The Role of Parental Monitoring in Understanding the Benefits of Parental Acceptance on Adolescent Adherence and Metabolic Control of Type 1 Diabetes

Objective: The study examined 1) whether the benefits of mothers’ and fathers’ accepting relationships with their adolescents on diabetic control were due to parental monitoring and 2) how parents together may provide sufficient acceptance and monitoring for diabetes management. Research Design and Methods: Adolescents aged 10-14 with type 1 diabetes (n = 185) and their mothers (n=185) and fathers (n =145) completed assessments of parental acceptance and monitoring of diabetes tasks. Adolescents completed a modified version of the Self-Care Inventory (1) to measure adherence. Glycosolated hemoglobin (HbA1c) scores were used as a marker of glycemic control. Results: Mediational analyses revealed that the benefits of adolescents’ reports of fathers' acceptance on HbA1c and mothers’ and fathers’ acceptance on better adherence were partially mediated by monitoring. Both mothers’ and fathers’ monitoring and fathers’ acceptance had independent effects in predicting adherence. However, only fathers’ monitoring had an independent effect on HbA1c . The effect of fathers’ monitoring on HbA1c occurred as fathers were monitoring at a lower level than mothers. Mothers’ and fathers’ reports of their own acceptance and monitoring were not associated with HbA1c or adherence. Conclusions: Results reveal the importance of fathers’ acceptance and monitoring in diabetes management, a role that should be encouraged, despite the little attention it has received. Page 2 of 19 Diabetes Care