43 Predictors of Adherence in Small Children with Type 1 Diabetes

Abstract

Aims: Although type 1 diabetes incidence is increasing in younger children, they are neglected in paediatric adherence research despite the fact that younger children are more vulnerable medically, less capable of managing their disease, and parents have enormous caretaking responsibilities. We investigated the predictors of treatment adherence in young children with type 1 diabetes.

Methods: Mothers of 65 children aged 2 to 8 years were interviewed about children's diabetes care (e.g., injections, diet). Nutritional analyses were conducted to assess children's extrinsic sugar consumption (e.g., confectionary). Mothers completed assessments of diabetes knowledge, parenting stress, family functioning and child psychological adjustment. Demographic and medical information was also collected.

Results: More relationship difficulties and less frequent blood glucose monitoring predicted higher % energy intake from extrinsic sugars. The blood glucose monitoring and dietary regimens showed greater adherence variability than medical treatment components such as injection frequency. Better maternal diabetes knowledge correlated with less injection time variability, more frequent blood glucose monitoring, lower % energy intake from extrinsic sugars, lower HbA1c levels, and fewer relationship difficulties. Longer diabetes duration, greater injection time variability, and higher % energy intake from extrinsic sugars predicted less frequent blood glucose monitoring.

Conclusion: Healthcare professionals can facilitate treatment adherence through provision of socioemotional, educational, and practical support. Findings show that

• 1) healthcare professionals should be sensitive to the differential caretaking challenges presented by different components of treatment,

• 2) education is related to better outcomes, and

• 3) interventions should target the blood glucose monitoring and dietary regimens in particular.

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