Family and household structure are associated with acute type 1 diabetes complications: results of cross-sectional analyses

Diabet Med. 2020 Dec;37(12):2075-2080. doi: 10.1111/dme.14230. Epub 2020 Jan 26.

Abstract

Aim: To examine the association of family/household structure with short-term diabetes complications in adolescents and emerging adults with early-onset type 1 diabetes in more detail.

Methods: Data on 1690 11-21-year-olds with type 1 diabetes were used to estimate associations of family/household structure with self-reported severe hypoglycaemia, hospitalizations for severe hypoglycaemia or diabetic ketoacidosis, applying multiple negative binomial regression.

Results: Compared with living with both biological parents living with a single mother was associated with an increased rate of hospitalizations for ketoacidosis (incidence rate ratio 1.71, 95% CI 1.00-2.82). Incidence rate ratio of hospitalizations for ketoacidosis was similar (1.67, 95% CI 0.91-3.07) if the mother lived with a partner, however, hypoglycaemia-related hospitalizations increased (3.66, 95% CI 1.54-8.71). Participants living with a single father had 4.43 (95% CI 1.30-15.05) /10.42 (95% CI 1.55-70.22) times higher rates of severe hypoglycaemia and related hospitalizations, while living with a father and his partner was associated with an increased incidence rate ratio of hospitalizations for ketoacidosis (3.48, 95% CI 0.96-12.63) compared with living with both biological parents.

Conclusions: Findings of our exploratory analyses point to different self-reported diabetes outcomes depending on the family/household structure. If confirmed in future studies, they may help to identify young people with diabetes at risk of short-term diabetes complications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetic Ketoacidosis / epidemiology*
  • Fathers*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Hypoglycemia / chemically induced
  • Hypoglycemia / epidemiology*
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use
  • Male
  • Mothers*
  • Nuclear Family
  • Parents
  • Residence Characteristics
  • Severity of Illness Index
  • Single-Parent Family / statistics & numerical data*
  • Young Adult

Substances

  • Hypoglycemic Agents
  • Insulin