Parental monitoring and therapeutic adherence in adolescents and young adults with type 1 diabetes mellitus: Systematic review with meta-analysis.
Abstract
Aim
To synthesise and quantify the association between parental monitoring and therapeutic adherence in adolescents and young adults (10-24 years) with Type 1 Diabetes Mellitus (T1DM).
Methods
We conducted a systematic review with meta-analysis following PRISMA guidelines (PROSPERO: CRD420251231615). Searches were conducted in PubMed, CINAHL, SCOPUS, and PsycINFO up to June 2026. Observational studies examining the association between parental monitoring (active supervision of diabetes self-management) and multidimensional therapeutic adherence in individuals aged 10-24 years with T1DM were included. Random-effects models were used to pool correlation coefficients. Heterogeneity (I2), publication bias (Egger's test and trim-and-fill method), and sensitivity analyses were assessed. Methodological quality and certainty of evidence were evaluated using predefined criteria and GRADE principles.
Results
Eight studies (8 independent samples; N = 1209) met inclusion criteria. All the studies were cross-sectional and conducted in the United States. The pooled analysis showed a significant positive association between parental monitoring and therapeutic adherence (r = 0.286; 95% CI: 0.232-0.337), with no statistical heterogeneity. Findings were consistent across informants (parent- or adolescent-reported) and remained robust in sensitivity analyses. Risk of publication bias was low and did not materially affect the estimates. Overall certainty of evidence was moderate.
Conclusion
Parental monitoring is consistently and positively associated with therapeutic adherence in adolescents and young adults with T1DM. Although effect sizes were small to moderate and studies were cross-sectional, the findings support the clinical relevance of collaborative and non-intrusive parental supervision. Family-centred interventions promoting adaptive monitoring may help mitigate the decline in adherence during adolescence.