Caring for Pets Linked to Glycemic Control in Children with Diabetes

Diabetic children and adolescents who actively care for pets are 2.5 times as likely to have good glycemic control as those who do not care for pets, according to a study published recently in PLoS One. The authors suggest that positive attributes related to active pet care could translate to successful management of a chronic disease.

Patients with type 1 diabetes mellitus must practice responsible self-management to maintain target blood glucose levels. Glycemic control may worsen during adolescence because of age-related physiologic insulin resistance and the risk-taking behavior typical of this age group, according to the study authors. Negative factors such as stress, depression, and poor self-esteem have been shown to adversely affect self-care behaviors and hence glycemic control. On the other hand, positive factors including family cohesion, coping strategies, and social support improve glycemic control.

“One may speculate that the presence of a companion animal, capable of enhancing the positive factors named above, would augment the array of tools available for the successful management of a chronic illness such as type 1 diabetes,” write the authors. “The process of caring for, loving and being loved by a companion animal could offer direct and/or indirect benefits that have yet to be specifically quantified in children with type 1 diabetes mellitus.”

The authors recruited 223 patients from 9 to 19 years old with type 1 diabetes mellitus. Participants were classified according to their glycemic control, assessed by 3 consecutive measurements of glycated hemoglobin (HbA1c) levels at regularly scheduled visits to the pediatric diabetes clinic at the University of Massachusetts Medical School. Target HbA1c values were based on American Diabetes Association guidelines.

Participants and their parents completed a pet ownership questionnaire that included questions about the frequency and duration of their pet care activities. All patients also completed the Self-Management of Type 1 Diabetes in Adolescents instrument to assess their levels of diabetes self-care.

The authors rated participants’ levels of pet care as high involvement, little involvement, or having no pets. Of the 223 participants, 180 lived in households with at least 1 pet; for 76 patients, a dog was the main pet. One hundred ten participants had a high level of involvement with their pets.

Statistical analysis revealed a strong relationship between HbA1c measurement and high level of involvement with a pet, adjusted for the confounding factors of duration of disease, age, socioeconomic factors, collaboration with parents, and care activities (adjusted odds ratio, 2.49). A separate analysis restricted to the care of only dogs yielded a similar result (adjusted odds ratio, 2.59).

“Our findings reveal that patients with HbA1c values below the ADA target are more likely to take responsible care of a household pet than those with HbA1c values above the target,” write the authors. Possible mechanisms by which active care of a pet could translate to better glycemic control include an increased feeling of responsibility; a household routine that provides structure for daily care habits; and improvement in mood, which has been shown to relate to glycemic control.

The authors conclude that active pet care is positively related to glycemic control but do not suggest that caring for a pet directly improves diabetes management. They note that study participants who were already taking responsibility for managing their diabetes could have been applying those same behaviors to pet care. Other limitations of the study include the lack of validation of the pet care questionnaire and potentially incomplete diabetes self-care assessments (because only one assessment instrument was used). The authors recommend further studies to investigate ways by which caring for a pet might correlate with glycemic control.

The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the WALTHAM Centre for Pet Nutrition, neither of which had a role in study design, data collection, data analysis, or manuscript preparation.

Dr. Laurie Anne Walden received her doctorate in veterinary medicine from North Carolina State University in 1994. After an internship at Auburn University College of Veterinary Medicine, she returned to North Carolina, where she has been in companion animal general practice for over 20 years. Dr. Walden is also a board-certified Editor in the Life Sciences and owner of Walden Medical Writing.