
    Desrocher M, Rovet J. Neurocognitive correlates of type 1 diabetes mellitus in childhood. Child Neuropsychol. 2004;10:36–52. doi: 10.1076/chin. Scholar
  14. 14.
    Golden MP, Russell BP, Ingersoll GM, Gray DL, Hummer KM. Management of diabetes mellitus in children younger than 5 years of age. Am J Dis Child. 1985;139:448–52. doi: 10.1001/archpedi.1985.02140070022019.PubMedGoogle Scholar
  15. 15.
    McNally PG, Raymond NT, Swift PG, Hearnshaw JR, Burden AC. Does the prepubertal duration of diabetes influence the onset of microvascular complications? Diabetes Med. 1993;10:906–8. doi: 10.1111/j.1464-5491.1993.tb00005.x.CrossRefGoogle Scholar
  16. 16.•
    Marzelli M, Masaika P, Barnea-Goraly N, Hershey T, Tsalikian E, Tamborlane W, et al. Neuroanatomical correlates of dysglycemia in young children with type 1 diabetes. Diabetes. 2014;63:343–53. doi: 10.2337/db13-0179. These data suggest that glycemic dysregulation or variability has significant implications for young children and brain structure and function.PubMedCrossRefGoogle Scholar
  17. 17.
    Barnea-Goraly N, Raman M, Mazaika P, Marzelli M, Hershey T, Weinzimer SA, et al. Alterations in white matter structure in young children with type 1 diabetes. Diabetes Care. 2014;37:332–40. doi: 10.2337/dc13-1388.PubMedCrossRefGoogle Scholar
  18. 18.
    Cato M, Mauras N, Ambrosino J, Bondurant A, Conrad A, Kollman C, et al. Cognitive functioning in young children with type 1 diabetes. J Int Neuropsychol Soc. 2014;20:238–47. doi: 10.1017/S1355617713001434.PubMedCrossRefGoogle Scholar
  19. 19.
    Wysocki T, Huxtable K, Linscheid TR, Wayne W. Adjustment to diabetes mellitus in preschoolers and their mothers. Diabetes Care. 1989;12:524–9. doi: 10.2337/diacare.12.8.524.PubMedCrossRefGoogle Scholar
  20. 20.•
    Hilliard ME, Monaghan M, Cogen FR, Streisand R. Parent stress and child behaviour among young children with type 1 diabetes. Child Care Health Dev. 2011;37:224–32. doi: 10.1111/j.1365-2214.2010.01162.x. Descriptive data clearly document the impact of managing young children's diabetes on parents, and the relationship among pediatric parenting stress and perceived behavior problems in young children with T1D.PubMedCrossRefGoogle Scholar
  21. 21.
    Hatton DL, Canam C, Thorne S, Hughes AM. Parents’ perceptions of caring for an infant or toddler with diabetes. J Adv Nurs. 1995;22:569–77. doi: 10.1046/j.1365-2648.1995.22030569.x.PubMedCrossRefGoogle Scholar
  22. 22.
    Dzygalo K, Szypowska A. Impact of insulins glulisine and aspart on postprandial glycemia after a high glycemic index meal in children with type 1 diabetes. Eur J Endocrinol. 2014;170:539–45. doi: 10.1530/EJE-13-0696.
  23. 23.
    Boland E, Monsod T, Delucia M, Brandt C, Fernando S, Tamborlane W. Limitations of conventional methods of self-monitoring of blood glucose: lessons learned from 3 days of continuous glucose sensing in pediatric patients with type 1 diabetes. Diabetes Care. 2001;24:1858–62. doi: 10.2337/diacare.24.11.1858.PubMedCrossRefGoogle Scholar
  24. 24.
    Nilsson A, Radeborg K, Bjorck I. Effects on cognitive performance of modulating the postprandial blood glucose profile at breakfast. Eur J Clin Nutr. 2012;66:1039–43. doi: 10.1038/ejcn.2012.80.PubMedCrossRefGoogle Scholar
  25. 25.
    Mackey ER, Herbert LJ, Monaghan M, Henderson C, Cogen F, Streisand R. Glycemic variability, nutrition, and physical activity in a pilot of young children with T1D. Diabetes. 2014;63(S1):A201. doi: 10.2337/db14-665-832.
  26. 26.
    Cathey M, Gaylord N. Picky eating: a toddler's approach to mealtime. Pediatr Nurs. 2004;30:101–6.PubMedGoogle Scholar
  27. 27.
