Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Community Medicine

Background: Type-1 diabetes mellitus is one of the most common endocrine diseases in childhood. Adherence to diabetes management plan is necessary to delay chronic complications, enhance the patients{u2019} quality of life, reduce economic burden and alleviate societal encumbrance. Aim: Assessment of adherence to diabetes management plan among diabetic children and revealing the associated factors of non-adherence as a first step towards adherence improvement. Methods: An observational analytical cross sectional study was conducted at the outpatient clinic of Diabetes Endocrine Metabolism Pediatric Unit, Children{u2019}s Hospital, Faculty of Medicine, Cairo University. Patients{u2019} care givers were subjected to an interview questionnaire. Archived patients{u2019} files were reviewed to collect data about the patients{u2019} medical profile and lab tests. Results: A total of 273 diabetic children were included in the study.The mean age of the children was 10.5 ± 2.7 years. The overall adherence to diabetes management plan was 13.2 %, while the adherence to each of insulin intake, blood glucose monitoring and dietary recommendation domains were 59.7%, 40.7% and 5.9% respectively. Older children, longer duration of diabetes, lower levels of parental education as well as lower socioeconomic level of the family and lower level of knowledge about diabetes were significantly associated with non-adherence to T1DM management. Some factors related to the social burden and the failure to be in harmony with the society were also significantly associated with non-adherence to diabetes management plan

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