title: Feeding problems reported by parents of young children with type 1 diabetes on insulin pump therapy and their associations with children's glycemic control.
abstract: OBJECTIVE
  Previous research demonstrated high rates of perceived mealtime behavior problems in families of young children with type 1 diabetes who were managed with conventional therapy. Because of new insulin regimens that offer greater flexibility, reexamination of mealtime behaviors is required. We assessed parent-reported mealtime behaviors in a sample of young children using an insulin pump. An additional aim was to evaluate the associations of two measures of parental feeding behavior with children's glycemic control.
  
  
  METHODS
  Primary caregivers of 31 young children (mean age = 5.0 +/- 1.3 yr) completed the Child Feeding Questionnaire (CFQ) and the Behavioral Pediatric Feeding Assessment Scale (BPFAS). Hemoglobin A1c (HbA1c) was used as a surrogate marker for children's glycemic control.
  
  
  RESULTS
  Children had a mean HbA1c of 7.8 +/- 0.64%. Mean CFQ - Restriction and Pressure to Eat scores were 3.1 +/- 0.94 and 2.0 +/- 0.88, respectively (range = 1-5). Mean BPFAS - Parent and Child scores were 16.0 +/- 4.3 (range = 10-50) and 44.9 +/- 9.3 (range = 25-125), respectively. Positive correlations were found between children's HbA1c levels and caregivers' reporting of frequency of child mealtime behavior problems.
  
  
  CONCLUSIONS
  Caregivers of young children on pump therapy report relatively low rates of mealtime behavior problems. However, correlations with children's HbA1c suggest that parent-child mealtime behaviors continue to relate to children's health outcomes. Research is needed to determine if changing mealtime interactions can improve children's glycemic control; items from the BPFAS and CFQ can offer targets to guide interventions.
authors.affiliation: Division of Child Behavioral Health, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital and The University of Michigan, Ann Arbor, MI 48109-5318, USA. susanap@med.umich.edu
authors.forename: Susana R
authors.initials: SR
authors.lastname: Patton
authors.forename: Laura B
authors.initials: LB
authors.lastname: Williams
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dolan
authors.forename: Ming
authors.initials: M
authors.lastname: Chen
authors.forename: Scott W
authors.initials: SW
authors.lastname: Powers
mesh_terms: D001290:Attitude; D001786:Blood Glucose / Q000378:metabolism; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology*; D005247:Feeding Behavior; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007332:Insulin Infusion Systems / Q000523:psychology*; D009034:Mother-Child Relations; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D010465:Perception; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin