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Parents Influence their Children’s Diabetes Control

Parents diagnosed with diabetes and hypertension found to negatively impact children’s glycemic control…

It is common knowledge that childhood obesity has been on a drastic increase for the last 20 years. The TODAY trial (Treatment Options for Type 2 Diabetes in Adolescents and Youth) was a large randomized clinical trial used to evaluate the safety and efficacy of treatment regimens in adolescents and children. The study, the most diverse one completed within this population, included 699 youth between the ages of 10-17 with recent-onset type 2 diabetes (within 5 months). Of the 699 youth, 623 youth were accompanied by a family support person (FSP). The FSP’s had to provide baseline data such as age, sex, race/ethnicity, height, and weight. History of diabetes and hypertension were also obtained from the FSP.

A multi-university team of researchers recently examined the questions:

  • Is the presence of diabetes in a parent associated with poorer glycemic outcomes, youth medication adherence, BMI scores, and diabetes-related complications?
  • Is the presence of parental hypertension or obesity associated with hypertension or obesity in the offspring?

The study showed that not only did the youth whose FSP’s had diabetes have a higher baseline HbA1C (6.2%) as compared to those whose FSP’s did not have diabetes (5.9%), but they also had failed to maintain adequate diabetes control. Of the 623 youth, 53.6% of those whose parents had diabetes failed to maintain glucose control compared with the 38.2% of those whose parents were diabetes free.

Parental hypertension was also shown to correlate between hypertension in the youth. It is important to note that more of the youth whose parents had both hypertension and diabetes had already been diagnosed with hypertension (30.8%) compared to those who had diabetes or hypertension or neither (13.9%). At the end of the study, 40.4% of the youth with parental hypertension compared to 27.4% of those without a hypertensive parent. Parental hypertension was also shown to correlate with a higher initial HbA1c.

The diabetes and hypertension in the FSP’s were self-reported, which could underestimate their prevalence. Parents also did not have to provide a baseline HbA1c.

The researchers concluded that, “Results of this study have helped to reinforce what we already know as health care professionals, in that we know those who have a family history of diabetes are more prone to the disease. However, this trial was able to shed light on how early a patient can become affected by their parental history.”

Practice Pearls:

  • Youth whose parents have diabetes are more likely to be diagnosed with diabetes at an early age and more susceptible to poor glycemic control.
  • Youth whose parents have diabetes and hypertension are more like to suffer from hypertension at early age.
  • Education and glycemic control of the parent may significantly help impact the child’s glycemic control.

Weinstock RS. Parental Characteristics Associated with Outcomes in Youth With Type 2 Diabetes: Results From the TODAY Clinical Trial. Diabetes Care. May 2015; 3(5)784-92.