Our aim is to present pitfalls created by youth patients on HCP way to manage their diabetes perfectly.
41 participants (22 girls) of diabetes summer camp were included into the study, age 9 to 18 (mean 13.4 ± 2,6). 82.9% (n=34) used CSII and 31.7% (n=13) used CGM or FGM constantly before the camp. During the camp 92.7% (n=38) patients were put on FGM, the remaining continued CGM. All prandial and correction boluses were to be determined by the participants with HCP supervision – to improve sense of “self-efficacy”. Children had the opportunity to consult with HCP throughout the whole camp (24/7 for 14 days).
AVBG before and during the camp (163.1±31.3 vs. 158.4±27.9 mg/dl, p>0.05) and number of SMBG / day (8.1±2.9 vs. 8.1±3.3) did not differ. % of blood glucose <70 mg/dl increased from 6.9±5.4 to 9.4±5.6 (p=0.0247), as were glucose variability measured by CV (44.4±9.8% vs. 49.6 vs. 8.4%, p=0.0321). Detailed analysis of pump data indicated episodes of patient non-compliance that might have led to misinterpretation of the measurement followed by incorrect dosing of insulin, e.g. using ‘prime’ function or setting a ‘scheme’ basal rate as a bolus, causing hypoglycemia.
This is another evidence of the well‐known problem of decreased compliance in diabetes management during adolescence, here causing therapeutic failure during diabetes summer camp (no improvement in overall AVBG, deterioration of CV). It is important to address sense of self-efficacy among youths with diabetes to empower their motivation and enhance therapeutic adherence.