Author(s): Chang CW, Yeh CH, Lo FS, Shih YL
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Abstract aims and objective: To describe the current non-adherence behaviours of Taiwanese children with type 1 diabetes mellitus. BACKGROUND: Poor adherence to prescribed protocols of long-term therapies is a pervasive and costly problem in the care of children with chronic illnesses. Non-adherence to diabetes mellitus treatment regimens of Taiwanese children with type 1 diabetes mellitus in Taiwan has not been well documented. DESIGN: Cross-sectional data were collected from 101 patients who had type 1 diabetes mellitus and were between the ages of 10 and 18 years. METHOD: Five types of adherence behaviours were measured: number of calories consumed per day, frequency of meals, self-monitoring of blood glucose, amount of time between injections and meals and frequency of exercise. RESULTS: Only 25\% of patients consumed the ideal daily number of calories (within +/-10\% of the ideal range), while 48\% of patients consumed 10\% fewer calories than the suggested ideal daily number of calories. Only 28\% of patients consumed the ideal percentage (50-60\%) of calories from carbohydrates. Approximately 15\% of patients consumed >60\% of their calories from carbohydrates and 30\% of their calories from fat. Approximately 30\% of patients ate their meals 20-40 minutes after injection; some patients ate their meals within 20 minutes after injection (45\% in the morning and 33\% in the evening). For frequency of meals, most patients (> or =90\%) ate their regular three meals, three or four times per day; only 18\% ate the ideal number of six times per day. For self-monitoring of blood glucose, most patients (>70\%) tested their blood sugar twice a day, once in the morning and again in the evening. In terms of frequency of exercise, 48\% of patients exercised once per day and 43\% of patients did not exercise at all. Only 7\% of patients met the good diabetes control of HbA(1c) < 7\%; almost half of the patients had HbA(1c) > 10\%. CONCLUSIONS: Overall, the patients had poor adherence behaviours in each aspect of diabetes mellitus management and diabetes control total glycosylated haemoglobin (HbA(1c)) was very poor. RELEVANCE TO CLINICAL PRACTICE: Studies are needed to explore factors related to non-adherence to treatment regimens as well as poor control of diabetes among Taiwanese children with type 1 DM.
This article was published in J Clin Nurs
and referenced in Journal of Diabetes & Metabolism