    Goonetilleke R, Pollitzer M, Mann N. Insulin for toddlers with difficult diabetes. Diabetes Care. 2004;27:1505. doi: 10.2337/diacare.27.6.1505.PubMedCrossRefGoogle Scholar
  28. 28.
    Powers SW, Byars KC, Mitchell MJ, Patton SR, Standiford DA, Dolan LM. Parent report of mealtime behavior and parenting stress in young children with type 1 diabetes and in healthy control subjects. Diabetes Care. 2002;25:313–8. doi: 10.2337/diacare.25.2.313.PubMedCrossRefGoogle Scholar
  29. 29.
    Patton S, Dolan L, Powers S. Differences in family mealtime interactions between young children with type 1 diabetes and controls: implications for behavioral intervention. J Pediatr Psychol. 2008;33:885–93. doi: 10.1093/jpepsy/jsn026.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.•
    Patton S, Dolan L, Smith L, Brown M, Powers S. Examining mealtime behaviors in families of young children with type 1 diabetes on intensive insulin therapy. Eat Behav. 2013;14:464–7. doi: 10.1016/j.eatbeh.2013.08.010. In videotaping mealtimes in families of young children with T1D, authors determined a relationship among negative child mealtime behaviors and glycemic control, urging that inclusion of mealtime behaviors is imperative in interventions targeting this age group.PubMedCrossRefGoogle Scholar
  31. 31.
    Monaghan M, Herbert LJ, Wang J, Holmes C, Cogen FR, Streisand R. Mealtime behavior and diabetes-specific parent functioning in young children with type 1 diabetes. Diabetes. 2014;63(S1):A67. doi: 10.2337/db14-1-388.
  32. 32.
    Sundberg F, Augustsson M, Forsander G, Cederholm U, Axelsen M. Children under the age of seven with diabetes are increasing their cardiovascular risk by their food choices. Acta Paediatr. 2014;103:404–10. doi: 10.1111/apa.12533.
  33. 33.
    Quick V, Lipsky L, Laffel L, Mehta S, Quinn H, Nansel TR. Relationships of neophobia and pickiness with dietary variety, dietary quality and diabetes management adherence in youth with type 1 diabetes. Eur J Clin Nutr. 2014;68:131–6. doi: 10.1038/ejcn.2013.239.PubMedCrossRefGoogle Scholar
  34. 34.
    Taylor RW, Williams SM, Farmer VL, Taylor BJ. Changes in physical activity over time in young children: a longitudinal study using accelerometers. PLoS One. 2013;8:e81567. doi: 10.1371/journal.pone.0081567.PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Yardley J, Mollard R, Macintosh A, Macmillan F, Wicklow B, Berard L, et al. Vigorous intensity exercise for glycemic control in patients with type 1 diabetes. Can J Diabetes. 2013;37:427–32. doi: 10.1016/j.jcjd.2013.08.269.PubMedCrossRefGoogle Scholar
  36. 36.
    Baquet G, Stratton G, Van Praagh E, Berthoin S. Improving physical activity assessment in prepubertal children with high-frequency accelerometry monitoring: a methodological issue. Prev Med. 2007;44:143–7. doi: 10.1016/j.ypmed.2006.10.004.PubMedCrossRefGoogle Scholar
  37. 37.
    Bailey RC, Olson J, Pepper SL, Porszasz J, Barstow TJ, Cooper DM. The level and tempo of children's physical activities: an observational study. Med Sci Sports Exerc. 1995;27:1033–41. doi: 10.1249/00005768-199507000-00012.PubMedCrossRefGoogle Scholar
  38. 38.•
    Sundberg F, Forsander G, Fasth A, Ekelund U. Children younger than 7 years with type 1 diabetes are less physically active than healthy controls. Acta Paediatr. 2012;101:1164–9. doi: 10.1111/j.1651-2227.2012.02803.x. In one of the only studies specifically examining physical activity in young children with T1D, data indicate that children with diabetes are less active than healthy peers, highlighting the need for inclusion of physical activity in intervention research as a way to promote better longer term cardiovascular health for these children.PubMedCrossRefGoogle Scholar
  39. 39.
    Sullivan-Bolyai S, Deatrick J, Gruppuso P, Tamborlane W, Grey M. Constant vigilance: mothers’ work parenting young children with type 1 diabetes. J Pediatr Nurs. 2003;18:21–9. doi: 10.1053/jpdn.2003.4.PubMedCrossRefGoogle Scholar
  40. 40.
