Family functioning at meals relates to adherence in young children with type 1 diabetes

Aims: This study examined associations between mealtime family functioning, dietary adherence and glycaemic control in young children with type 1 diabetes mellitus (T1DM). We hypothesised that poorer family functioning would correlate with poorer dietary adherence and glycaemic control. Methods: Thirty-five families of children (M = 5.6 +/- 1.5 years) with T1DM had meals videotaped in their home, which were coded for family functioning according to the McMaster Interaction Coding System. Children's dietary adherence was assessed according to deviations from the prescribed number of carbohydrate units per meal and recommended carbohydrate intake levels per day. Glycaemic control was measured via 14 days of self-monitoring of blood glucose levels. Results: Findings demonstrated significant negative associations between children's dietary adherence and two dimensions of family functioning: Task Accomplishment (r = -0.43, P = 0.03) and Behavioral Control (r = -0.54, P = 0.00). Affect Management correlated negatively with the percent of blood glucose levels below the normal range (r = -0.33, P = 0.05). Eleven families (31%) of young children with type 1 diabetes demonstrated mealtime family functioning in the unhealthy range. Conclusions: This was the first study to examine the relationship between mealtime family functioning and children's dietary adherence and glycaemic control in families of young children with T1DM. Previous research has found mealtime family functioning to be impaired in families of young children with T1DM when compared with families of children without diabetes. Research is needed to determine if family functioning and dietary adherence can be improved via specific family-based behavioural training around mealtimes.