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Self-care activities in pediatric patients with type 1 diabetes mellitus
Mirjana Smudja1,2, Tatjana Milenković3, Ivana Minaković2,4
1Department of Higher Medical School, Academy for Applied Studies Belgrade, Belgrade, Serbia.
Insights
Pediatric patients with type 1 diabetes often struggle with self-care adherence despite reporting independence. Insufficient parental involvement in insulin therapy is linked to severe hypoglycemia in children with type 1 diabetes.
Area of Science:
- Pediatric Endocrinology
- Diabetes Self-Management Research
- Child Health Behavior
Background:
- Type 1 diabetes self-management requires pediatric patient autonomy and parental collaboration.
- Assessing adherence and parental involvement is crucial as children transition to self-care.
- Understanding sociodemographic and clinical factors influencing self-care is essential.
Purpose of the Study:
- To evaluate differences in self-care adherence based on patient sociodemographics and clinical characteristics.
- To determine the extent of parental involvement in pediatric diabetes management.
- To analyze pediatric self-management behaviors in relation to patient characteristics.
Main Methods:
- Comparative cross-sectional and correlational study design.
- Inclusion of 182 pediatric patients diagnosed with type 1 diabetes (duration ≥ 3 months).
- Utilized sociodemographic questionnaires, adherence/parental involvement surveys, and clinical data documentation.
Main Results:
- 71% of participants demonstrated non-adherence to self-care tasks.
- Despite this, 78% reported independence in managing their diabetes.
- Low parental involvement in insulin therapy administration predicted severe hypoglycemia.
Conclusions:
- Pediatric type 1 diabetes patients exhibit significant autonomy but paradoxically report poor adherence.
- Younger children (8-12 years) depend more on parental support, particularly for insulin therapy.
- Parental engagement in insulin administration is vital; its absence increases severe hypoglycemia risk.
Introduction:
Effective diabetes self-management and collaborative responsibility sharing with parents are imperative for pediatric patients with type 1 diabetes mellitus, particularly as they gradually assume more self-care responsibilities. The primary goal of this study was to assess differences in adherence to self-care activities regarding sociodemographics and clinical characteristics in pediatric patients with type 1 diabetes. The secondary goal of this study was to understand the level of parental involvement in diabetes management and to assess the pediatric patients' behaviors (independent or dependent on disease self-management) that relate to sociodemographic and clinical characteristics.
Methods:
This was a comparative cross-sectional and correlational study. The study sample included 182 children and adolescents who had been diagnosed with type 1 diabetes at least 3 months prior. Data collection instruments included a sociodemographic and questionnaire about Adherence to self-care activities and parental involvement in diabetes self-management, as well as a documentation sheet for recording clinical data.
Results:
A majority of participants (71%) exhibited non-adherence to self-care tasks, despite 78.0% asserting their independence in diabetes self-management. Notably, insufficient parental involvement in administering insulin therapy significantly predicted severe hypoglycemic episodes.
Conclusions:
Pediatric patients dealing with type 1 diabetes demonstrate a substantial degree of autonomy in managing their condition, paradoxically coupled with self-reported non-adherence to critical self-care responsibilities. Notably, children (aged 8-12) rely more heavily on parental support, especially concerning insulin therapy administration. The study underscores the crucial role of parental engagement in insulin therapy, as its deficiency significantly predicts the likelihood of severe hypoglycemic episodes.
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