    Linm H, Mu P, Lee Y. Mothers’ experience supporting life adjustment in children with T1DM. West J Nurs Res. 2008;30:96–110. doi: 10.1177/0193945907302456.Google Scholar
  41. 41.
    Smaldone A, Ritholz MD. Perceptions of parenting children with type 1 diabetes diagnosed in early childhood. J Pediatr Health Care. 2011;25:87–95. doi: 10.1016/j.pedhc.2009.09.003.PubMedCentralPubMedCrossRefGoogle Scholar
  42. 42.
    Niedel A, Traynor M, McKee M, Grey M. Parallel vigilance: parents’ dual focus following diagnosis of type 1 diabetes mellitus in their young child. Health. 2013;17(3):246–65. doi:  10.1177/1363459312451180.
  43. 43.
    Sullivan-Bolyai S, Lee M. Parent mentor perspectives on providing social support to empower parents. Diabetes Educ. 2011;37:34–43. doi: 10.1177/0145721710392248.CrossRefGoogle Scholar
  44. 44.
    Landolt MA, Ribi K, Laimbacher J, Vollrath M, Gnehm HE, Sennhauser FH. Posttraumatic stress disorder in parents of children with newly diagnosed type 1 diabetes. J Pediatr Psychol. 2002;27:647–52. doi: 10.1093/jpepsy/27.7.647.PubMedCrossRefGoogle Scholar
  45. 45.
    Landolt MA, Vollrath M, Ribi K, Gnehm HE, Sennhauser FH. Incidence and associations of parental and child posttraumatic stress symptoms in pediatric patients. J Child Psychol Psychiatry. 2003;44:1199–207. doi: 10.1111/1469-7610.00201.PubMedCrossRefGoogle Scholar
  46. 46.
    Streisand R, Mackey E, Elliot B, Mednick L, Slaughter I, Turek J, et al. Parental anxiety and depression associated with caring for a child newly diagnosed with type 1 diabetes: opportunities for education and counseling. Patient Educ Couns. 2008;73:333–8. doi: 10.1016/j.pec.2008.06.014.PubMedCrossRefGoogle Scholar
  47. 47.
    Kovacs M, Iyengar S, Goldston D, Obrosky DS, Stewart J, Marsh J. Psychological functioning among mothers of children with insulin-dependent diabetes mellitus: a longitudinal study. J Consult Clin Psychol. 1990;58:189–95. doi: 10.1037/0022-006X.58.2.189.PubMedCrossRefGoogle Scholar
  48. 48.
    Powell PW, Chen R, Kumar A, Streisand R, Holmes CS. Sociodemographic effects on biological, disease care, and diabetes knowledge factors in youth with type 1 diabetes. J Child Health Care. 2013;17:174–85. doi: 10.1177/1367493512456105.
  49. 49.
    Schwartz D, Cline V, Axelrod M, Anderson B. Feasibility, acceptability, and predictive validity of a psychosocial screening program for children and youth newly diagnosed with type 1 diabetes. Diabetes Care. 2011;34:326–31. doi: 10.2337/dc10-1553.PubMedCentralPubMedCrossRefGoogle Scholar
  50. 50.
    Banion CR, Miles MS, Carter MC. Problems of mothers in management of children with diabetes. Diabetes Care. 1983;6:548–51. doi: 10.2337/diacare.6.6.548.PubMedCrossRefGoogle Scholar
  51. 51.
    Whittemore R, Jaser S, Chao A, Jang M, Grey M. Psychological experience of parents of children with type 1 diabetes. Diabetes Educ. 2012;38:562–79. doi: 10.1177/0145721712445216.PubMedCentralPubMedCrossRefGoogle Scholar
  52. 52.
    Stallwood L. Influence of caregiver stress and coping on glycemic control of young children with diabetes. J Pediatr Health Care. 2005;19:293–300. doi: 10.1016/j.pedhc.2005.04.003.PubMedCrossRefGoogle Scholar
  53. 53.
    Jaser S, Whittemore R, Ambrosino JM, Lindemann E, Grey M. Coping and psychological adjustment in mothers of young children with type 1 diabetes. Child Health Care. 2009;38:91–106. doi: 10.1080/02739610902813229.CrossRefGoogle Scholar
  54. 54.
