/. ChiU Psychol. Psychial. Vol. 28. No. 6, pp. 823-833. 1987. 0021-9630/87 $3.00 + 0.00 Primed in Great Britain. Pergamon Journals Ltd. © 1987 Association for Child Psychology and Psychiatry. FAMILY LIFE AND DIABETIC CONTROL THERESA M . MARTEAU,* SIDNEY BLOCH^ AND J. DAVID BAUM* Abstract—Seventy two children with diabetes and their parents were studied to examine the relationship between family functioning and diabetic control. Children in families characterised by cohesion, emotional expressiveness, lack of conflict and a mother satisfied with her marriage, had better diabetic control than children living in families with opposing characteristics. Children living with both biological parents or with a single parent had significantly better diabetic control than those living with a step-parent or adoptive parents. There was no relationship between social class, family income, employment status or educational attainment of either parent, and diabetic control. Keywords: Family, childhood diabetes, diabetic control, marital relationship INTRODUCTION IN A recent review of studies concerning families with children with chronic illnesses, Shapiro (1983) argues that: "It is by now clear that an undeniable relationship exists between family and illness, and that a specific illness both affects and is affected by the family context." It is unclear however, which aspects of the family context are implicated in this relationship and how the relationship is mediated. In the case of diabetes in children these questions are particularly important given the chronicity of the disease and the frequency of life-threatening complications associated with it. In considering which aspects of the family may be related to the child's diabetic control, studies point to the importance of the family's psychological functioning. Among aspects that have been studied are conflict, children living in homes characterised by little conflict having better diabetic control (Koski & Kumento, 1977; Anderson, Miller, Auslander & Santiago, 1981; Schouval, Ber & Galatzer, 1982); and family stability, more children in poor diabetic control having a family history of divorce (Simonds, 1977; Tietz & Vidmar, 1972). Extrapolating from other areas, it is likely that the quality of the parents' marriage is also important. For example, in a study of mothers of children with a wide variety of physical and mental handicaps, the best overall predictor of mothers' coping behavior was marital satisfaction, accounting for 79% for the variance (Friedrich, 1979). Accepted manuscript received 27 April 1987 •Psychology Unit, Royal Free Hospital School of Medicine, London NW3 2QG, U.K. fPsychotherapy Department, Wameford Hospital, Oxford, U.K. ^University Department of Child Health, Bristol, U.K. Requests for reprints to; Dr. T. Marteau, Psychology Unit Royal Free Hospital School of Medicine, London NW3 2QG, U.K. 823