Family Impact, Caregiver Burden, Parental Monitoring, and Glycemic Control in Children with Type 1 Diabetes: A...

Objectives: To examine the association between family-related psychosocial factors and glycemic control in children with type 1 diabetes. Methods: This cross-sectional study included 67 children with type 1 diabetes and their parents. Data were collected using the Diabetes Family Impact Scale, Caregiver Burden Scale, and Parental Monitoring of Diabetes Care Scale. Sociodemographic and clinical variables, including glycated hemoglobin (HbA1c) levels, were recorded. Spearman correlation analyses and multivariable regression models were performed. Results: A total of 67 parent-child dyads were included. Diabetes-specific family impact was strongly correlated with caregiver burden (ρ = 0.617, p < 0.001). Participants reporting household income below expenses had higher HbA1c levels (8.14 ± 1.85 vs. 7.07 ± 0.93, p = 0.002), higher DIFS scores (21.05 ± 8.55 vs. 14.29 ± 9.23, p = 0.005), and higher CBS scores (33.72 ± 14.35 vs. 26.13 ± 11.60, p = 0.022) than those reporting income equal to expenses. Higher parental monitoring was associated with lower HbA1c in the bivariate analysis (ρ = -0.533, p < 0.001) and remained associated after adjustment for perceived household financial adequacy (β = -0.580, p < 0.001). Perceived household financial adequacy was also associated with HbA1c in the adjusted model (β = -0.273, p = 0.002). Conclusions: Greater parental monitoring was consistently associated with lower HbA1c, while perceived household financial inadequacy was associated with poorer glycemic control and greater diabetes-specific family impact and caregiver burden. These findings highlight the relevance of both family and socioeconomic factors in pediatric type 1 diabetes care. Given the cross-sectional design, the observed associations should not be interpreted as causal.