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Adherence to insulin pump treatment declines with increasing age in adolescents with type 1 diabetes mellitus
Author(s) -
Spaans Engelina A. J. M.,
Kleefstra Nanno,
Groenier Klaas H.,
Bilo Henk J. G.,
Brand Paul L. P.
Publication year - 2020
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14931
Subject(s) - medicine , insulin pump , diabetes mellitus , insulin , distress , type 1 diabetes , confidence interval , emotional distress , disease , diabetes management , type 2 diabetes , pediatrics , endocrinology , psychiatry , clinical psychology , anxiety
Aim This study assessed the impact of illness perceptions, emotional responses to the disease and its management, and patient characteristics on the adherence to optimal insulin pump management in adolescents with type 1 diabetes mellitus. Methods From May to December 2013 and May 2015 to September 2016, we investigated 90 adolescents (50% boys), 12‐18 years with type 1 diabetes. We analysed the association of optimal adherence to insulin pump therapy to age, gender, diabetes duration, results of questionnaires relating to fear and problems of self‐testing, illness perceptions, emotional distress and family conflicts. Optimal adherence was defined as bolusing insulin on average ≥2.5/3 main meals/d. Results Adolescents with suboptimal adherence were on average 1.8 years older (95% Confidence Interval 1.09‐2.50 years, P < .001) than those with optimal adherence. After adjustment for age, no other patient or parent factors were related to optimal adherence. Conclusion Adherence to insulin pump self‐management in adolescents with type 1 diabetes declined with increasing age, illustrating the challenges of transition of self‐management from parents to the adolescent patient themselves.