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Families working together improves diabetes management for low income kids, study finds

ANN ARBOR, Mich. -- When kids with diabetes approach the teenage years, their diabetes management tends to become more challenging. It's even more difficult for economically disadvantaged kids.

In a pilot study, researchers at the University of Michigan Health System found a family-based self-management intervention aimed at low income adolescents with Type 1 diabetes led to better health and functioning in the short term. Results of the study will be presented May 1 at the Pediatric Academic Societies' annual meeting in San Francisco.

"Almost all kids can struggle with their diabetes control when they move into adolescence. It's so hard when you have a chronic illness and are on a stricter regimen for eating than your friends. Parents expect kids to take on more responsibility for their diabetes care. At the same time, kids tend to be on their own more and the diabetes care can become overwhelming," says Lisa Opipari-Arrigan, Ph.D., clinical assistant professor of Pediatrics at the U-M Medical School.

"With kids who are economically disadvantaged, there can be a lot more stressors involved," Opipari-Arrigan adds. "The child's diabetes care may need to be secondary to the parents being at work, maintaining shelter or basic necessities. Even though the parents want to be involved, it might not be possible."

The study looked at 29 children ages 10-14 who were on Medicaid or other state-assisted insurance. The researchers developed a diabetes self-management program based on proven techniques. Families met in groups of eight to 10 for six weeks, getting diabetes education, information on adolescent development and tips on working as a family to manage the child's diabetes. Families practiced hands-on techniques for communicating, problem solving and setting goals.

Each child was tested both before and after the intervention program for blood glucose control and physical functioning. Parents were also asked to assess family life
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