Adolescents with Type 1 Diabetes Mellitus demonstrate poorer adherence to treatment regimens than other pediatric age groups . Nonadherence is tightly linked to suboptimal glycemic control, increasing morbidity, and risk for premature mortality. The aim of this study is to investigate the reasons for noncompliance.
We identified 46 patients with Type I Diabetes Mellitus who were at least 10 years old with a HbA1c at 10% or above. We reviewed the problems identified related to poor compliance
On average, patients had Type 1 Diabetes Mellitus for 5 years. The mean Hgb A1C at the first visit during the study period was 11.3%. About 24% of the patients were hospitalized for Diabetic Ketoacidosis during the study period. About 10% of the patients’ parents separated or divorced either 6 months before or during the study period ,15% of the patients moved and 10% of children changed schools during the study period. One patient experienced the death of a 1st degree relative during the study period. About 10% of the patients experienced other events categorized as life stressors during the study including having a parent with a chronic illness, having a sibling with a prolonged PICU stay, the birth of a sibling and failing classes.
Exploring the psychological and social factors in pediatric diabetes is an essential step in improving adherence to optimal management and better disease outcome.