Family and disease management in young type 1 diabetic patients

The main objectives of type 1 diabetes mellitus (DM) management include kee ping glycemia levels within the euglycemic range to prevent complications. Daily self-monitoring is an important problem for many diabetic patients, p articularly for adolescents. The aim of this study was to evaluate the dete rminants of poor daily self-monitoring, focusing on the patients' parents' perception of the problem. In order to evaluate parents' awareness of their children's disease-monitoring status, we carried out a cross-sectional inv estigation of a sample of children and adolescents from a population-based register, with the corresponding population of parents. To collect our data , we used a 33-item questionnaire, separately administered by diabetologist s to both parents and children. We estimated the concordance with respect t o patients' and parents' answers. Adolescents followed their overall medica l prescriptions more regularly (48.8%) than children (29.7%), but most freq uently they forgot to use glycemic tests (adolescents 42.4%, children 29.7% ). A major duration of disease affected HbA(1c) levels (values > 8%) of pat ients younger than 14 years (PFisher = 0.016). Our results indicate a worse compliance of adolescents with respect to children in attending to daily s elf-monitoring, not just regarding daily glycemic levels but also the cours e of daily activities such as going to school, studying, working, and simul ating symptoms and signs of hypo-hyperglycemia. Parents mostly ignored thei r child's self-monitoring status and the related motivations.