Behavioral Family Therapy and Type One Diabetes

The success or failure of type 1 diabetes mellitus (T1D) management in children depends not
only on access to care, diabetes technologies and diabetes education, but also on the
abilities of the patient and his/her family to carry out complex demands. Recent data show
that family dynamics play a critical role in determining glycemic control in pediatric
patients with T1D. The investigators prior work (Loomba-Albrecht and Glaser, unpublished
data) suggests that the strongest determinants of glycemic control are factors related to the
primary caregiver's involvement in supportive relationships with others, either a spouse or
other family members. This provides a potential therapeutic target to improve outcomes for
children with T1D.

Inclusion Criteria:

Aim 1: Eligibility and exclusion criteria:

Eligible patients will be recruited through the UC Davis pediatric endocrinology clinic or
during their initial admission (if they plan to seek care at our clinic) and must meet the
following criteria:

- age 2 to 17 years

- newly diagnosed (within the past 10 weeks) with T1D

- child lives in a two parent household

Aim 2: Eligibility and exclusion criteria:

Eligible patients will be recruited through the UC Davispediatric endocrinology clinic and
must meet the following criteria:

- age 2 to 17 years

- diagnosed with T1D with a duration of diabetes of at least 2 years (to ensure the
child is no longer producing endogenous insulin)

- using a "multiple daily injection" or "basal-bolus" insulin regimen (includes pump
users)

- HbA1c level of 9% or higher at enrollment visit

- child lives in a two parent household

Exclusion Criteria:

- Families will be excluded if the child has severe underlying psychiatric, behavioral
or medical conditions which could independently affect parental marital stress