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

  1. Amy E. Baughcum, PHD1,
  2. Suzanne Bennett Johnson, PHD2,
  3. Stacy K. Carmichael, PHD2,
  4. Adam B. Lewin, MS3,
  5. Jin-Xiong She, PHD4 and
  6. Desmond A. Schatz, MD5
  1. 1Center for Biobehavioral Health, Columbus Children’s Research Institute, Columbus, Ohio
  2. 2Department of Medical Humanities and Social Sciences, College of Medicine, Florida State University, Tallahassee, Florida
  3. 3Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
  4. 4Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta, Georgia
  5. 5Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
  1. 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

Abstract

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.

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted December 22, 2004.
    • Received September 27, 2004.
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