title: Family CHAOS is associated with glycaemic control in children and adolescents with type 1 diabetes mellitus.
abstract: BACKGROUND
  Despite advances in the medical management of type 1 diabetes mellitus (T1DM), for many, glycaemic control remains substandard. Other factors are clearly important in determining success, or lack thereof, with diabetes management. With this in mind, we have investigated whether family CHAOS may provide a novel tool to identify when environmental confusion could impact on diabetes management and subsequent glycaemic control.
  
  
  METHODS
  A case-control study of children and adolescents with established T1DM and age-/sex-matched controls was conducted. Demographic information, both maternal and paternal CHAOS scores, and HbA1c were collected. Statistical analysis was undertaken to explore associations between T1DM and CHAOS and between CHAOS and HbA1c.
  
  
  RESULTS
  Data on 65 children with T1DM and 60 age-/sex-matched controls were obtained. There was no evidence of group differences for maternal CHAOS (p = 0.227), but paternal CHAOS scores were higher for the T1DM group (p = 0.041). Greater maternal and paternal CHAOS scores were both associated with higher HbA1c (p ≤ 0.027). The maternal association remained after controlling for diabetes duration, SMBG frequency, and insulin therapy.
  
  
  CONCLUSIONS
  In children with T1DM, there appears to be a negative association between increased environmental confusion, as rated by CHAOS, and glycaemic control. In addition, when compared to controls, fathers of children and adolescents with T1DM appear to experience CHAOS differently to mothers. These findings contribute to the growing body of literature exploring psychosocial factors in T1DM. Continuing efforts are required to fully understand how the family and psychosocial environment interact with diabetes to impact on long-term health outcomes.
authors.affiliation: Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, 9054, New Zealand.
authors.forename: M
authors.initials: M
authors.lastname: Chae
authors.affiliation: Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, 9054, New Zealand.|Edgar National Centre for Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand.
authors.forename: B J
authors.initials: BJ
authors.lastname: Taylor
authors.affiliation: Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, 9054, New Zealand.
authors.forename: J
authors.initials: J
authors.lastname: Lawrence
authors.affiliation: Department of Psychology, University of Otago, Dunedin, New Zealand.
authors.forename: D
authors.initials: D
authors.lastname: Healey
authors.affiliation: Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, 9054, New Zealand.
authors.forename: D M
authors.initials: DM
authors.lastname: Reith
authors.affiliation: Department of Preventative and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: A
authors.initials: A
authors.lastname: Gray
authors.affiliation: Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, 9054, New Zealand. Ben.wheeler@otago.ac.nz.|Edgar National Centre for Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand. Ben.wheeler@otago.ac.nz.
authors.forename: B J
authors.initials: BJ
authors.lastname: Wheeler
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology* / Q000628:therapy*; D005190:Family / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007398:Interpersonal Relations; D008297:Male; D011584:Psychology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin
keywords: Adolescent; CHAOS; Children; Glycaemic control; Type 1 diabetes mellitus