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Maternal Efforts to Prevent Type 1 Diabetes in At-Risk Children

¹ Center for Biobehavioral Health, Columbus Children’s Research Institute, Columbus, Ohio
² Department of Medical Humanities and Social Sciences, College of Medicine, Florida State University, Tallahassee, Florida
³ Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
⁴ Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta, Georgia
⁵ Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida

Address correspondence and reprint requests to Dr. Amy Baughcum, Center for Biobehavioral Health, Columbus Children’s Research Institute, 700 Children’s Dr., Columbus, OH 43205. E-mail: Baughcua{at}chi.osu.edu

OBJECTIVE—The aim of this study was to assess maternal diabetes prevention efforts aimed at children identified as at risk through newborn genetic screening.

RESEARCH DESIGN AND METHODS—A total of 192 mothers of children identified as at risk for type 1 diabetes through newborn genetic screening were administered a structured interview 3.6 ± 0.8 years after risk notification. The interview assessed possible diabetes prevention behaviors across six domains: health surveillance, diet, physical activity, illness prevention, medications, and stress reduction. A mother’s cognitive (diabetes risk perception and perceived control), affective (anxiety), and coping responses to the child’s at-risk status were assessed.

RESULTS—A total of 67% of mothers reported one or more diabetes prevention behaviors. Monitoring behaviors (e.g., watching for signs of diabetes and checking blood glucose) were the most common, reported in 59%, followed by modifications in the child’s diet in 34% and physical activity in 14%. Potentially harmful prevention behaviors (e.g., limiting contact with other children, delaying immunizations, and giving medications including insulin) were rare. Mothers who engaged in diabetes prevention behaviors reported higher diabetes risk perception, greater anxiety, and more use of certain coping styles. Infants of these mothers were more likely to have a first-degree relative with diabetes.

CONCLUSIONS—In the absence of known methods of preventing type 1 diabetes, most mothers of at-risk children report diabetes prevention behaviors. Such behaviors must be more carefully assessed to ensure accurate interpretation of data obtained from natural history studies and prevention trials.

Abbreviations: PANDA, Prospective Assessment of Newborns for Diabetes Autoimmunity • WCC-R, Ways of Coping Checklist–Revised

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