    Streisand R, Swift E, Wickmark T, Chen R, Holmes CS. Pediatric parenting stress among parents of children with type 1 diabetes: the role of self-efficacy, responsibility, and fear. J Pediatr Psychol. 2005;30:513–21. doi: 10.1093/jpepsy/jsi076.
  55. 55.
    Streisand R, Braniecki S, Tercyak KP, Kazak AE. Childhood illness-related parenting stress: the pediatric inventory for parents. J Pediatr Psychol. 2001;26:155–62. doi: 10.1093/jpepsy/26.3.155.
  56. 56.
    Cox DM, Irvine A, Gonder-Frederick LA, Nowacek G, Butterfield J. Fear of hypoglycemia: quantification, validation and utilization. Diabetes Care. 1987;10:617–21. doi: 10.2337/diacare.10.5.617.PubMedCrossRefGoogle Scholar
  57. 57.
    Patton SR, Dolan LM, Henry R, Powers SW. Parental fear of hypoglycemia: young children treated with continuous subcutaneous insulin infusion. Pediatr Diabetes. 2007;8:362–8. doi: 10.1111/j.1399-5448.2007.00242.x.PubMedCrossRefGoogle Scholar
  58. 58.
    Freckleton E, Sharpe L, Mullan B. The relationship between maternal fear of hypoglycemia and adherence in children with type-1 diabetes. Int J Behav Med. 2013. doi: 10.1007/s12529-013-9360-8.PubMedGoogle Scholar
  59. 59.
    Patton SR, Dolan LM, Smith LB, Thomas IH, Powers SW. Pediatric parenting stress and its relation to depressive symptoms and fear of hypoglycemia in parents of young children with type 1 diabetes mellitus. J Clin Psychol Med Settings. 2011;18:345–52. doi: 10.1007/s10880-011-9256-1.PubMedCentralPubMedCrossRefGoogle Scholar
  60. 60.
    Mitchell SJ, Hilliard ME, Mednick L, Henderson C, Cogen FR, Streisand R. Stress among fathers of young children with type 1 diabetes. Fam Syst Health. 2009;27:314–24. doi: 10.1037/a0018191.PubMedCentralPubMedCrossRefGoogle Scholar
  61. 61.
    Faulkner MS, Clark FS. Quality of life for parents of children and adolescents with type 1 diabetes. Diabetes Educ. 1998;24:721–7. doi: 10.1177/014572179802400607.PubMedCrossRefGoogle Scholar
  62. 62.
    Herbert L, Monaghan M, Cogen F, Streisand R. The impact of parents’ sleep quality and hypoglycemia worry on diabetes self-efficacy. Behav Sleep Med. 2014.Google Scholar
  63. 63.
    McKnight-Eily LR, Liu Y, Perry GS, Preseley-Cantrell LR, Strine TW, Lu H, et al. Perceived insufficient rest or sleep among adults - United States, 2008. MMWR. 2009;58:1175–9.Google Scholar
  64. 64.
    Monaghan M, Herbert LJ, Cogen FR, Streisand R. Sleep behaviors and parent functioning in young children with type 1 diabetes. Child Health Care. 2012;41:246–59. doi: 10.1080/02739615.2012.685385.PubMedCentralPubMedCrossRefGoogle Scholar
  65. 65.
    Monaghan M, Hilliard ME, Cogen FR, Streisand R. Nighttime caregiving behaviors among parents of young children with type 1 diabetes: associations with illness characteristics and parent functioning. Fam Syst Health. 2009;27:28–38. doi: 10.1037/a0014770.
  66. 66.
    Grey M, Cameron ME, Lipman TH, Thurber FW. Psychosocial status of children with diabetes in the first 2 years after diagnosis. Diabetes Care. 1995;18:1330–6. doi: 10.2337/diacare.18.10.1330.PubMedCrossRefGoogle Scholar
  67. 67.
    Laffel LMB, Connell A, Vangsness L, Goebel-Fabbri A, Mansfield A, Anderson BJ. General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. Diabetes Care. 2003;26:3067–73. doi: 10.2337/diacare.26.11.3067.
  68. 68.
    Zenlea I, Mednick L, Rein J, Quinn M, Wolfsdorf J, Rhodes E. Routine behavioral and mental health screening in young children with type 1 diabetes mellitus. Pediatr Diabetes. 2013. doi: 10.1111/pedi.12099.PubMedGoogle Scholar
  69. 69.
    Johnson S, Cooper M, Davis E, Jones T. Hypoglycaemia, fear of hypoglycaemia and quality of life in children with type 1 diabetes and their parents. Diabetes Med. 2013;30:1126–31. doi: 10.1111/dme.12247.CrossRefGoogle Scholar
  70. 70.
