Supporting Parents to Improve Diabetes Outcomes: What Works?
Mandy Jansen, Paul G. Voorhoeve, Lianne Wiltink, Judith B. Prins, Giesje Nefs
Parenting interventions for parents of children with type 1 diabetes-a systematic review.
J Pediatr Psychol. 2025 Sep 22:jsaf078.
Managing Type 1 Diabetes (T1D) is challenging for the whole family, requiring intensive daily care (blood glucose monitoring, insulin administration, diet management) to prevent severe complications. Despite these efforts, fewer than 20% of young people meet the recommended HbA1c target of <7.0% (53 mmol/mol). Parents are crucial in this management, but balancing involvement with a child's growing need for autonomy often leads to conflicts. Parental behaviors that are either intrusive (like criticism or nagging) or prematurely uninvolved (permissive strategies) are linked to poorer health outcomes.
A systematic review conducted by Mandy Jansen and colleagues evaluated the effectiveness of parenting interventions designed to enhance supportive parenting behaviors, aiming to improve family dynamics, psychosocial outcomes, and diabetes control in pediatric T1D. Researchers systematically searched five major databases (PubMed, EMBASE, Cochrane, CINAHL, and PsycINFO) for studies published since 1980 up to February 25, 2025.
Key findings:
- The review ultimately included 51 studies covering 37 unique interventions, varying significantly in intensity, ranging from 1 to 46 sessions, and focused on outcomes related to family dynamics, parental well-being, child well-being, and diabetes (e.g. HbA1c).
- Parenting interventions in pediatric type 1 diabetes show mixed and inconsistent effects and most studies and outcomes included had an increased risk of bias.
- Intensive, targeted programs for families with psychosocial difficulties or poor glycemic control tend to show more consistent benefits.
- Benefits are more often seen in psychosocial outcomes than in glycemic outcomes (HbA1c).
- Preventive or brief interventions show potential, but evidence is limited and often underpowered.
- No single intervention component (e.g., communication training, problem solving) can be uniquely linked to better outcomes.
- Future research needs to identify which families benefit most, and which program elements are essential.
Concluding, the authors state
"Targeted and preventive parenting interventions serve as a potential, although not exclusive, approach to improve psychosocial and diabetes outcomes. Future research should elucidate which families benefit from parenting interventions compared to other educational or supporting interventions, thereby delineating their essential intervention components. " -
Please click here for the Pubmed link.