Family focused teamwork prevented deterioration in diabetes control in children and adolescents

摘要

Deterioration of glcaemic control is a common problem in adolescents with diabetes.Lattel et a/ studied the parent- adolescent "team" using a short, office based intervention, unlike many studies that focus on either adolescents or parents.The inability to detect within or between group differences in adolescent quality of life, family conflict, and family involvement might have resulted from an insufficient number of participants or inadequate time to observe such changes. The findings that a teamwork approach prevented deterioration of glycaemic control and increased, by more than twofold, the number of families that maintained or increased family involvement in diabetes tasks are striking. However, increasing parental involvement with older adolescents might threaten the normal developmental tasks necessary for autonomy and responsibility for self care. Although a positive relation between adherence and glycaemic control has long been assumed, there is some evidence to the contrary.2 Clinician ratings of patient adherence to diabetes tasks was not reported despite the authors' hypothesis that improvement in glycaemia would be achieved through increased adherence. Further investigation of the adherence-glycaemia relationship is warranted.This study is particularly relevant to health professionals who work with adolescents and their families. The finding that deterioration of glycaemic control can be prevented by using a short intervention delivered at the usual frequency of healthcare appointments, without increasing family conflict, is encouraging. The promise of a minimal cost intervention providing immediate health benefits and possibly preventing long term diabetes complications is worthy of longer term investigation.