Family Density and SES Related to Diabetes Management and Glycemic Control in Adolescents With Type 1 Diabetes

Objective Youth with Type 1 diabetes (T1D) from single-parent families have poorer glycemic control; a finding confounded with socioeconomic status (SES). Family density (FD), or youth: adult ratio, may better characterize family risk status. Methods Structural equation modeling assessed the relation of single-parent status, SES, and FD to parenting stress, diabetes-related conflict, parental monitoring, adherence, and glycemic control using cross-sectional parent and youth data (n = 257). Results Single-parent status exhibited similar relations as SES and was removed. Lower FD was associated with better glycemic control (beta = -.29, p = .014) via less conflict (beta = .17, p = .038) and greater adherence (beta = -.54, p < .001). Conclusions Beyond SES, FD plays a significant role in adherence and glycemic control via diabetes-related conflict. In contrast, the effects of single-parent status were indistinguishable from those of SES. FD provides distinct information related to adolescent glycemic control.