The relation of alexithymia and attachment with type 1 diabetes management in adolescents: a gender-specific analysis.

BACKGROUND: Several studies indicate the role of psychosocial factors in the management and control of chronic diseases in adolescents. In this regard, the roles of attachment and alexithymia in the management of type 1 diabetes in adolescents and related gender-specific patterns have rarely been the focus of empirical research. In this study we investigate the gender-specific relationship of alexithymia and attachment with self-care and blood glucose level in adolescents with type1 diabetes. METHODS: This is a cross-sectional study conducted on adolescents aged 12-18 years, with type 1 diabetes. Participants were recruited from diabetes clinics and the Iranian Diabetes Society. Data were collected using the Farsi versions of the Toronto Alexithymia Scale (FTAS-20), the Inventory of Parent and Peer Attachment (IPPA) and the Summary of Diabetes Self-Care Activities Scale (SDSCA). Blood glucose levels were measured by determining HbA1c which were abstracted from medical records. Data were analyzed using SPSS21 software. RESULTS: Participants were 150 adolescents (57% female), mean age 14.97 ± 2.30. Alexithymia (ß = 0.10, P = 0.01), difficulty identifying feelings (ß = 0.15, P = 0.03) and communication with mothers (ß = - 0.08, P = 0.03) predicted HbA1c in girls, whereas no significant relationships were observed for HbA1c with alexithymia and attachment in boys. Factors that predicted self-care in girls were alexithymia (ß = - 0.04, P = 0.02), difficulty identifying feelings (ß = - 0.06, P = 0.04); in boys however in addition to these two factors predicting self-care [alexithymia (ß = - 0.07, P = 0.01) and difficulty identifying feelings (ß = - 0.11, P = 0.01)], we also found difficulty describing feelings (ß = - 0.16, P = 0.02), communication with mother (ß = 0.04, P = 0.04), alienation to mother (ß = - 0.06, P = 0.03), to father (ß = - 0.06, P = 0.01) and to peers (ß = - 0.09, P = 0.03). CONCLUSIONS: Our results suggest that, in a gender-specific pattern, alexithymia and attachment could affect self-care and blood glucose level in adolescents with type 1 diabetes; findings that can be used to facilitate more effective treatment strategies and interventions in this age group.

Diabetes in women and health-related quality of life in the whole family: a structural equation modeling.

BACKGROUND: Although several studies indicate the effects of diabetes type 2 on health-related quality of life (HRQoL) in female subjects, the related impact of the disease on HRQoL in their family members has rarely been the focus of the empirical research. In this study we aim to investigate associations between diabetes in women and the HRQoL in these women and their family members, using the structural equation modeling (SEM). METHODS: This family-based study was conducted on 794 women (11.1% with diabetes) as well as their spouses and children who participated in the Tehran Lipid and Glucose Study (TLGS) from 2014 to 2016. Data on HRQoL were collected using the Iranian version of the Short-Form 12-Item Health Survey version 2 (SF-12v2) and the Pediatric Quality of Life Inventory version™ 4.0 (PedsQL). SEM was conducted to evaluate the network of associations among studied variables. Data were analyzed using IBM SPSS Statistics & AMOS version 23 software. RESULTS: Mean age of women was 41.37 ± 5.32 years. Diabetes in women significantly affected their mental HRQoL (ß = - 0.11, P < 0.01) but showed no significant direct associations with physical and mental HRQoL in their spouses or their children. However, poor mental HRQoL in women with diabetes was associated with decrease in both physical (ß = - 0.02, P = 0.013) and mental (ß = - 0.03, P < 0.01) HRQoL in their spouses and total HRQoL score in children (ß = - 0.02, P < 0.01). CONCLUSIONS: Among women with diabetes type 2, beyond its effect on their mental HRQoL per se, demonstrated a negative association with the self-assessment of health status in their spouses and children. Such familial consequences are mainly attributed to the negative effect of the disease on the mental rather than the physical HRQoL in women with diabetes.