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Psychological predictors of diabetic ketoacidosis in children: Health belief model-based case-control study

Nawal Alissa1, Sara Al Zahrani2

  • 1Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia. nalissa@ksu.edu.sa.

World Journal of Diabetes
|August 21, 2025
PubMed

Insights

Caregiver understanding is key to preventing diabetic ketoacidosis (DKA) in children with type 1 diabetes mellitus (T1DM). Improving comprehension enhances adherence and reduces DKA risk.

Area of Science:

  • Pediatric Endocrinology
  • Health Psychology
  • Diabetes Management

Background:

  • Diabetic ketoacidosis (DKA) is a significant complication in pediatric type 1 diabetes mellitus (T1DM).
  • Psychological factors influencing health behaviors in T1DM management are underexplored.
  • DKA prevention in children with T1DM requires understanding contributing factors.

Purpose of the Study:

  • To investigate psychological predictors of DKA in children with T1DM using the Health Belief Model.
  • To assess the impact of caregiver-perceived understanding on adherence and DKA occurrence.
  • To identify key factors for improving pediatric T1DM management and DKA prevention.

Main Methods:

  • A case-control study involving 191 caregivers of children with T1DM in Riyadh, Saudi Arabia.
  • Utilized validated questionnaires to measure perceived severity, susceptibility, understanding, and adherence.
  • Employed statistical analyses including t-tests, correlations, and multiple regression.

Main Results:

  • Caregiver-perceived understanding strongly predicted adherence (β = 1.03, P < 0.001) and was inversely linked to DKA.
  • Children without DKA history demonstrated significantly higher perceived understanding and adherence.
  • Perceived severity positively correlated with adherence; perceived susceptibility showed a weak negative correlation.

Conclusions:

  • Caregiver-perceived understanding is crucial for adherence and DKA prevention in pediatric T1DM.
  • The Health Belief Model may benefit from incorporating perceived understanding as a distinct construct.
  • Comprehension-focused strategies are vital for effective pediatric diabetes education.
Abstract

Keywords:
AdherenceDiabetic ketoacidosisHealth belief modelPediatric diabetesPerceived understandingType 1 diabetes

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