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Child and Adolescent Psychiatry and Mental Health
Published in: Child and Adolescent Psychiatry and Mental Health 1/2023

Open Access 01-12-2023 | Research

Attachment in close relationships and glycemic outcomes in children with type 1 diabetes

Authors: Simona Klemenčič, Jasna Klara Lipovšek, Anja Turin, Klemen Dovč, Nataša Bratina, Yael Shmueli-Goetz, Katarina Trebušak Podkrajšek, Barbka Repič Lampret, Barbara Jenko Bizjan, Sašo Karakatič, Tadej Battelino, Maja Drobnič Radobuljac

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2023

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Abstract

Background

Our aim was to determine whether child attachment to parents, parent attachment style, and morning cortisol levels were related to diabetes outcomes measured by average glycated hemoglobin (HbA1c), HbA1c variability over 4 years and time in range (TIR) in children with type 1 diabetes (T1D).

Research design and methods

101 children with T1D and one of their parents were assessed at baseline for child attachment (Child Attachment Interview; CAI) and parent attachment (Relationship Structures Questionnaire; ECR-RS). Serum samples were collected for cortisol measurements before the interviews. HbA1c levels were measured during a 4-year follow-up period at regular 3-monthly visits, and data for TIR were exported from blood glucose measuring devices. Multivariate linear regression models were constructed to identify independent predictors of glycemic outcomes.

Results

More girls than boys exhibited secure attachment to their mothers. The results of the regression models showed that securely attached girls (CAI) had higher average HbA1c than did insecurely attached girls (B = −0.64, p = 0.03). In boys, the more insecure the parent's attachment style, the worse the child's glycemic outcome: the higher the average Hb1Ac (B = 0.51, p = 0.005), the higher the HbA1c variability (B = 0.017, p = 0.011), and the lower the TIR (B = −8.543, p = 0.002).

Conclusions

Attachment in close relationships is associated with glycemic outcomes in children with T1D, and we observed significant differences between sexes. A sex- and attachment-specific approach is recommended when treating children with less favorable glycemic outcomes. Special attention and tailored support should be offered to securely attached girls in transferring responsibility for diabetes care and at least to male children of insecurely attached parents to prevent suboptimal glycemic control. Further studies in larger samples and more daily cortisol measurements may help us better understand the links between stress response, attachment and T1D.
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Metadata
Title
Attachment in close relationships and glycemic outcomes in children with type 1 diabetes
Authors
Simona Klemenčič
Jasna Klara Lipovšek
Anja Turin
Klemen Dovč
Nataša Bratina
Yael Shmueli-Goetz
Katarina Trebušak Podkrajšek
Barbka Repič Lampret
Barbara Jenko Bizjan
Sašo Karakatič
Tadej Battelino
Maja Drobnič Radobuljac
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2023
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-023-00672-1

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