Psychosocial adjustment of latency-aged diabetics: determinants and relationship to control

The relationship of psychosocial adjustment, family functioning, self-esteem, and diabetic control was studied in 20 latency-aged diabetic children and their parents. Moderate to severe adjustment problems were found in 11 (55%) of the patients. Child self-esteem, parental self-esteem, and family functioning, as scored by standard instruments, were all significantly greater in the group of children considered to be well-adjusted as compared to the maladjusted group (P less than .05 to .001). Of these, parental self-esteem appeared to correlate most closely with the child's adjustment. Twenty-four-hour urinary glucose excretion was two- to threefold greater in maladjusted as compared to well-adjusted patients (71 +/- 20 vs 20 +/- 5 gm, P less than .05). These data suggest that psychosocial adjustment problems frequently occur in latency-aged children with diabetes, are associated with poorer chemical control, and require a family-centered approach to intervention and management.