    Churchill J, Ruppe R, Smaldone A. Use of continuous insulin infusin pumps in young children with type 1 diabetes: a systematic review. J Pediatr Health Care. 2009;23:173–9. doi: 10.1016/j.pedhc.2008.07.002.PubMedCrossRefGoogle Scholar
  71. 71.
    Muller-Godeffroy E, Treichel S, Wagner V, on behalf of the German Working Group for Paediatric Pump Therapy. Investigation of quality of life and family burden issues during insulin pump therapy in children with type 1 diabetes mellitus - a large-scale multicentre pilot study. Diabetes Med. 2009;26:493–501. doi: 10.1111/j.1464-5491.2009.02707.x.CrossRefGoogle Scholar
  72. 72.
    Mauras N, Beck R, Xing D, Ruedy K, Buckingham B, Tansey M, et al. A randomized clinical trial to assess the efficacy and safety of real-time continuous glucose monitoring in the management of type 1 diabetes in young children aged 4 to <10 years. Diabetes Care. 2012;35:204–10. doi: 10.2337/dc11-1746.PubMedCentralPubMedCrossRefGoogle Scholar
  73. 73.
    Mednick L, Cogen FR, Hentinen M, Kitessa D, Streisand R, editors. Stress and anxiety in parents of very young children with type 1 diabetes: hope as a resilience factor. Washington, DC: Poster presented at: the annual meeting of the American Psychological Association; 2005.Google Scholar
  74. 74.
    Herbert L, Clary L, Owen V, Monaghan M, Alvarez V, Streisand R. The impact of school/daycare functioning and fear of hypoglycemia on quality of life in caregivers of young children with type 1 diabetes. J Clin Nurs. [In press].Google Scholar
  75. 75.
    Murphy H, Rayman G, Skinner T. Psycho-educational interventions for children and young people with Type 1 diabetes. Diabetes Med. 2006;23:935–43. doi: 10.1111/j.1464-5491.2006.01816.x.CrossRefGoogle Scholar
  76. 76.
    Sullivan-Bolyai S, Grey M, Deatrick J, Gruppuso P, Giraitis P, Tamborlane W. Helping other mothers effectively work at raising young children with type 1 diabetes. Diabetes Educ. 2004;30:476–84. doi: 10.1177/014572170403000319.PubMedCrossRefGoogle Scholar
  77. 77.
    Grey M, Jaser SS, Whittemore R, Jeon S, Lindemann E. Coping skills training for parents of children with type 1 diabetes: 12-month outcomes. Nurs Res. 2011;60:173–81. doi: 10.1097/NNR.0b013e3182159c8f.PubMedCentralPubMedCrossRefGoogle Scholar
  78. 78.
    Monaghan M, Hilliard M, Cogen F, Streisand R. Supporting parents of very young children with type 1 diabetes: results from a pilot study. Patient Educ Couns. 2011;82:271–4. doi: 10.1016/j.pec.2010.04.007.PubMedCentralPubMedCrossRefGoogle Scholar
  79. 79.
    Gaudieri P, Chen R, Greer T, Holmes C. Cognitive function in children with type 1 diabetes: a meta-analysis. Diabetes Care. 2008;31:1892–7. doi: 10.2337/dc07-2132.PubMedCentralPubMedCrossRefGoogle Scholar
  80. 80.
    Patton S, Odar C, Midyett L, Clements M. Pilot study results for a novel behavior plus nutrition intervention for caregivers of young children with type 1 diabetes. J Nutr Educ Behav. 2014. doi: 10.1016/j.jneb.2013.11.007.PubMedGoogle Scholar
  81. 81.
    Chisholm V, Atkinson L, Donaldson C, Noyes K, Payne A, Kelnar C. Maternal communication style, problem-solving, and dietary adherence. J Clin Child Psychol Psychiatry. 2011;16:443–58. doi: 10.1177/1359104510373312.CrossRefGoogle Scholar
  82. 82.
    Nieuwesteeg A, Pouwer F, van Bakel H, Emons W, Aanstoot H-J, Odink R, et al. Quality of the parent-child interaction in young children with type 1 diabetes mellitus: study protocol. BMC Pediatr. 2011;11:28. doi: 10.1186/1471-2431-11-28.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Center for Translational ScienceChildren’s National Health SystemWashingtonUSA

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