Kids and Type 1 Diabetes: Parents Can Be the Problem

Young healthcare providers tend to expect that parents will always make the best decisions for their children who have chronic or life-threatening diseases. It takes very little exposure to clinical practice to learn that parents can misunderstand, struggle with, or sabotage treatment. A good example is dietary choices for children with type 1 diabetes mellitus (T1DM). Many of these kids eat typical American diets full of carbohydrate, sugar, and fat.

Researchers from Children’s Mercy Hospital, Kansas City, MO published a study describing parents’ perceptions of healthful eating for T1DM ahead of print in the Journal of the Academy of Nutrition and Dietetics. They reported that parents need psychological and behavioral strategies if we expect them to help their children make good dietary choices.

This study asked parents from 23 families to complete a questionnaire, 3-day weighed diet record, and a semi-structured interview about their dietary management approaches for their children. All participant families had a child with T1DM between the ages of 1 and 6 who’d carried the T1DM diagnosis for at least 6 months and received intensive insulin.

Parents seemed to understand the components of a healthful T1DM diet, but had difficulty providing such a diet at home. They identified barriers to healthful eating that were similar to those identified in other conditions: limited time to prepare homemade meals, belief that healthier foods are costly, and children’s peer influences and picky food preferences.

A noteworthy finding was that parents often were permissive about their children’s diet because they feared making their children “feel different.” They would simply give in to requests for unhealthy food rather than argue.

The researchers indicate that strengthening the food environment in which families of young children with T1DM live also can promote individual behavior changes. A significant recommendation is to help parents of young children learn strategies to manage their own negative feelings about “their child being different.” Children with T1DM need coping strategies so they reduce the impact of “feeling different.”