It's good and bad news: Parents matter when it comes to helping their diabetic teens stay healthy.
A University of Utah study found when parents become less involved in their teens' care of type 1 diabetes and when their relationship quality drops, teens are less likely to manage the disease.
Without proper management, diabetes can lead to blindness, kidney failure and heart disease.
But the reverse is true, too: When the relationship improves and when parents, say, monitor their children's insulin levels, the teens do a better job of watching their diet, exercising and testing their blood-sugar levels.
So what's a parent to do when they are supposed to start turning over responsibility to a naturally risk-taking teen?
Stay involved, say the study's authors. While children might be able to physically do the work of managing their diabetes at age 13, they will still need help for a couple more years.
"They're still making gains in cognitive development until late adolescence. There's evidence they make poor decisions when they're in social settings. They don't have as sophisticated problem-solving skills and reasoning as an adult would have," says Pamela King, the study's author and a postdoctoral researcher in psychology.
King will present the findings Friday in Seattle at the Society of Behavioral Medicine's annual meeting.
She suggests parents continue to ask whether teens have tested their blood, what their glucose levels are, what they are eating and what problems they are having.
It feels like nagging to Janet Hubley. But the Bountiful mother stays on top of her 17-year-old's care, fearing the long-term health consequences if she doesn't.
"We just have a short time before she's out of our house. [Her diabetes] needs to be under control," said Hubley, whose daughter, Frances, participated in the study. "You gotta step back a little. That's really hard for me."
Frances, who rates her management a 7 out of 10, says she gets annoyed by her parents' reminders. But she realizes she needs their help.
"There's so much I depend on them for, like getting my supplies," she said. "I don't think I could do it on my own."
King said the study is one of the first to look at the impact of parental involvement on diabetics over time. Since 2005, psychologists have been interviewing 252 teens and their parents -- recruited from the U.'s Diabetes Center and Mountain Vista Medicine in South Jordan -- every six months. Their ages initially ranged from 10 to 14.
Researchers measured the tween's and teens' self management of their diabetes, as well as their perceptions of their parents' involvement. Involvement was defined by how parents monitored teens' disease -- for example, whether parents knew their child's blood glucose levels -- and parental "acceptance," or how much the youngsters felt loved and accepted. Both measures have been shown to be important in keeping teens out of trouble in general, says Cynthia Berg, one of the study authors and chairwoman of the U.'s psychology department.
When it comes to diabetes, the study found that parental involvement generally decreased over time. But when either parent increased their monitoring, the teens did better at following their diabetes management plan.
But only the quality of the relationship between mother and teen predicted how well the teen managed his or her disease. The quality of the father-teen relationship had no impact. That might be because mothers are more often involved in the daily management of their children's health. "It's possible on a day-to-day level moms and teens having a high-quality relationship better facilitates a teen's adherence," King said.
The other researchers in the study are Jorie Butler, a postdoctoral researcher in psychology at the U., and Deborah Wiebe, a professor of psychiatry at the University of Texas Southwestern Medical Center in Dallas.